Case Title: Jackson v. Prudential Ins. Co. of America

Citation: 474 So. 2d 1071

Docket Number: 

State: alabama

Court: Alabama Supreme Court

Date: 1985-07-19T00:00:00Z

Document:
474 So. 2d 1071 (1985)
Inez C. JACKSON, as Administratrix of the Estate of Andrew Jackson, Deceased
v.
PRUDENTIAL INSURANCE COMPANY OF AMERICA.
84-474.

Supreme Court of Alabama.
July 19, 1985.
*1072 William H. Saliba, Mobile, for appellant.
J. Edward Thornton, Mobile, for appellee.
SHORES, Justice.
This dispute arose out of an insurance policy which the plaintiff contends the defendant breached. The trial court found for the defendant, and the plaintiff appeals. We affirm the judgment of the trial court, which is as follows:
The dispositive issue in this case is whether the rider referred to in the trial court's order relieves the defendant from liability under the policy. In pertinent part, it reads as follows:
The plaintiff contends that the rider should be construed so that the defendants' liability on each medical bill is determined by taking each of the bills, calculating the liability of the company on that bill, and subtracting the amount paid by Medicare. Under this construction, she argues that the defendant is liable under the policy for the balance of those bills not paid by Medicare. We disagree.
Any ambiguity contained in an insurance policy must be resolved in favor of the insured. However, if a policy in its terms is plain and free from ambiguity, there is no room for construction and it is the duty of the court to enforce it as written. Likewise, the court cannot refine away the terms of a policy that are expressed with sufficient clarity to convey the intent and meaning of the parties. Kinnon v. Universal Underwriters Ins. Co., 418 So. 2d 887 (Ala.1982).
The purpose of the rider in the present case is to prevent retired employees subject to Medicare benefits from receiving more benefits than those available for actively-working employees of Alabama Dry Dock. The language contained therein is not ambiguous. The key word is "aggregate," which according to Webster's New International Dictionary (2d ed. 1956) means the sum or total. The rider clearly means that the amount payable under the group policy is the surplus, if any, where the (a) figure (i.e., the sum or total of the benefits payable under the group policy) is greater than the (b) figure (i.e., the sum or total of the benefits paid under Medicare). See Bybee v. John Hancock Mut. Life Ins. Co., supra. Because the total benefits paid under Medicare exceed the total benefits payable under the group policy, there is no surplus and, consequently, no liability on the part of the defendant.
Other errors argued by the plaintiff are without merit. The judgment of the trial court is affirmed.
AFFIRMED.
TORBERT, C.J., and MADDOX, JONES and BEATTY, JJ., concur.