Franklin Casualty Insurance Company v. Jones

HALLEY, Justice.

August 5, 1956, the Franklin Casualty Insurance Company, a domestic corporation with headquarters at Tulsa, Oklahoma, issued to Michael L. Enos a policy of insurance covering personal injury, property damage and automobile medical payments on his automobile. The latter is classed as “Coverage C” and provided for the payment of $500 for each person injured while a passenger or entering or leaving the automobile, to cover medical services for the party injured.

On October 3, 1956, Julia Wagner was riding as a passenger in the car of Michael L. Enos and was injured. She went to Dr. W. E. Jones of Seminole for treatment, although the accident in which she was injured occurred in Oklahoma County, where she was employed.

This action was filed by Dr. Jones November 18, 1957, in the Stxperior Court of Seminole County against the defendant insurance company to recover the sum of $499.50 for professional services rendered to Julia Wagner on account of injuries received in the car accident above mentioned.

Defendant demurred and plaintiff secured an order allowing him permission to make Julia Wagner a party plaintiff, which was done. Previous to this Julia Wagner had filed a personal injury action in Oklahoma County in which she asked for a judgment for money due for medical services.

The court overruled the demurrers and objections of the defendant to venue and jurisdiction of the court at the time the case was tried to the court.

On April 28, 1959, the court rendered judgment for the plaintiff, W. E. Jones, for the sum of $441 against the defendant Julia Wagner, after overruling all motions, pleas to jurisdiction and demurrers of the defendant. Motion for a new trial was overruled and defendant has appealed. We shall refer to the parties as they appeared in the trial court.

The defendant has raised several propositions as grounds for reversal but we think that there is one question which is decisive of this case and makes the discussion of the others unnecessary. The point is: Dr. W. E. Jones is not a proper party plaintiff in this action.

The provision in the insurance policy involved in this case is shown in Item 4, which is:

“The insurance afforded is only with respect to such and so many of the following coverages as are indicated by specific premium charge or charges. The limit of the company’s liability against each such coverage shall be as stated herein, subject to all the terms of this policy having reference thereto.

*966The term “Automobile Medical Payments’’ is defined in Insurance Agreements and designated as “Coverage C”, heretofore mentioned and is as follows:

“To pay all reasonable expenses incurred within one year from the date of accident for necessary medical, surgical and dental services, including prosthetic devices, and necessary ambulance, hospital, professional nursing and funeral services:
“Division 1. To or for each person who sustains bodily injury, sickness or disease, caused by accident, while in or upon or while entering into or alighting from the automobile, provided the automobile is being used by the named insured or his spouse if a resident of the same household, or with the permission of either; or
“Division 2. To or for each insured who sustains bodily injury, sickness or disease, caused by accident, while in or upon, or while entering into or alighting from, or through being struck by, an automobile.”

15 O.S.1951 § 29, provides:

“A contract, made expressly for the benefit of a third person, may be enforced by him at any time before the parties thereto rescind it.”

In order for one to get the benefit of this section of the statutes he must come within the provisions of the policy. That person must be a third-party beneficiary. Dr. W. E. Jones was too far removed to receive the benefits of this provision.

In Traders & General Insurance Co. v. Sand Springs Home et al., 195 Okl. 509, 158 P.2d 1018, 1020, we said:

“The general rule is that an action may not be maintained on a contract on the theory that it was made for the benefit of the plaintiff, a third party, merely because such third party would be incidentally benefited by the performance of the contract. He must be a party to the consideration, or the contract must have been entered into for his benefit, and he must have some legal or equitable interest in its performance (in some States, under code provisions, it must be expressly made for the benefit of such third party), in order to entitle him to sue thereon. 13 C.J. 709, 17 C.J.S., Contracts, § 519.”

A reading of this insurance policy reveals that it was not made for the benefit of the doctor.

In Sciaraffa v. Debler, 304 Mass. 240, 23 N.E.2d 111, 112, the Supreme Court of Massachusetts held:

“Under automobile liability policy indemnifying insured against loss by reason of liability to pay damage to others for bodily injuries or for consequential damages, physician who rendered services to minor injured in automobile accident could not have recourse to the policy. G.L.(Ter.Ed.) c. 90, § 34a; c. 175, § 113; c. 214, § 3, cl. 10.”

We think this holding is sound and applicable here.

The plaintiff has cited several cases to sustain his right to sue the defendant insurance company directly but the only case cited that permitted direct action was Kelly v. Maryland Casualty Company, 89 Minn. 337, 94 N.W. 889. There the court held that the insured was an agent of the insurer when, under the provisions of the policy of insurance, he called the doctor in an emergency case.

The case of Severson v. Milwaukee Auto Insurance Company, 265 Wis. 488, 61 N.W.2d 872, 42 A.L.R.2d 976, in which plaintiff places so much faith, is not in point here because there the suit was by the personal representative of the person killed in the automobile collision and the pivotal point really was whether the liability and medical and funeral expense coverages, although contained in the same policy, constituted separate contracts. It was held that it did and that the action was not precluded on the theory of prior payment, of absence of privity of contract, or of splitting of cause *967of action. In that case the policy made the deceased a third-party beneficiary.

For the reason that the plaintiff here was not a proper party plaintiff, this cause is reversed with directions to dismiss.

WILLIAMS, C. J., and WELCH, JACKSON and IRWIN, JJ., concur. BLACKBIRD, V. C. J., and DAVISON and BERRY, JJ., dissent.