Docket No . 103754.



### IN THE SUPRE ME COURT OF THE STAT E OF ILLIN OIS

DA VID R ICH, Appell ant, v. PRI NCIPAL LIFE INSURANCE

COMPANY, A

ppel le e.
Opinion filed September 20, 2007.

JUSTICE FREEMAN de li vered the j udg men t of th e c our t, w i th op inion. Chi ef Justice Thomas and JusticesFi

tzgerald, Kilbride, G ar man, Karmeier , a nd Bu rk e co ncur re d in t he judg ment a nd o pinion.

OPINI ON

Pla int iff, Davi

d Ri ch, brought an action in the ci rcuit cour t o f Wi nne bago County agai

nst def endan t, Pr in ci pal Li fe In surance Co mp an y, f

or brea ch of a n i ns ura nce co ntract. Defendan

t file d a
co un t er cla im

ag ains t pla int iff see king a d ec lar at o ry ju dg ment . P laint iff and defend ant fil

ed c ro ss- mot ions fo r su mmary judgment in the decl ara toryj udgm

en t acti on. The ci

rcui t court enter

ed sum mary judg ment in favo r o f pla int iff . T he app ellate co ur t re ver sed and entered sum mary j udgm en t in f av or of de f

endan t. No. 2 –05–11 97 (unpubl is hed ord er un der Su pr em e C our t Rul e 23). We al

lowed plain tiff ’s pe ti ti on f or l ea v e to ap pe al ( 21 0 I ll. 2d R . 31 5(a )), a nd now af f i rm th e j udgm

en t of th e a pp el l ate cou rt.1 Fu rt her, acc ording to t he policy: “ SIC KNE SS means sickness ordi sease of th e In sured f

irst mani fe ste d w

hile th is po li cy isin fo rce .”
-2- I. BACKG

ROUND The pert in

ent and undisputed facts are as foll ows. On March

20, 1980, Ba nke rs Life Co mp an y, no w k no wn a s d efe nda nt , P rinc ipa l Life Insuranc e Company, issued a di sabi li ty in sura nce po licy t o pla int iff. The policy

pr ovid es t hat defend ant wil l pa y m onthly ben efi ts “i f Total Disa b i l i ty (a s th at t erm is def

in ed i n thi s poli

cy ) of the Insured
comm ences whi l e th e Policy

is in force.” The poli

cy defi nes “ to tal di sa bilit y” as “the c omplete in abi li ty of the Insur ed due

to In j ury or Sickness to perform a

ny and ev ery duty pertaini ng to anoccupa

ti on (as def i ne d he rei n) f or rem une rati on or prof

i t.” The poli

cy defi nest he terms “Sickn

ess” and “Inj ury” as f

ollows: “INJURYmeans ac cident al bod ily injury sust ained by t he Insured wh ile t his P o licy is in

force. Injury whi

ch i s a di rect or in direct res ul t of phy si cal or mental i

nf irm ity, i ll ness or disease of an y ki nd , or m edi cal orsurgic al

treatm en t theref or or Inj ury whi ch resul ts in Tot al Dis abi li ty whi ch com me nces m ore t han 90 da y s af ter th e date th e In j ur y i s s us tai n ed wi l l b e deemed

to be Si ckn ess .” 1 In the ben efi t and premi

um s chedul

e, the policy

pr escr ibe s life t ime b en ef i ts if the dis abi li ty resul ted from an

“i nj ury,” b ut limit s t he be ne fit peri od to fi ve years i f the d i sab i l i ty re sul ted f rom a “s i ckn ess .” On Jan uary 19, 1999, pl

ai nti f f wa s l oadi ng 50-poun d ti res onto a truck at wor k. A tire b ounced back and st ru ck his r ight wr ist . P laint iff continue d worki ng d esp i te pai n a nd s wel l i ng i n the wrist. T he next da y, a me di ca l ex amin at io n w it h X

- r ays re vealed only a co nt usio n and st ra in. However, plai

ntif f conti nue d to expe rience pain and swe lli ng inhis ri ght wr i st. On Marc h 3, 1 999, pl

ai ntif f rece i ve d an MRI. O n March 3 and 18 , based on the MR I, various ph

ys ic ia ns di agnosed pla int iff as h av i n g a te ar of t he ri

gh t sc ap h ol un ate l i ga men t wi th segm ental insta bili t y. Dr . R obe rt Sche nck c onfirmed t hi s diagno sis and
recomm ended su r ge ry. Pla int iff

was f ull y e mpl oyed f rom Jan uary 19, 1999, through May 17, 1999. On May 18, 199 9, Dr . Schenck perfor med surger y on plai ntiff ’s righ t wrist. Exploration of

