191 Mo. App. 524 | Mo. Ct. App. | 1915
This is a suit on three separate certificates of life insurance. The finding and judgment were for defendant, and plaintiff prosecutes the appeal.
The petition proceeds in three counts, one declaring upon each separate certificate of insurance, and avers that such certificates are contracts of life insurance issued by defendant, whereby it was bound to pay plaintiff the full sum of $1000 on each.
There is a question made in the case as to the character of insurance stipulated in the certificates sued upon, for plaintiff asserts that, though defendant may be a fraternal order, the insurance here involved is insurance on the assessment plan, and, under the statute, it is required to pay the . specified sum mentioned in the policy — that is $1000 on each certificate; whereas defendant insists the contracts are merely fraternal beneficiary certificates and the amount to be paid thereunder is limited by competent provisions. However, as the defense of breach of warranty is available in a suit on either a policy issued on the assessment plan or a fraternal beneficiary certificate, the question concerning the character of the insurance contract will be postponed for consideration in the opinion, until other matters pressed upon us are treated with.
The first argument advanced for a reversal of the judgment relates to the propriety of a question propounded and answer elicted from the plaintiff by defendant in the cross-examination. On opening its cross-examination of plaintiff, defendant’s counsel propounded the following question to him: “Q. Are you the same Henry J. Kribs under indictment for arson in this city?” To this question plaintiff objected, because an indictment is not evidence of guilt, but this the court overruled, and exception was duly saved,
The application for the insurance and the certificates issued thereon recite that the answers to the questions given in such application are in all respects true and stipulate warranties to that effect, so as to render the insurance contracts void in event the facts are not in all respects wholly true as stated. Touching this matter our statute, to the effect that such statements shall be regarded merely as representations, and abrogating the doctrine of warranty, unless it appear the fact misrepresented is material to the risk, in that it .pertained to a matter which subsequently contributed to the death of the insured, is beside the case, for the rule there prescribed, perforce of other statutes, relates alone to insurance contracts entered ■into on the stipulated premium, plan. In other words, if the contracts in judgment here are of insurance on the assessment.plan, the doctrine of warranty in insurance law which obtained prior to the statute may be
However, it appears here that the insured died from consumption, and the statements of fact contained in the application touching his own condition of health at the time are such as to render them material, even under the statute. But this is beside the instant case. In the application for the insurance involved here the following questions and answers appear over the signature of the insured:
“Have you ever had any of the following diseases or ailments? 28. Consumption? No. 52. I have had no disease or ailment, except as above or hereafter stated ... 65. Have you ever applied for life insurance? No. 66. No examining physician has ever declined to recommend me for life insurance, except . . . . 67. I have never been rejected for insurance by any physician, company or association, nor suspended or expelled by your Order, except . . .”
The application then recites:
“79. The following is a true statement of-the age, if living, condition of health, age at death, cause of death, how long sick and previous health of my father, mother, brothers, sisters and grandparents, to-wit: Mother — Age at death, 36; .cause of death, in confinement; previous health, good. 80. None of my grandparents, uncles, aunts or near relations have been afflicted with consumption” — all of which statements are warranted to be true.
But there is evidence, too, on the part of plaintiff, Henry Kribs, uncle of the insured, who was present at the time the application for insurance to this defendant was made, that the insured did not answer the questions above referred to. The evidence of this witness goes to the effect that defendant’s medical examiner, Dr. Waterhouse, examined the insured carefully and asked him a number of questions, but, upon coming to these questions, the doctor referred to them as a lot of “tomfoolishness,” and said he would later fill in the answers to them. So saying, he directed the insured to sign the application with such questions unanswered, which was done. Dr. Waterhouse testifies that each and all of the questions in the application were propounded to the insured personally and that the .answer was written by him therein precisely as given by the insured.
In submitting the matter of breach of warranty to the jury on the part of defendant, the court apparently did not reckon with the evidence of plaintiff,
While the insured is held to account for such statements and warranties as he makes, this is not true when it appears the statements were not laid before him, so as to obtain his assent thereto, or that the
Defendant’s instructions were erroneous because they authorized a verdict for defendant on the mere signing of the application by the insured, without regard as to whether he or Dr. Waterhouse was responsible for the false statements of fact contained therein.
It is argued the court erred in receiving in evidence the application made by the insured to the Modern Woodmen of America, a fraternal order or association, a short time before, as evidence tending to prove that he had made a false statement to defendant in the application here, to the effect that he had never been rejected for insurance by any physician, company or association. But we are not so persuaded. The application made to defendant and before us here recites :
*540 “67. I have never been rejected for insui'ance by any physician, company or association, nor suspended or expelled by your Order, except . . .”
