174 Mo. App. 671 | Mo. Ct. App. | 1913
This is. a suit on. a fraternal beneficiary certificate of insurance issued by the defendant to one of its members, M. M. Keys, whereby it agreed to pay $2000 to the beneficiaries therein named, upon the death of said M. M. Keys while a member of said order in good standing.
The plaintiffs are the said member’s three minor children who were named as beneficiaries in said certificate, and they prosecute this suit through-their statutory guardian.
Mrs. Keys died December 28, 1910. It is defendant’s contention that, at the time of her death, she had forfeited her rights and was not a member in good standing, but stood suspended by- reason of her failure to pay certain- monthly premiums, dues or assessments, within the time required. Plaintiff met this contention with the charge that this requirement of prompt payment of said monthly dues, on pain of suspension if they were not so paid, had been waived, and that defendant was estopped to defend the plaintiff’s claim. A trial of this issue was had, and the jury found a verdict in favor of plaintiff for the amount due on the certificate. Defendant appeals, and contends that there was no evidence of any waiver.
Mrs. Keys had been a member and the holder of the certificate in the order since October 4, 1901. On
The defendant order was composed of various ‘‘councils,” each located in its respective community and made up of the individual members at that place, and the executive head of the institution, or “national council” as it was called, was located at Topeka, Kansas. Mrs. Keys was a member of the local council at St. Joseph. In each local council there was an officer called the “financier.” The individual members of the order paid their assessments or monthly dues to this local officer, and it was his duty to send the money thus collected by him to the national council each
Deceased failed to pay her assessment for May, 1910,.and at midnight of the 31st of that month, she, ipso facto, stood suspended. The report of the local “financier” to the national council made June 20, revealed this fact because no payment by her was reported therein. She also failed to pay her assessment for June, 1910, and again the local “financier’s” report made about the 20th of July showed her delinquency. It was therefore apparent to the company itself, as well as to the agent, that she was delinquent for both May and June. She did not pay any assessments or premiums during July, but on August 20, 1910, being then delinquent for July also, she paid the three assessments for May, June, and July, and these were sent in by the local “financier” in his report for July, and Mrs. Key’s name was thereupon marked “reinstated.” The premiums for August and September, 1910, were thereafter paid within the time required for them. At the time the delinquent payments for May, June, and July, were made, that is, on August 20, 1910, Mrs. Keys was not in good health but no inquiry in regard thereto was made either by the local “financier” or
On August 8, 1910, Mrs. Keys went to a hospital in Kansas City suffering with cancer of the uterus, an incurable disease from which she died in the hospital on December 28, 1910, having remained at the hospital constantly from the time she entered it.
On December 27th, the day before she died, Mrs. Keys told her son to pay the premiums for October, November and December, amounting to $6.50 and he sent' a draft for that amount’ to Mr. Webb, the local “financier” at St. Joseph, with a letter telling him it was in payment of his mother’s premiums. Webb observing that the money was not sent in Mrs. Keys name, did not credit it on the books but wrote to the son that he held it only on" condition his mother was in good health. Not receiving any reply to this, and learning, on December 30, of Mrs. Keys death, Webb, after consulting the president of the company at Topeka, Kansas, sent the money to J. B. Hinkle at Kansas City, with minute directions to return it to Mrs. Keys’ son, and, if he refused to take it, to make him a formal tender of it. Hinkle could not find young Keys and finally returned the money to Webb. Young Keys was a minor and one of the beneficiaries named in the certificate of insurance sued on. Hinkle 'could not find him in Kansas- City because he had returned to St. Joseph.
Shortly thereafter an attorney went with a Mr. Brown, who seems to have been a relative or friend of the Keys children, to Webb’s office and asked bim if they were going to contest the payment of the Keys’ claim. Webb told him he did not know, but that his instructions were to have a guardian appointed for the
Thereupon Bowen was appointed guardian for the three children by the probate court, and duly qualified. When he did so, Webb immediately tendered to him the $6.50 sent Webb to pay Mrs. Keys’ last premiums.