the wrist reveale d

a co mple t e, irr ep ar ab le-3- rupture of the scaph

oluna t e l iga me nt. Consequentl

y, Dr. Schen

ck performe d

a s ca ph ol un ate f us i on , i n se rti n g p i n s to at t ach a bone gr aft f rom the distal radius. On A

ugust 23, 199 9, Dr . S chenc k r emove d t he cast from pla in tif f’ s righ t hand an

d wrist. Dr. Schen

ck observed
swe lli ng on the dorsal

aspe ct of p laintiff’s hand a nd dr ainage at t he f us i on si te. Dr. Schen

ck remove d the pin

s and pres cr ibe d oral antibiotics

to pr event infect ion fro m spre ading t o t he bone. On August 25, 199 9, p l ai

nti f f retu rned to Dr. Sch

en k w i th c om pl ai nts of abnorm al redn ess and swe l l i

ng n ear the si te wh erethe pin

s had been removed. Cult ur es fro m the pi n-re moval si te reveal ed a “ raregr owth of staphyl oco ccus species.” As a

resul t, Dr. Schen

ck dir ec t ed pla int iff to continue taking his antibi ot ics. On August 25, 19 99, p laint iff ap plie d fo r be ne fit s u nd er his di sa b i l i ty i n su ra n ce pol i cy b y su b m i tti n g to def

en da n t a v eri fi ed di sa b i l i ty cla im no t ice

. Pla in

t i f f i den tif i ed h i s i nj ury as the torn ligament in

hi s righ t wrist, whi ch h

e i ncurred whi

le loadi ng tires a t work on J anu ary

19, 19 99 . Pl

ai n ti f f sta ted th at h i s to tal di sa b i l i ty
co mmen ce d o n M ay 1 8, 19 99 , t he da t e o f his wr ist su r ge ry. Pla int iff expl ai ned: “I was put o n di sabi

li ty because of an i

nf ection in my wrist that wa s opera

ted on.” Ina le tt er dated September 8, 1999, defen dant acknowledge d
rec ei pto f pla int iff’s d isab ility c laim no t ice . D efe nda nt ad vise d p laint iff: “The Ma ximu m Be ne fit Period i s f iv e y ears. For disabil

ities as a di

rect
r es ult wit hin

90 da y s of an ac ci den t/i n j ur y , y our b en ef i t i s exten de d to your lif et ime.” Also , d efend an

t r equest ed an at tending physician’s st at ement to further process pl ai ntif f’ s clai m. Pl ai ntif f thereaf ter subm itted t he st at ement , p re par ed byDr. Schenck, wh o verif ie d that he “ t o ld t he p at ient [p laint iff] to restrictemployment act ivities, ” and that the re stri cti ons b egan on Ma y 18, 199 9. In

a l etter dated Octo ber 1, 199 9, rely

in g on the verifi

ed i nf ormation that plai

ntif f provi ded, defend ant determi

ned that pl ai

ntif f was to tall y di sabl ed as of Ma

y 18, 1999, and a war ded him be ne fit s und er t he po licy beginning on Ju ne 17, 1999, after the policy ’s 30-day elim in ation period. Dr. S ch en ck co nt inu ed t o t r ea t pl ain t iff o n a mo nt hly b asis f or hand and wr ist pa in. On J anu ar y 31 , 2 00 0, pla int iff co mpla ine d a ga in of swell in g and redness . X-ray s r eveal ed tha t plai nti f f su f f ere d f rom o st eo myelit is in the p ro ximal scapho id and a djace nt l un ate bones. A biopsy of p laintiff’s wrist re vealed a r ar e gr ow t h of stap hy lococcus-4- species an d m

old . As a res ul t, Dr. Schenck ref

erred pl ai ntif f to Dr. Da vid Sim

on, an inf ectious disease sp ec i al

i st, who ordered a six-week
cour se of int ra veno us a nt ibiot ics. O n Mar ch 3 0, 2000, Dr. Schenck operated a second tim

e on pl ai ntif f’ s righ t wrist and di scovered that t he lunat e and adjac ent portions of his sc aph oid bones w erenecrotic. Dr. Schen

ck excised m

ost o f the n

ecrotic bone an

d advi se d p laint iff that if the scaphoid fai

le d to fus e, he would e

ven tuall y n eed a tot al wrist f usi on. On Octobe r 22, 20 01, p la i

nti f f un de rwe nt w ri st f us i on su rg er y an d a n ul n ar h ead r ep l ac em

en t on h i s r i gh t wri st. The record shows that defendan t admi ni stered pla int iff’s cla im

as having a fi

ve-y ear ben efi t period. In a Ju ly 12 , 2 00 1, let t er t o pla int iff, in whi ch def endan t appro ved

