196 A. 904 | Pa. Super. Ct. | 1937
Argued October 8, 1937. This was an action of assumpsit, on a self-styled `beneficiary certificate,' against a fraternal beneficial *572 association, incorporated under the laws of Nebraska, to recover a death benefit of $1,000 payable on the death of the member, Harry Hatfield.
The jury rendered a verdict in favor of the plaintiffs on which judgment was duly entered. Defendant appealed. The judgment will be affirmed.
Harry Hatfield applied for membership "by adoption" in Keystone Camp No. 606 of Woodmen of the World on March 25, 1935, and at the same time made application for a beneficiary certificate on the Twenty-Payment Life plan, with double indemnity in case of accidental death, to be issued by the Sovereign Camp, in the sum of $1,000. He was examined by the Camp physician and passed as a "first-class" risk. The certificate was issued on April 16, 1935 and accepted by the applicant as of that date, with a statement warranting "that I am in good health at this time, and have not been sick or injured since the date of my application." He died on July 23, 1935. The physician in charge certified that the cause of Hatfield's death was pulmonary tuberculosis, and that he had attended him from July 5, 1935, when he was admitted to the Philadelphia General Hospital, until his death, but had not "treated or advised" him prior thereto.
Defendant, on October 15, 1935, rejected the claim of the beneficiaries for payment of the death benefit on the ground that "false warranties and material misrepresentations were made in the application therefor." This action was brought on September 16, 1936.
At the trial the defendant presented two grounds of defense, each requiring — it contended — binding instructions in its favor:
(1) That the warranty in the application made by Hatfield on March 25, 1935, that he was in sound bodily health was false; and his warranty in the acceptance of the certificate on April 16, 1935 that he was then in good health, was likewise false. *573
(2) That under the by-laws of the association the action was brought too late.
We will consider them in that order.
(1) It is not contended that the applicant made any false answers in the application as respects not having consulted or been attended by a physician for any disease or injury, or having undergone any surgical operation; or that he had never been under observation, care or treatment in any hospital, sanatorium, asylum or similar institution (Personal history, answers 11 and 13). The alleged breaches of warranty relied upon relate solely to his sound or good health at the times he was examined by the camp physician and accepted the certificate, respectively. And the alleged falsity of these warranties rests not on the testimony of any physician who had examined him prior to, or between, March 25, 1935 and April 16, 1935, but on the opinions of physicians formed afterwards from an examination of his condition some weeks or months later. The applicant had every appearance of good health. He had not consulted or been treated by a physician for very many years. The physician who examined him for the defendant corporation found and pronounced him a first-class risk. It does not appear in the record that he had been treated by any doctor until April 21, 1935, when the family physician found him suffering from influenza, with bronchitis and laryngitis. This physician, called as a witness by the defendant, stated that there was an epidemic of influenza in Philadelphia at that time. He also testified that he had then made a thorough examination of the patient — had gone over his lungs, chest, heart, throat, etc. — and found no evidence of pulmonary tuberculosis. That he was suffering on July 5, 1935, when treated by a physician, with pulmonary tuberculosis was not conclusive that his health was not sound on March 25, or April 16. He was a truck driver, whose duties took him out in all *574
sorts of weather, and it is not beyond the realm of possibility that a man of sound health might under certain conditions become the victim of `galloping consumption,' as it is sometimes popularly called. See McBride v. Sun Life Ins. Co.,
The question whether or not an applicant for insurance was in sound health when examined by the insurer's physician, and when the policy was delivered, is ordinarily a question of fact for the jury: Horne v. John Hancock Mut. Life Ins. Co.,
The most that can be said for the defendant is that the evidence as to Hatfield's sound health on March 25, 1935 and April 16, 1935 was conflicting and therefore was for the jury. There was ample competent and credible evidence to sustain the verdict and the trial judge, in the exercise of his discretion, saw no occasion to grant a new trial.
(2) The `insured' died on July 23, 1935. This *576 action was brought on September 16, 1936. The by-laws of the Sovereign Camp, which were offered and received in evidence, but not contained in or attached to the certificate or contract sued on, provided, inter alia, as follows:
"After proof has been properly executed and the claim approved by the President, the Secretary of the Association shall draw and cause to be delivered a warrant or warrants on the beneficiary fund, signed by the President and attested by the Secretary of the Association, for the amount approved, payable to the beneficiary or beneficiaries." [Section 83(b)].
"No legal proceedings for recovery under a certificate shall be brought within ninety days after receipt of proof of death or disability by the Secretary of the Association; and no suit shall be brought upon a certificate unless said suit is commenced within one year from the date of death or within one year from the date of the rejection of the claim for disability benefits." [Section 83(c)]. Defendant contended that as the action was not brought within a year of the insured's death, it was commenced too late and required binding instructions in its favor. Plaintiff's reply to this position was that as the defendant was a fraternal beneficial association, incorporated under the laws of the State of Nebraska, its by-laws must be interpreted and enforced in accordance with the law of the state of its incorporation, (See Modern Woodmen v. Mixer,
Appellant did not contend, on the argument, that Mr. Shane's interpretation of the law of Nebraska was incorrect, but objected to the competency of the means or methods used for proving the law of Nebraska on the *578
trial. We agree with the court below that the evidence produced was competent: Bayuk Bros. v. Wilson Martin Co.,
The court instructed the jury on this point: "If you find from the evidence in this case that the claim in question was rejected on October 15th, and that suit was commenced the following year on September 16, 1936, then, of course, less than one year had elapsed since the date of the accrued claim"; and ruled that, in that event, the action was brought in time.