As stated above, the answer set up that Mrs. Keys, by failing to pay the assessment for October, on or before the last day of that month, became suspended and her certificate void and all her rights thereunder forfeited inasmuch as she was not in good health when she paid the October assessment on December 27th. (It will be noticed that this assessment was paid within sixty days after the delinquency which occurred at midnight October 31st.) Plaintiffs’ reply set up that defendant was estopped from setting up the failure to pay said assessment in the time specified by the bylaws, because the course of'dealing with Mrs. Keys was such as to waive a strict compliance therewith in that regard; that Bowen, the guardian of the children, was not the legal representative of the estate of Mrs. Keys and that the tender to him of the $6.50 paid was not a tender to the proper person; that defendant .knew, at the time of Mrs. Keys death, that she had not paid her premiums in time but, notwithstanding such knowledge, defendant had requested plaintiff to go to the expense of furnishing proofs of death and of having a guardian and curator appointed, by reason of which fact defendant was estopped from making any defense to plaintiff’s claim.
Where the issue is whether or not the company has followed a course of conduct which may be said to indicate waiver, the question of waiver is one for the jury. [Fink v. Ins. Co., 60 Mo. App. 673; Summers v. Ins. Co., 45 Mo. App. 46.]
It is thus seen that the problem to be first solved in this case is whether there is any substantial evidence from which a waiver can be inferred. If there is, then the verdict of the jury is, in the absence of error in the trial, determinative of that fact.
In order to correctly determine whether or not there is any evidence that a waiver was created by the course of dealing adopted by the company, it is necessary to keep clearly in mind just what constitutes a
Applying these principles to the facts in the case before us, wé find: 1. That the company was in the habit of accepting premiums from suspended members, at least if paid within, sixty days from suspension, without inquiry as to whether they were in good health or not. 2. That the company knew, whenever a report for a month came in, that a member, whose name was not shown as having paid a premium, was delinquent and suspended. 3. That it knew that reports of collections were not sent in until the 20th of each month, and that all collections made up to the day of sending the report in were included in the report. 4. That the local “financier’s” office knew, on August 20, 1910, that Mrs. Keys was delinquent and stood suspended from May 31st, more than sixty days previous, and yet took the premiums paid at that time without inquiring as to her health and without demanding the certificate of medical examination showing good health. She was marked “reinstated” although the by-laws provided that she could not be reinstated without the aforesaid certificate. It seems to the writer that the acceptance of the premiums paid on August 20th, when a certificate' of good health was necessary, and Mrs. Keys’ reinstatement without such certificate, was a reinstatement of her without regard to the question of her health. But it is said'the company itself did not know Mrs. Keys was more than
After Mrs. Keys’ death, when the company was undoubtedly well aware of the facts concerning Mrs. Keys’ being in.arrears for the dues of October and November and of her ill health at the time they were paid, the company, when asked if it intended to insist on the forfeiture, failed to assert such defense, but requested plaintiff to go to the expense of having a guardian appointed for the beneficiaries and insisted upon it, although told by plaintiffs that they had no other property and that the appointment of a guardian was .unnecessary unless the claim was going to be paid. There was no absolute denial of liability. The company knew then perfectly well the facts constituting forfeiture by reason of the failure to pay the October
The conduct of the company in not promptly, openly and emphatically declaring a forfeiture is not only admissible and can be considered in determining what was in its knowledge while retaining Mrs. Keys’ premiums prior to her death, but, such conduct can also be considered as creating a waiver of its defense of forfeiture after her death, if the company required the appointment of a guardian and plaintiffs were thereby induced to go to the extra trouble and expense of having one appointed. In this case the company did not merely sit close-mouthed letting plaintiffs choose their own course, and then, when the proper time came, raise the defense of forfeiture. It did more than this. While it endeavored, it is true, to place itself where it could insist on a forfeiture if it chose to do so, still it did not unequivocally declare that it would insist on a forfeiture. Even when asked what it was going to do, an evasive answer was given, and the appointment of a guardian was required. And this, too, in the face of the fact that the company knew the children had no property and would need no guardian if the claim were not paid; that the proofs of death, and of the' facts bearing upon the forfeiture now relied upon, could be presented without the ap
In Traders, etc., Ins. Co. v. Johnson, 200 Ill. 359, it is held that if a company has knowledge of its right to declare a forfeiture, but did not then insist upon it but recognized the continued validity of the policy
In Granger v. Manchester Ins. Co., 119 Mich. 177, it was held that where the company, with knowledge of the forfeiture, called for additional proofs, the forfeiture was waived although in the letter calling for the proofs there was a general statement that the company did not thereby waive any defense it might have. This was certainly as strong as the stipulation in the rules of the company, in the case at bar, that the requirement of proofs would not waive any defense.