plaint iff ’s co nt inued be nefits, defend ant noted: “Ben

efi ts wil l c ontinue un

til June 16, 2004, whi

ch i s when your ben efi ts wil l e xha ust, as long a s y

ou continue to be Di sabl

ed per t he pr ovisio ns o f y our pol i cy and provi de Proof

of L oss that y

ou are sati sf y i ng th i s pol i cy requi rem en t.” On August 28, 2002, plai

ntif f requested that defenda

nt reconsi der it s de term i na ti on that he was inel

igi ble for lifetim

e benef its. Defend ant responded

in a le tt er dated August 30, 2002. Defen dant expl ai ned that i t was correct ly

adm in is tering pl ai ntif f’ s clai m a s a “s ic

kness ” under t he policy

, based on the verifi

ed facts that plai

ntif f gave i n his c la i m forms. Ci ti n g th e po li cy provisi on defi ni ng “ si ckness ,” defen

dant noted t he policy ’s 90-day

in jury li mi tation. Defen

dant in form ed pl ai n ti f f th at,
acc or ding t o t he info r mat io n in h is c laim file , pla int iff did no t be co me dis abl ed f rom th e Ja nua ry 19, 1999, in

jury until May 18, 1999, or 120 da ys af ter he sus taine d the in

jury. Defen

dant further ex

pla in ed that b ecause pla int iff’s t o t al d isab ility be ga n mo re t han 90 da ys aft er th e da te the inj ury was sustained, the clai m was adm

in istered as a sicknes s and that plai

ntif f was not eli gible for lif etim e ben efi t s. D efenda nt advi sed pla int iff t ha t if he wis he d t o be fur t he rco nsid er ed fo rlifet ime b en ef i ts under the poli

cy , he would n

eed to pro vi

de de fe n da

n t wi th
me dic al and em ploy me nt documen

tation that would sup por t t hat he becam e tot al ly dis abl ed wi thin the 90 day s that foll

owed t he Jan

uary 19 , 19 99 , wo r k- r ela t ed inju ry. In a letter dated

Jan uary 24, 200 3, pl

ai ntif f , thro ugh coun se l, dis agreed wit h defend ant ’s po sitio n, c ont ending : “T he i nj ury f or which [p laint iff] i s d

i sa bl ed occurred on May 18 , 1 999 , t he da t e t hat he was exposed to a contami

nated operat io n fie ld . Th i s f i el d c au se d h

i m to-5- suf fer a s ev er e s t ap h infe ct io n w hic h r es ult ed in su bst an t ia l de teri orati on o f his bon es. I t is

f or thi s rea son th

at he i s disab l ed.” Theref ore, ac cordi

n g to pla in tif f, “ hi s di sabi li ty occurred as the di

rect
r es ult o f his inju ry wit hin90 da ys of his onset of di sabi li ty. Theref ore, he shoul d be

en titl ed to the b enef

i t exten ded i nto hi s l i f eti me.” Defend ant ad vise d p laint iff’s co un se l t ha t it wo uld ag ain reviewit s ad minist r at io no f pla

in tif f’ s clai m. In a le tt er dated April

1, 2003, def end ant deni ed plai

ntif f’s s econd request for lifetim e benef its. Defend ant ag ain ci

ted the pol i cy ’s de f i ni ti on of “i nj ury” an d expl ai ned th at, because th e v

eri f i ed i n f orm ati on th at p l ai n ti f f su b m i tted wi th his cla im showed that plai

ntif f ’sdi sab i l i ty b egan on Ma y 18, 199 9, m

ore than 90 days after his January 1999 accident, plain tiff ’s inj ury was pr o pe r ly deem ed a “ sickn

ess ” un der the pol

i cy

. De fe ndant also adv i sed pl ai nti f f ’s cou ns el tha t i f pl ai nti f f ha d a ddi ti ona l i nf orm ati on to sup po rt his req ues t for lif et ime benefits, he sho uld fo rw ar d t he informat ion t o d efenda nt for co nsider at ion. At pla in tif f’ s req ue st, Dr . Je ffrey Co e exa mined plaint iff and reviewed pl aint iff ’s medi cal rec ords . In

a d etai l ed

ex pl an ati on of plaint iff ’s medi cal history and hi s own f i ndi ngs on ex am i na tion , Dr. Coe re ported as

f oll ows. On Jan uary 19, 199 9, pl

ai ntif f suf f ere d a con tus i on an d s trai n to hi s righ

t wrist in an acci dent at work, whi

ch caused an inte rna l der ange ment with s caphol unate di ssocia

tion. Ini tial t re at ment f

or the Jan uary 1999 i nj ury led t o o nly

l i m i ted i m pr ov em en t, and pla in tif f’ s phy si ci ans ev en tu ally re co mmend ed su rg er y. P laint iff unde rw ent sur ger y on Ma y 18, 199 9, and appe ar ed to be r eco ver ing through l ate

