Cummings v. Masonic Protective Ass'n
Cummings v. Masonic Protective Ass'n
Opinion of the Court
Upon an appeal by defendant from the judgment of a justice of McDowell County the plaintiffs, in the circuit court, obtained a judgment against defendant for $214.50"with interest and costs, to which judgment we awarded the defendant the present writ of error.
The action was to recover the amount of disability or sick benefits alleged to have accrued to the insured from .June 15, 1918 to October 24, 1918, a period of twenty weeks, at the rate of $5.00- for the first week and $10.00 for each week thereafter as provided in a policy or certificate of insurance issued to J. A. Cummings, now deceased, on August 3, 1912.
There is no controversy about the facts, which were submitted to the court in lieu of a jury, with the result already-indicated. It is conceded that according to its terms the insured forfeited the policy for non-payment of the quarterly premium due June 1, 1918, and that unless the defendant thereafter, in some way, waived the forfeiture plaintiffs would not.be entitled to recover the amount sued for or any part thereof. , The plaintiffs claim,
“We have just received a report from our collector and notice' that you had not paid your premium up to the time he mailed his remittance.
“We furnish accident and health insurance at a very moderate cost, and strive to make our service satisfactory to members, for we want not merely their premiums, but their good will.
“We hope the situation is that you have merely overlooked paying your premium, and will forward us a check or money order for the amount or hand the same to the collector. If, however, we have failed in any way to give you satisfactory service we wish you would advise us.
“We enclose an addressed envelope and shall be glad to hear from you.”
It is claimed that this letter amounted to demand of payment of the premium by the secretary, after notice of the forfeiture, and that the payment being sent by the insured pursuant to the demand, the defendant was bound thereby as a waiver, and liable to the plaintiff. In response to the letter of the secretary, described by the officers of the association as the “Follow up Letter”, the insured wrote:
“I have for acknowledgment your letter of the 10th relative to my failure to pay my insurance premium.
“I have been sick for the past month and have failed to send my. cheek covering my insurance. The doctors have ordered me in bed for three months, and I am not working at present time nor will I return until I have fully recovered. The doctors have pronounced my case a swollen Thyroid gland, and this has caused me to lose 28 pounds and I am very nervous at all times.
“Kindly advise if I am entitled to compensation for this trouble.”
Promptly on receipt of this letter the association, through Charles A. Harrington, General Manager, replied as follows:
“We acknowledge your letter inclosing remittance to apply on your overdue June 1st premium.
*201 “As we cannot recognize the disabilty from which you advise you have been suffering for a month past, on account of its having commenced while your policy was not in force, we return your cheek herewith. a
“If you desire to apply for reinstatement of your policy when you have fully recovered we shall be glad to hear from you in this regard.”
Upon this documentary evidence and the testimony of the clerks that it was a custom of the association to send out to delinquents “follow up letters” like the one already quoted, the court found for plaintiffs and gave judgment in their favor.
As evidencing the authority of the secretary to waive forfeiture of the policy claimed^ we are referred to a provision as follows: “Ho person, except the President, Secretary, or Manager, shall alter or waive any provision or condition of this Policy, issue permits, or make contracts of any kind.” Reading this provision in connection with another provision of the policy specifically providing how reinstatement may be made, we do not think it was within the power of the secretary to waive a forfeiture, certainly not without knowledge of all the facts affecting the health of the insured. The provision for reinstatement is as follows: “Failure to pay a, premium upon the appointed days shall terminate this contract except as to such claim as has then accrued. In ease of such failure to pay a premium the insured may apply at the Home Office at Worcester, Mass.3 for reinstatement, subject to the approval of the Directors.”
It is quite true effect must be given to the other provisions of the policy denying to any except the officers named the right to alter or waive any provision of the conditions of the policy, issue permits, or make contracts of any kind. But must not this provision be confined rather to the inception of the contract, to the altering or waiving of some of its provisions or conditions, and awarding permits, etc ? Unless wc treat the contract in this way, the provision relating to reinstatement would be practically nugatory and useless. The clause relied on by plaintiff contains no specific authority to waive payment of premiums, or relieve from forfeiture; and in so serious a matter as waiving forfeitures, when the insured might be sick or perchance in extremis,
The policy sued on ex vi iermini became forfeited without further action of the insured, not merely suspended. It required no affirmative action of the insurer, and the policy provides the method of reinstatement, which amounts to making a new contract. Mutual Fire Ins. Co. v. Mapel, (Ore.), 38 L. R. A. (N. S.) 726; Kennedy v. The Grand Fraternity, 25 L. R. A. (U. S.) 78, and note. In Virginia if was recently decided that request for payment of a past due premium note did not constitute a waiver of the condition in the note as well as the policy, providing that in event of failure to pay the note there would be no'further extension of the payment, and the policy should then cease and determine and be treated in all respects as if the conditional note had not been given. Mercer v. South Atl. Life Ins. Co., 111 Va. 699.
The court below in a written opinion relied mainly on the case of Murray v. Home Benefit Life Association, (Cal.), 27 Pac. 309. In that case the insurance company not only notified the insured of past due payments but about the same time notified him of premiums to become due at a future date, apparently treating the policy as then in force. We are not prepared to follow that case, if it was intended thereby to hold that the mere sending of the notice of past due premiums to the insured amounted to a waiver of the forfeiture. The cases cited by the court in that case, we do not think justify the conclusion drawn therefrom. Those cases are: Viele v. Germania Ins. Co., 26 Iowa 9, a fire insurance' case; Insurance Company v. Young, 86 Ala, 424; Titus v. Insurance Co., 81 N. Y. 410; Knickerbocker Ins. Co. v. Norton, 96 U. S. 234. It will be found by examining these cases that if after knowledge of the default the insurer enters into negotiations with
It is with some regret that we feel called upon to reverse the judgment and enter judgment here for defendant.
Reversed and judgment for defendcvnt.
Reference
- Full Case Name
- Marjory Cummings v. The Masonic Protective Association
- Status
- Published