Fowler v. United Equitable Insurance

O’Connok, J.,

dissenting: I must dissent from the majority opinion which fell to my lot to author. In the first place, the clause in question is clear and unambiguous, and, therefore, does not require judicial interpretation or the application of rules of liberal construction. (Esfeld Trucking, Inc. v. Metropolitan Insurance Co., 193 Kan. 7, 392 P. 2d 107.) The words of the contract are to be taken and understood in their plain, ordinary, and popular sense, and all that remains for the court is to enforce the contract according to its terms so as to give effect to the intention of the parties. By the language of the clause the insurer has effectively limited coverage to one period of hospital confinement (one day to a lifetime) resulting from a particular accidental injury. The court is not warranted in ignoring or eliminating the unambiguous clause included by the parties in their contract. The distinction drawn by the majority between the terms “continually confined” and “continuously confined” is tenuous and unrealistic, and the holding of Atkinson v. Insurance Co., 260 N. C. 348, 132 S. E. 2d 681, furnishes sound authority for proper disposition of this case.

Although I subscribe to a broad definition of the phrase “continually confine the insured to a hospital,” just as the majority of *640the courts have done with the wording “continuously confined within or to the house” so that occasional absences for therapeutic reasons under the advice of a physician will not preclude recovery, no assumption can be drawn from the record before us that the insured’s absence from a hospital for twenty-six days was for such reasons. Nor is this a case where a patient was given periodic passes for therapeutic purposes but at all times reserved his bed in the hospital (Texas Reserve L. Ins. Co. v. Texas Rehabilitation Ctr. [Tex. Civ. App.], 332 S. W. 2d 403).

Secondly, assuming arguendo the clause is uncertain and ambiguous and, therefore, must be construed liberally in favor of the insured, I am of the opinion that under the guise of liberal construction the court has remade the insurance contract into one that was never contemplated by either party. As I interpret the majority opinion, an insured under this policy can recover benefits for every period of hospitalization resulting from a particular accidental injury, notwithstanding the interval between periods may be twenty-six years instead of only twenty-six days. Arguably, the word “continually” may be less restrictive than “continuously,” and the restrictive nature of the coverage could have been manifested more clearly. Even so, the language in the light most favorable to the insured cannot be stretched to provide gratuitous benefits that not even a reasonable person in the insured’s position would have dreamed. My research on this case has revealed no decision where any other court has gone to such lengths to construe a policy in favor of the insured.

I would reverse that part of the trial court’s judgment allowing recovery for the second period of hospitalization.

Fontron, J., concurs in the foregoing dissenting opinion.