Jul y 1999. Ho weve r, re co ver y became c omp licate d by t he deve lop ment o f an inte rna l inf ect ion. Based on his f

in din gs, Dr. Coe opine d that: (1) t here was a c aus al r ela tionsh i p be tween the i nj ury suf fer ed by plaintiff at w or k o n Janu ar y 19, 199 9, and his c ur re nt symp t o ms and sta

te of im pai rmen t; and (2) pl ai

ntif f’ s i nj ury h as caused pe r man en t pa r t ial d isa bilit y t o his r igh t ar m. Pla int iff subm itted Dr. Coe’ s rep ort to defen dan t in supp ort o f his thi rd request for li

feti me b enefi ts. In a Novem ber 21, 20 03, letter, defend ant con

f i rm ed i ts den i al , ex pl ai ni ng tha t Dr. Coe

di d n ot provide an y n ew or di f f er en t i n f orm ati on that wou

l d c h an ge i ts po sitio n. Accordin

g to defen dant’s records, plai

ntif f’ s i nj ury occurred
on Ja nu ar y 19 , 19 99 , bu t his di sa bilit y did n ot beg in until May 18, 1999, and, under

t he t er ms of t he po licy, plaintiff’s claim cou ld no t be-6- considered

an “ in jury ,” butrather was deem

ed a “si ckness ,” for whi

ch he has recei

ved the appro priate benef its. On January 7, 2004, plain

tiff ’s co unse l req ues t ed d efenda nt for t he fou rt h t ime to re view its denial o f li fet ime benefits t o p laintiff. In t he l etter, counsel

contended

t hat pla int iff

was i nj ured on May

18, 1999, when he sustaine d

the st aph infect ion. Defend ant re spo nded in a Jan uary 16, 2004, letter, explai ni ng that it did n

ot dis pute that plain tiff ’s disabi li ty began on May 18, 1 999. Accor dingl y, plai ntiff ’s May 18, 1999, disab il

ity did n ot qualif y f or li feti me ben efi ts because: (1) pla in tif f’ s Jan uary 19, 1999, i

nj ury, wh ic h r es ult ed in his su r ge ry, and t he da t e o f his d is abi li ty, May 18, 1999, occurr ed m

ore t han 90 da ys apa rt ; and (2 ) p l ai

n ti f f ’s Ma y 18 , 19 99 , di

sa b i l i ty was the di

rect
ori n di re ct res ul t of su rg i ca l tre atm en t an d, t h er ef

ore , the d i sa b i l i ty
wasdeem ed to be a “ sickn ess .” On April 12, 200 4, def

en da nt’ s a ss i sta

nt d i rectorof clai

ms spoke wi th pla i nti f f ’s cou ns el by tel ep hon e re ga rdi ng pl ai nti f f ’s cl ai m f or li feti me ben efi ts. She expl

ai ned tha t plai nti f f ’s con di ti on was a di rect
ori ndi rect res ul t of an i l l ne ss or di sea se, i.e. , th e s ta ph

i nf ec ti on, or surg i cal t r ea t men t in t he fo r m o f t he Ma y 18 , 19 99 , wr ist su r ge ry. Theref ore, pla in tif f’ s clai m was consi

dered a sic kn es s u nd er t he po licy. On June 16, 2004, def

endan t sent a letter to pla

in tif f adv is in g hi m that he ha d e xh au ste d h i s f i ve -y ea r pe riod of d isabili

t y benefits a s o f June 16, 2004, and thatn o f

ur th er b en ef i ts were pay

abl e for his clai

m un der t he t er ms o f t he po licy. The reaf ter, on October 21 , 2 004, p laintiff fi led a o ne- co unt
co mplaintag ain st de fen da nt fo rbr ea ch o f co nt r ac t , se ek ing lifet ime b en ef i ts unde r t he pol

i cy . De f en da nt a ns wered an d c oun terc l ai med f or a dec larat or y judgment t hat defend ant had no furt her obligat ions under the po li cy. Pl ain tiff answ e re d de fendant ’s co unt er claim by admit t ingall

stat emen ts o f f act and denyi

ng only the appro priateness
o f d ef en da nt ’s de t er mina t io n o f d isa bilit y be ne fit s u nd er t he po licy. Pla int iff and de f en da nt f i l ed cros s- moti ons

f orsummary judg ment in def endan t’s de claratory

j udg men t ac ti on. In

i ts m oti on f orsum mary judg ment and in it s r es po nse t o pla int iff ’sm oti on, defend ant contended

t ha t it had pro perly admi

nistered p lai

ntiff ’s dis ab ilit y cla im
as a “si ckness .” Defen

dant argued

that pla in tif f’ s tot al dis abi li ty be gan on May 18, 199 9, m

ore t ha n 9 0 d ays af

t er his Ja nu ar y 19 99 inju ry. Defend ant argued al

ternativel y tha t, even i f pl

ai ntif f’ s staph i nf ec ti on2 Pr ior t o the entry of ju dgment, the circ uit c our t gr ant ed plaint iff leave to file an am en ded c om plai nt, in which plaint iff a dded a claim a gains t defendant alleging bad f

aith pursuan t tosec tion 155 of the Ill in oi s Insuran

ce Cod e (215 ILCS 5/1 55 (Wes t 2004) ). The ci rcui t co urt gran ted defe nd ant’ s m otion to di sm iss this cl aim