The argument is, that an application addressed to a fraternal society, such as the Modem Woodmen, for a certificate of insurance on life therein, is in no sense an application for life insurance and, therefore, the court erred in receiving’ the one theretofore made to that’ order and on which the insured was rejected as not a desirable insurable risk. It is unnecessary to consider this matter in the instant case further than to say that the warranty of fact before us goes to the effect that the insured “had never been rejected for life insurance by any physician, company or association. ’ ’ It is entirely clear that if it be found as a fact that he was rejected by the physicians of the Modern Woodmen of America, on application to that order for insurance on his life, such would reveal a • breach of the warranty set forth, if we are to give effect as we must, to plain English words.
It is certain that the case of Peterson v. Manhattan Life Ins. Co., 244 Ill. 329, 91 N. E. 466, relied upon touching this matter is not in point, for there the breach of warranty asserted was that the insured stated in his application he had never been declined by any other insurance “company,” whereas it appears he had been so declined as a desirable insurable risk by the Modern Woodmen, a fraternal society. It was said that, under the strict construction which obtains in the law of warranty under insurance contracts, a fraternal society does not fall within the meaning of the word insurance “company.” However, even that case recognizes the distinction well established, where it appears the insured has answered that he has not been declined by any company or “association. ’ ’
Here the covenant is, that the insured had never been rejected for insurance by any physician, company
It is insisted on the part of plaintiff that the contracts of insurance involved here vouchsafe insurance on the assessment plan, so as to entitle him to recover, if at all, the full amount mentioned in the certificates, while defendant urges that the certificates are fraternal in character. It is to be conceded that defendant is a fraternal organization and organized as such under the laws of Wisconsin. Its constitution and by-laws reveal the general structure of the society to be one possessing a representative form of government, a lodge system and ritualistic work, conducting an insurance business by levying fixed monthly assessments, and dues on members, which amounts go into a common fund. But it possesses also another feature distinct from this, which will be subsequently adverted to. It appears, too, that it was admitted to do business in this State as a fraternal society under our statute, on Januáry 6, 1902. The three certificates in suit here were issued several years after that date — that is, Novem
In considering this question, it will be necessary to set forth so much of one of tbe certificates in suit as is material, and it will speak for all, as each of tbe others are identical, save only tbe serial number. We copy, too, relevant portions of tbe by-laws pertaining to tbe character of tbe insurance contemplated under these certificates, for tbe by-laws are aptly referred to as part of tbe contracts throughout tbe certificates. However, it should first be said that it appears defendant, tbougb conducting a fraternal insurance business On tbe whole life plan, erected within tbe order a special feature known as limited term, insurance on its natural premium plan, and tbe certificates here involved are of tbe latter class. Tbe by-laws authorize such certificates and provide a scheme with respect to them and their payment independent of the whole life fraternal insurance offered by tbe order. So much
“No. 41 Benefit Certificate $1000 United Order of Foresters. (Seal)
“This certifies that William T. Kribs, of St. Louis, Mo., has been admitted by the United Order of Foresters (a fraternal benefit order, organized and existing as a corporation under the laws of the State of Wisconsin) as an insured member thereof, on its natural premium plan, and is entitled to such rights and benefits, and is subject to such obligations and forfeitures, as are or may be in such case provided from time to time in the laws, rules and regulations.of said Order, and among such benefits, said Order will pay, at the death of said member while in good standing, to Henry Kribs two-thirds and Lizzie Gibson 1-3, bearing relationship to said member of uncle and aunt,, the wet amount realised by said Order in its term insurance fund from one assessment upon all its members holding• limited term benefit certificates on its natural premiwn plan, but not exceeding the sum of one thousand dollars less such sums, if any, as may have been paid to such member on account of disability benefits upon receipt of such proof of death as the executive council may require with the surrender of this certificate. ’ ’
We have italicized some of the words of the certificate with a view of inviting special attention thereto. The sections of the by-laws of the order which are relevant for immediate consideration in this connection are to be found in law 8 of the order.
“Sec. 4. Natural Premium Eates. — Members taking term certificates shall pay monthly for each one thousand dollars benefit according to their attained
MONTHLY RATE FOR $1000 BENEFIT NATURAL PREMIUM PLAN.
Age Ordinary Occupations. Specially Hazardous Hazardous Occupations. Occupations.
