49 Ga. App. 666 | Ga. Ct. App. | 1934
Mrs. Zonie Padgett, as next friend of Pauline Padgett, brought suit against the ZEtna Life Insurance Company to recover $1000 as principal by reason of a certificate issued to her under a group policy issued by the defendant to her employer. By agreement the case was tried before the judge, without a jury, upon an agreed statement of facts. The judge rendered judgment against the insurance company and the case was brought to this court on exceptions thereto.
It appears that on May 11, 1931, the defendant company issued to the Georgia Kincaid Mills a group policy of insurance, upon the lives of certain employees of said mills, which contained permanent total-disability benefits; that Pauline Padgett became an employee in said mill on April 7, 1931, and a certificate was issued to her, under the group poliejr, on July 7, 1931, three months after the commencement of her employment; that on November 6, 1931, she became totally disabled and was forced to quit work on that date; that no premiums were paid on her insurance after that date, and the insurance on her life was canceled as of December 10, 1931; that on December 7, 1931, she filed claim for disability benefits, and thereafter proof of the same, and that the company denied all liability thereunder.
The determination of whether the insured should be allowed to recover disability benefits under the certificate issued to her under the group policy depends upon the construction of the provisions contained in the policy and certificate, taken together. Carruth v. Ætna Life Insurance Co., 157 Ga. 608 (122 S. E. 226); Metropolitan Life Ins. Co. v. Harrod, 46 Ga. App. 127 (166 S. E. 870). In the construction of insurance contracts, as well as all other contracts, we are to be guided by certain, well-settled rules. Among
In the present case both the group policy and the certificate contained the following provisions: “Six months after receipt at the Home Office of the Company of satisfactory evidence (1) that any insured employee has, while under age sixty, become totally disabled by bodily injuries or disease from engaging in any occupation for compensation or profit, and will be so disabled for life, and (2) that such employee has been continuously insured hereunder for at least one year immediately preceding the commencement of disability, or was eligible for insurance on the date of this policy and has been continuously insured from a date not more than three months thereafter to the commencement of disability,” the company agrees to pay certain described benefits. These, it seems to us, are plain and unambiguous provisions to the effect that the insured, in order to obtain the disability benefits under the policy, must have either been eligible for insurance at the time of the issuance of the group policy, and have been continuously insured from a date not more than three months thereafter to the commencement of disability, or must have been continuously insured under the group policy for at least one year immediately preceding the commencement of the disability. In other words, the policy and the certificate issued thereunder divide into two classes the persons eligible to this feature of the contract, viz., (1) those who were employed at the Kincaid Mills at the time of the issuance of the group policy and who had completed three months continuous service, and (2) those that were not so employed at the time of the issuance of the group policy. It is admitted that the insured fell within the second class and that she
Judgment reversed.