. -7- constitutes a “new an

d in dependent” inj ury, which he sust aine d on May 18 , 1999, t hat in

jury arose as a resul

t o f wrist surge ry

. Co ns eq ue nt ly, in t he lan gu ag e o f t he po lic y, plaint if f’s i nj ury was a sickn ess be ca us e i t wa s th e re sul t of “ph y si cal or men t al in fir mit y, il ln ess or disease of

any kin d, or medi cal

or surgica l trea t ment there f or.” In hi s m ot ion f or summ ary j udgme

nt an d in hi s re sp on se

to defendant’s motion, pl

ai ntif f contende d that he wa s e nt it led t o lifet ime di sa b i l i ty benefit s pu rsu ant t o t he po licy. Plai ntif f argued as foll

ows. The l an gua geof the pol i cy wa s a m bi guou s a nd, t her efo re , mus t be construed i

n h i s f av or a n d agai n st d ef en da n t. The poli

cy la nguage was agains t public po licy and co nt ra ry t o t he exp ect at ions o f a reasonabl e, ordinar y per son m

aki ng a contract. Als o, plai

ntif f’ s staphy lococcal i nf ec ti on was a ne wand separate i

nj ury, wh ic h wa s th e di rect res ul t of th e Ma y 18 , 19 99 , w

ri st s urgery . C on se qu en

tl y , pl ai n ti f f ’s di sa b i l i ty be ga n no t o nly w it hin90 da ys o f, bu t o n t he sa me d ay a s, t he inju ry. In a me mo r an du m de cis io n, t he c irc uit co ur t fo und t hat pla int iff
was en t it led t o life t ime d isa bilit y be ne fit s p ur su an t t o t he po licy. 2 In it s fi nal jud gme nt order , th e c i

rcu i t cou rt gran ted pl ai nti f f ’s m oti on f or su m mar y j udgm en t an d d en i ed th at of de f en da n t. Defend ant ap pe ale d fr o m t he cir cu it court’s f i na l j udgm en t order. The appe l l ate

court found that the pertin ent poli cy la nguage was

cl ear and unam bi guous. Further, t he appel la te court found that i

t was not
un us ua l, un r ea so na ble , o rag ain st pu blic p o licy fo ra d is abi lit y in surance policy to li mi t benef its b y pres crib in

g the condi

tions that
constitute a

n “i nj ury ” or a “ sickn

ess .” Applying the pol i cy prov i si on t o t he un di spute d f ac ts, th e a pp el l ate courtfound as

follows. Plai

ntif f b ecam e di sabl ed more t ha n 9 0 d ays after his w o r k- r ela t ed inju ry. I n lig ht o f t he st ipu lat ed ve r ified fac t s in plain tiff ’s o wn cla im

subm issi ons, pla in tif f coul d not avoid the 90-day l i m i tation by clai m i ng th at the M ay

18, 199 9, s t ap h i

nf ec ti on3 Before the appellate cour t, p laintiff cr oss-a ppealed from the circuit court’s di sm

iss al o f h

is cl aim bro ug ht pursu an t to section 1 55 of t he Insura nce Code. The ap pellate court affir med the dismis sal, f

rom wh ich plaintiff does not appeal.
-8- constituteda “new” inj ury. Furt her, even if plaintif f’s di sa b i l i ty arose wit hin 90 da y s of a new i nj ury, i.e. , t he infe ct io n, pla int iff wa s s t ill not entitled to l i f eti me di sa bi l i ty be ne f i ts b ec au se thi s “ ne w i njury ” w asnot
an “a cc id en t al” inju ry t ha t fe ll u nd er t he po licy’ s ge ne ral gra nt of coverage. Because t he ne w in jur y wa s no t “a cc ide nt al” an d c o gn iza ble under the poli

cy ’s gen eral gran t o f coverage

in t he first insta nce, t he appe l l ate courtdid n

ot consider whether plai

ntif f’ s i nj ury was “a di rect or i nd i rect res ul t of physical or mental i

nf irm ity, i ll nessor dise as e of any ki nd, or m edi cal or surg i ca

l tre atm en t th er ef or.” The a pp el l ate courtreverse d t he circuit co urt ’s ent ry o f summary judg ment i n f av or of pl ai ntif f and en tere d s umm ar

y j udgm en t i n f av or of de f en da n t. Pl ai n ti f f appe als to th i s c our

t. 3

II. AN AL YSIS T his matte

r i s b ef oreuson th e g ra n t of sum mar y jud gme nt in f av orof de fen da nt