18 to 25 $ .67 $ .77 $ .87
25 to 30 .71 :8i .91
30 to 35 .73 .83 .93
35 to 40 .79 .89 .99
40 to 45 .90 1.00 1.10
45 to 50 1.07 1.17 1.27
“Provided, that in case the mortality experience of the Order shall be less than that shown by the National Fraternal Congress Table of Mortality, then the executive council shall have authority to remit a monthly payment in whole or in part, from time to time, so as to make the payments in this plan to conform to the actual mortality experience of the Order. ’ ’
“Section 8. Special Term Assessments. — Whenever in the opinion of the executive council the amount of money in the term insurance fund is not sufficient to promptly pay all claims against said fund, said council shall levy one or more assessments against each member holding a term benefit certificate according to the rate provided for such members in the laws of the Order. All special assessments made on the term members shall become due and payable on the first day of the calendar month next following the month in which the notice of such assessment shall have been published. ’ ’
“Section 10. — The beneficiary of each term member shall be entitled to participate in the term insurance fund of the Order to the extent of the net amount*545 realized by the Order from one assessment upon ail of its term members, but not exceeding the amount named in the benefit certificate of such member; provided, that if there be sufficient money in the term insurance fund for that purpose, then the executive council may in its discretion pay the full amount named in the certificate. ’ ’
It appears to be clear enough that the contract of insurance set forth in the certificates, ■ the payment of which is authorized and provided for by these bylaws, is one on the assessment plan under our statute. The statute (section 7901, R. S. 1899') was in force when these certificates were issued and long prior thereto and ever since that time. [See same statute, section 6950, R. S. 1909.] By this statute it is declared that every contract whereby a benefit is to accrue to a person or persons named therein upon the death of a person also named therein, the payment of which said benefit is in any manner or degree dependent upon the collection of an ássessment upon persons holding similar contracts, shall be deemed a contract of insurance upon the "assessment plan, and each contract shall be subject to the provisions of the succeeding sections touching such insurance. It is said the controlling principle of the statute is, that the benefit is to be paid out of a fund raised by assessment upon other persons holding similar contracts, by which they are made liable for the payment of such assessments. Assessment insurance is to be distinguished by reference to the right on the part of the insured to require others holding similar contracts to pay an assessment levied against them to compensate a benefit accrued to him or his beneficiary thereunder, and by reference, too, to the power which is reserved or resides in the insurer to levy assessments upon and require the payments from persons holding similar contracts to pay such benefits as may accrue under
Here, the certificate ■ of insurance on its face reveals a contract of life insurance on the assessment plan, for it recites that the order will pay “the net amount realized by said Order in its term insurance fund from, one assessment upon all its members holding limited term benefit certificates on its natural, premium plan, but not exceeding the same of $1000'.” This provision obviously assures to those entitled to the benefit a right to have an assessment made with a view of compensating such benefit, and this assessment is to be made against members holding similar contracts. Such being true, the correlative duty obtains on the part of the defendant to make the assessment accordingly against the holder of every similar-contract, with a view of compensating' the benefit accrued under these. But the face of the certificates are modified as to this by section 4 of the Law 8, which fixes the amount to be assessed at a certain prescribed amount monthly, and if this were all, it may be the insurance would be other than assessment in character. But when the by-laws above set out are considered together, all of which are parcel of the contract of insurance, it appears defendant expressly reserved the power to make assesments over and above the fixed monthly stipend, and in certain contingencies the in
When it is remembered that, under the provisions of section 4, the insured is required to pay monthly, say, in this case, as the member was only twenty-four years of age at the time of negotiating the insurance, an assessment of sixty-seven cents on each $1000 certificate and $2.01 on the three certificates per month, the provision of sections 8 and 10, considered together, would render him and every other holder of similar contracts liable to an aditional assessment, whenever, in the opinion of the executive council, such was neces^ sary, as therein recited.
Thus it is that the amount to be paid on these certificates held by the insured, after treating the monthly payments as stipulated premium, depend, in a manner or degree, when the discretion of the executive . council is considered, on assessments made on ■other persons holding similar contracts. Obviously, under sections 8 and 10 of by-law 8, when considered
The rule is well established that insurance is to be regarded as on the assessment plan when the payments are not unalterably fixed by the contract, other elements under our statute above pointed out appearing. When such elements are present and the payments to be made are stipulated in a manner, so as to destroy their character as unalterable and certain, and to introduce the element of uncertainty by variation, as by levying other and additional assessments in the discretion of the insurer, the assessment feature appears. [Hadel v. Mut. Reserve, 98 Fed. 200; Knott v. Security, etc., Life Ins. Co., 161 Mo. App. 579, 592, 144 S. W. 178; Moran v. Franklin Life Ins. Co., 160 Mo. App. 407, 140 S. W. 955.]
It appearing that the insurance contracts involved here are on the assessment plan, the statute expressly requires they specify the exact amount of money which they promise to pay, and this statute becomes parcel of the contracts on issuing the certificates in this State as was done here. In this view, it is immaterial that the certificates recite, and the by-law too, for that matter, that the sum to be paid under each is the amount of one assessment upon persons holding similar contracts not exceeding $1000, for the statute fixes the amount and requires it to be specified in each, contract. [See McFarland v. United States, etc. Accident Ass’n, 124 Mo. 204, 220, 221, 27 S. W. 436.] The same thought is expressed in Hanford v. Massachusetts Ben. Ass’n, supra. It, therefore appears that if plaintiff prevails, he is entitled to recover $1000 and interest on each certificate, rather than $380, the amount of one assessment, as asserted by defendant, on the three.
The judgment should be reversed and the cause remanded. It is is so ordered.