The defendant contends that this ruling is contrary to the decisions of this court in Abolin v. Farmers American Mut. FireIns. Co.,
The decisions of this court relied upon related to actions against fire insurance companies, which contained in the policy contract a provision that "no suit or action on this policy shall be sustainable . . . . . . unless commenced within twelve months next after the fire." It may be admitted that the appellate courts of this State have not construed limitation clauses in insurance policy contracts in accordance with the ruling of the Supreme Court of Nebraska in Kettenbach v. OmahaLife Assn., supra; but have ruled that where the limitation period fixes a definite date, such as the date of death, or the date of the fire, as the starting point of the period within which suit must be brought, and the period is reasonable, it will govern unless other provisions in the policy relative to proofs of death, *579
proofs of loss, ascertainment of loss or damage, etc., make it impossible to bring the action within the limitation period(O'Connor v. Allemannia Fire Ins. Co., supra, p. 340; Fritz v.British America Assurance Co.,
It may further be admitted that if the defendant were a fraternal beneficial association incorporated under the laws of this State, and limiting its business to its chartered field, an action on its benefit certificate would have to be brought within one year after the member's death to be sustainable. But a different situation confronts us here. The defendant is incorporated as a fraternal beneficial association under the laws of Nebraska and if it confines its activities to its chartered powers and does not intrude into the field of insurance companies, its by-laws are to be construed and interpreted according to the laws of the state of its incorporation: Modern Woodmen v. Mixer,
Appellant relies chiefly on the case of Marcus v. Heralds ofLiberty,
A careful reading of Mr. Justice ELKIN'S opinion in that case shows that he did not dispute the general *581
principle that the by-laws of a fraternal beneficial association, operating as such, are to be construed and interpreted in accordance with the law of the state of its incorporation or domicile; and that he recognized that a certificate of membership of a purely beneficial association was not an insurance policy within the meaning of the Act of 1881, supra, so as to make its by-laws inadmissible in evidence if not attached to the certificate (citing, Beatty v. Supreme Commandery,
An examination of the so-called beneficiary certificate and the application for the same signed by Hatfield in the present case brings it within the operations characterized by Mr. Justice ELKIN (pp. 435-6) as doing an insurance business. The applicant was given *582
the option of choosing any one of the following plans: `Ordinary Whole Life', Twenty-payment Life, Fifteen-payment Life, Universal Whole Life, Ten-year Renewable Term, Twenty-payment Endowment, Life Paid-up at Age 70. The questions follow in the line of applications for insurance risks as to physical condition, health and habits. The certificate provides for the payment of a definite sum to the beneficiaries at the death of the insured, and double that sum in case of accidental death. The title on the back of the certificate reads: "The Sovereign Camp of the Woodmen of the World Life Insurance — Twenty-Payment Certificate." The certificate makes specific provision for `Death Benefit', `Cash Surrender', `Automatic Premium Loan', `Paid-up Insurance' and `Extended Insurance' according to tables set out per $1,000, from the third year to and including the twentieth, when it has a cash or loan value of $551.81, and a paid up insurance of $1,000. The payments are called `premiums'. Plaintiff's exhibits 2 and 3 show that defendant advertised itself as the "World's Strongest Fraternal Insurance Association"; and "Woodmen of the World Life Insurance Association" with details of the various plans above referred to and others, the Twenty-year Endowment Option being called "a combined insurance, savings and income plan"; the Retirement Income Certificate, "Life Insurance, Savings and Old Age Security all in one Contract." The Ordinary Life certificate, Twenty-payment Life Certificate, Fifteen-payment Life Certificate and Life Certificate Paid-up at Age 70 all were based on "mortality standards of American Experience Table of Mortality and four per cent interest," and provided for cash and loan values, paid-up insurance and extended insurance after three years. Calling a policy of insurance a `certificate' does not change its character as an insurance contract. "The law looks to the substance rather than to the form and is not to be cheated by *583
any gloss of words." Marcus v. Heralds of Liberty, supra, p. 435;Com. ex rel. v. Fidelity Land Value Assurance Co.,
The provisions of the Act of May 11, 1881, P.L. 20, have been re-enacted in substance by section 318 of the Insurance Company Law of May 17, 1921, P.L. 682, p. 701,
Whichever horn of the dilemma is taken by the defendant in this case, the net result is the same. If it is carrying on the business of a purely beneficial society, the by-laws are governed by the law of the State of Nebraska, which interprets them so as to permit a beneficiary to bring an action within one year after the cause of action accrued. If, on the other hand, defendant is carrying on the business of a life insurance company in Pennsylvania, the contract will be construed as governed by our laws regulating insurance within this State and it cannot defend on any provisions of its by-laws or answers in the application for insurance not contained in or attached to the contract of insurance. *584
The assignments of error are overruled and the judgment is affirmed.