. Su mmar y jud gme nt is app ro pr iate only wher e “t he pl eadings, de

pos i ti on s, an d adm i ss i on s on

f i l e, togeth er

wi th th e aff idav its, i f an y , sh owthat t here i s no genui

ne i ssueas to any m

aterial fact and t hat t he moving par t y is entit led t o a judg ment asa m atte r of l aw.” 735 ILCS 5/2–1005(c) (We st 2004 ). The ci rcui t court’s e

ntry of summary judg ment i s s

ub j ec t to de novo revi ew. Outboard Marine Corp. v. Liberty Mutual Insurance Co. , 154 Il l . 2d 90, 1 02 (1 992)

. S pe cif ica lly, the con stru cti on of an i ns ura nc e p ol icy is a q

ue sti on of la w, whi ch i s revi ewed de novo

. Central Illinoi s Light Co. v. Home Insurance

Co. , 21 3 Ill. 2d 141 , 15 3 (2 004 ); Travelers Insurance Co. v. Eljer Manufacturing, I nc. , 197 Il

l . 2d 278 , 292 (2 001). Wh en constru in

g the language of an insurance po li cy, a cou rt ’s pri mary objec t iveis to asc er t ain and g ive effect t o t he inte nt ions o f the parties as ex pr es se d b y the w ord s of the p oli cy

. Hobbs v. Hartf

ord Insurance

Co. of the Midwest , 214 Il

l

. 2d 11, 17 (20 05) ; Central Illinois Light , 21 3 Ill. 2d at 153 ; American St ates Insura nc e Co. v. Koloms , 177 Ill . 2d473, 479 (1997) . Because t he court must as su me-9- that ev ery provisi on wa s i nten ded to se rv e a purpose, an in

surance policy is to be construed

as a wh ol e, g i vi ng ef f ec t to every

prov i si on ( Central Illinois Light , 213 Ill. 2d at 153 ), and t aking int o a cco unt t he typeof insur ance pr ovid ed, t he nat ur e o f the risks involved, and t he
o ve r all purpo se of

th e c on tra ct ( Koloms , 17 7 Ill. 2d at 479 ; Outboard Marine , 154 Ill . 2d at 108) . “A ll the provis ions

of the i nsuran ce con tra ct, rathe

r than an i sol ated pa

rt, shoul d be read together t o in terpret it and to d etermine wh ether an ambi

guity ex ists. ” United States FireInsurance Co. v. Schnacken berg , 88 Ill . 2d 1, 5 (198 1). If t he wo rd s us ed in t he po licy are clea r a nd unambiguo us, t hey must be giv en their pl ai n, ordina ry, an d popu lar me ani

ng ( Centr al Illinois Ligh t , 21 3 I ll. 2 d a t 15 3) , an d t he po licy w ill be a pp lied as wr it ten , un les s it co nt r av en es pu blic po licy ( Hobbs , 214 Il l . 2d at 17 ). If t he wo r ds us ed in t he in sura nc e p o licy a r e r ea so na bly
su sc ep t ible to more than one m eani ng, they are considered

am bi guous and wil l b e c onstrue d st rict ly against t he insur er who dr aft ed t he pol i cy

. Central Illinois Light , 21 3 Ill. 2d at 153 ; Koloms , 177 Ill . 2d at 479 ; Outboard Marine , 154 Ill . 2dat 10 8- 09

. T his is es pe cia lly true wi th re spe ct t o p ro visions t ha t li m i t or excl ude c overa

ge. Outboard Marine , 154 Ill. 2d a t 1 19; Pioneer Life Insurance Co . v. Alliance Li feInsurance Co. , 37 4 Il l . 57 6, 5 86 ( 194 0). A

con tract i s n ot rendered am bi guous merel

y b ec aus e th

e p ar ti es di sa gr ee on i ts
me ani ng. Central Illinois Light , 21 3 I ll. 2 d a t 15 3. A c o ur t will consider o nly r ea so na ble int er pr et at io ns o f t he po lic y l angu age and will n ot s trai

n to find an am bi gui ty w here none exists. Hobbs , 21 4 I ll. 2d at 17; Eljer Manufacturing , 197 Ill . 2d at 293; Schnackenberg , 88 I ll. 2d at 5. “Al

though policy

terms that li

mi t aninsu r er ’s liabilit y will be l i beral l y construed i

n f av or of cov

era ge, t hi s r ule of con stru cti on o nly com es i n to pla y w hen the policy

is am bi guous.” Hobbs , 214 I ll. 2d at 17. Exc lusions such a s thos e con tai ne d i n the pol i cy be f ore us a re not contrar y t o pu blic p o licy. “D isa bilit y insu r an ce is designed to provide prot ection f

rom loss of i

ncom e caused by an i nj ury or disease whi

ch ei ther l i m i ts or destroys the i

nsured’s abi li ty to wo rk.” 10ACouch

on Insuranc e 3d §146:2, at 146–10 (1998) ; 1 J. Appl ema n & J. Ap ple ma n , Ins uran ce L aw &

Practi ce §2 3, at 60 (1 981) (s am e).