In Bowen v. Ins. Co., 69 Mo. App. 272, the forfeiture relied on was the violation of the “iron safe” clause. The company did not discover the violation of this clause until the adjusters were on the ground. The evidence tended to show that, with this knowledge, the adjusters requested Bowen to assist in going over the books with them. ITe did so for six or eig*ht hours, and then they notified him that the company denied all liability by reason of the violation aforesaid. It was held that the court properly submitted the question of waiver to the jury.
In Dolan v. Missouri Town Mut. Ins. Co., 88 Mo. App. 666, l. c. 674, it is said: “If a defendant, through its agents, after becoming aware of its defenses, has led plaintiff into additional expense and trouble in preparing proofs of loss, it would be considered as having waived such defenses of which it was aware at the time.' .
In New York Ins. Co. v. Baker, 83 Fed. 647, l. c. 652, it is said that after the company “became aware that the policy was invalid, it was not entitled to exact .from the plaintiff a technical compliance with the pro.yisions of the policy relative to proofs of loss, which would involve her in trouble and .expense, unless, on
But it is contended by defendant that this rule has no application here because plaintiffs knew from the refusal to accept the premiums, and the endeavor to return them, that the company was going to insist on the forfeiture, and consequently they were not misled to their injury or prejudice. But no one told plaintiffs positively that the company was going to deny liability. The plaintiffs knew, and all they knew was, that the local agent had taken certain steps to preserve the company’s right to a forfeiture if it chose to insist upon it. And while the mere furnishing of blanks at plaintiffs ’ reqnest, with the notice contained in said blanks that furnishing them did not waive any of the company’s rights, may not, of itself, constitute a waiver (which we-do not decide), yet in this case there was much more than this. The company was told that the children had no other property and that the proofs of death could be made and the question of the company’s liability could be litigated without the appointment of a guardian if the company was' going to refuse payment. To this the agent replied he did not know what the company would do but that its instructions were to have a guardian appointed. It would seem that under these circumstances the question whether the plaintiffs were thereby induced- to go to the trouble and expense of having'a guardian appointed, in such manner as to constitute a waiver, should have been submitted to the jury..
To sum it all up, on the question of whether a demurrer to the evidence should have been sustained, we think that the company, through its agent Webb, knew that Mrs. Keys was more than sixty days in arrears when she paid her May, June, and July dues on August 20th, and, by the receipt and retention of such dues without requiring a certificate of health, the
We think also that there was sufficient evidence requiring the submission to the jury of the question, whether or not the company, by failing to state positively and definitely that the forfeiture would be insisted upon, and by requesting the appointment of a guardian, induced plaintiffs to go to the extra trouble and expense of obtaining a guardian, thereby resulting in the waiver, by the company, of the defense of forfeiture. So much for the question of the propriety of the court’s ruling upon the defendant’s demurrer to the evidence. It was properly overruled.
We are next to inquire whether the question of waiver was properly submitted to the jury. The question whether the company on August 20, waived the forfeiture on account of Mrs. Keys being delinquent and in ill health, would depend upon whether the company took her payment of that date with knowledge of her ill health, or with knowledge that she was'more than sixty days overdue and without requiring a health certificate, which was the same as taking it without re-’ gard to her health or ill health, or would depend upon whether the company, after receiving actual knowledge of her ill health through Dr. McCall’s testimony, ratified the agent’s act in receiving her premiums on August 20th, without a certificate, by retaining said premiums and failing to return them. Whether there was
With reference to the evidence showing that Mrs. Keys’ neighbors knew she was sick, we think it was error to admit such testimony. The purpose was to show that the company had actual knowledge of her sickness. It was not shown that knowledge of the neighbors was of such a character as to show or even raise an inference’ that it was communicated to the company or reached the ears of the agent. Hence it had no efficacy in showing knowledge of either the company or the agent. For the reasons given the judgment is reversed and the cause remanded for a new trial.