“ So me pol i ci es m

ay ex pres sl y l i m i t li ab i l i ty to di sab i l i

tie s tha t are
so lely the resul t o f an accident, as di st ing uis h ed f rom a d i sa b i l i ty-10- whi ch res ul ts i n p art f rom the i ns ure d’ s p rior con

di ti on o rso me ot her
cause than an

accident, such as i

ll ness or disease. ” 10A Couc h on Ins uran ce 3d §146: 12, at 14 6–30 ( 1998) . Furth er: “M odern po lic ie s, however, are m ore li kel y to cover dis abi li tiesre sult ingf

rom both acc i den

t and i l l ne ss, b ut to vary t he ben efi ts dependi

ng on wh ic h. For exam

ple , a p olicy

ma y af f ordben efi ts for a li

mi ted amount of tim

e w he re t he di sa b i l i ty is caused by

si ckness or disease, butprovi

de l onger, ev en un l i m i ted , b en ef i ts w he re d i sa bi l i ty res ul ts f rom acc i den t.” 10A Couch on Insur an ce 3d §146:12, at 146–31 (1998 ). Ac co r di ng ly, th e exten

t of an i n su re r’ s l i ab i l i ty un der a di sa b i l i ty in surance policy depends on the terms of the i nsuran ce contract. 22A Il l . L. & Prac. Insurance

§383, a t 73 (1999 ). Ad di t io na lly, t he inc lus io n o f t ime limit at io ns in in surance polici es, such as th e 9 0- da y l i m i tati on i n th e p oli cy

b ef oreus , do es

n ot v i ol ate pu blic pol i cy

. Ki

rk v. Fi na nc ia l S ec ur it y L ife Insurance Co. , 75 Ill . 2d 367, 377 (1978); accord 10A Couch on Ins urance 3d §146:22, at 146–48 (1998) (stat in

g that “i t is com mon f or t he po lic y

to requi re t hat t he disa bili

t y occ ur wit hin a spe cified t ime after t he in jury ”); 1C J. Appleman & J. Appl

em an, Insuran

ce Law & Practice §612, at 128 (1981) (st at ing

that ins urancecon

tracts f re qu en tl y pr ov i de “ th at dea th
ordis abi li ty m ust foll ow withi n a sti pula ted number of d ays follow ing
an acc ident . T hese pr ovisio ns have be en co nsider ed va lid and
en f orceab l e”). As there is nothi ng i n the i nsuran ce contract bef

ore us that violates pub lic p o lic y, i f i ts lan guage i s unam

bi guous, it is

our duty to giv e i t ef f ect. Hobbs , 214 Ill . 2d at 18. In t he pr ese nt cas e, viewing t h e p oli cy as a w h ol e, wh i l e n ot a
mo d el of cl ar it y, w e c o nc lud e t ha t t he po licy la ng ua ge is
unam biguous. The

pol i cy en titl es p l ai ntif f to li f eti me b enef i ts f or a di sa b i l i ty resu l tin g f rom a n “i nj ury .” The poli

cy defi nes “in jury ” as an “acci dental bodil y i nj ury s ustain ed by the I nsur ed w hile the Po licy is in fo r ce

. ” A co nt r ac t t er m may b e una mbi guous because i t has acqui redan estab l i shed l

egal mean i ng. Schnackenberg , 88 Ill . 2d at 5. “A cci dental bo d il y i nj ury” ref

ers to an unforeseen

or unexpected bodil y i nj ury. See Yates v. Bankers Li fe& Casualty Co. , 415 Ill . 16, 19 (19 53); Carney v. Paul Revere Life Insurance Co. , 359 Ill . App. 3d 67, 8 2 (200 5).-11- The po licy o t he rwis e limi ts pl ai nti f f to a f i ve -y ea r b en ef i t pe riod f or adi sab i l i

ty re sul tin g f rom a “s i ckn ess .” The p oli cy

i n cl ud es i n i ts de f i ni ti on of “s ic kness ” four types of

in juri es. Al thoug hth e pun ctu ati on use d in an in su

ra n ce con tra ct c an n ot b e m an i pul ate d to al ter t he plain meaning of the text, rules of gramm ar may be consul ted to ill umi ne the true mean

in g of the language use d. See Continental National America Insurance Co. v. Aetna Life & Cas ualty Co. , 186 I ll. App. 3d 891, 897 (1989); 2 Couch on Insuran ce 3d §22:5 (2005 ). I n t his c as e, t he ab se nc e o f co mmas in t he policy

li mi tation in dic ates
a seri es of restri ctivec lause s t hat ident ify or define t he ant ece dent
no un –i nju ry. See W . Strunk & E. W hi te, The El em en ts of S tyl e 3-4 (3ded. 1979) (d iscuss ing re st rict iveand n onrestrictiv

e cl auses). Thus the policy l i m i tation can b e separated as f

oll ows: (1) an in

jury whi ch is a d ire ct o rind ire ct r es ult o f ph ysic al o r ment al in fi rmi ty; (2) an i nj ury wh i ch i s a di re ct o r indire ct re sult of illness, o r d isease of a ny kin d; (3) an i

nj ury wh ic hi s a di rec t or i nd i rect res ul t of medi cal or s ur gic al treat me nt therefor; or (4) an i

nj ury wh ic h resul ts in to tal di sa b i l i ty wh ich co mmen ces mor e t han 90 days a fte r t he da t e t he i nj ury is sustain ed will be deemed to be “sickness.” By deem in g these four types of i nj ury as si ckness, the policy

ex clu de s t he m fro m lifet ime b en ef i ts for an “ accidental

bodil y i nj ury,” b ut ra t her lim

its t hem to five years of b enef i ts f or asickne ss. This co nst ru ct ion is co nsist ent wit h a natural r ea di ng o f t he po licy, gr ammar, and t he na ture of thi s ty peof po licy. Pla int iff as si gn s error to t

he app el la

te court ’s concl

usi on that defend ant pr op er ly admini st er ed his c laim as a “sickne ss” u nder t he t er ms of the poli

cy . P l ai n ti f f con ten dsth at h

i s “ex pos ur e to staphy lococcal ba ct er ia is a compensabl

e accidental

injury unde r t he Pol i cy .” However, plai

ntif f’ s contention i

gnores the poli

cy ’s two coverage l i

m i tations. F i rst, rega rdi ng th e 90-d ay peri od between

i nj ury and dis abi

li ty, pl aint if

f’ s characteri

zation of the May

18, 1999, i nf ec ti on as an “ injury” do es no t nega t e t he ca usa t ive effect of t he Jan uary 19, 1999, acciden

t. Seco nd, even view ingthe May 18, 1999, i nf ec ti on in isolation, plain

tiff ’s alleged “n

ew in jury ” is n onetheless pr o pe r ly li mi ted to coverage as a “sicknes s” u nder t he po licy as being t he r es ult o f illnes s o rdis ea se o rmed ica l o rsu r gic al t re at ment there f or.-12- A. “More Than 90 Days” The appe llat e court held that defe ndan t pro perly

adm in is tered plain tiff ’s cl ai m a s a “s ic

kness ” under th e pol

i cy ’s90-da

y i nj ury l i m i tation period. Af

ter reviewing the re cord, the appe l l ate court concl uded that t he ci

rcu it cour t ignored the uncontested evi dence, whi ch com pel l ed a f i ndi ng “ that pl ai ntif f ’si nj ury fell s qu ar ely

wit hin the policy ’s def

in ition of a si

ckness .” We agree. The undi sputed eviden ce demo nst r at es t ha t pla int iff inju r ed his wrist o n Ja nu ar y 19 , 19 99

. Alt ho ug h p laint iff su st ain ed t he inju ry in Jan uary 1999, he did n

ot becom e tot al ly dis abl ed until May 18, 1999,
more t han 90 days a fte r he sus t aine d t he in jury. The poli

cy defi nes “TotalDisa

b i l i ty ” a s th e “ com pl ete i n ab i l i ty of th e In su re d d ue to Inj ury o r Sickness to perform a ny and ev ery duty pertaini ng to an
occupa ti on *** f or rem une rati on or pro fi

t.” The date o f “Tot al Dis ab ilit y” is an unc ont est ed fac t sup po rt ed bythe record. It was also undi spu ted tha

t plai nti f f ’s di sa bi l i ty aros e f rom the sta ph i nf ec ti on in curredfrom

the May 18, 1999, surgery, f

our months af

ter his in itial i njury at w ork on

Ja nu ar y 19 , 19 99

. Mo r eo ve r , pla int iff himse lf fi rst provided t he Ma y 18 , 19 99 , da t e o f dis ab ilit y in his i n i ti al di sa b i l i ty cla im n oti ce to defen dant. He descri

bed h is “i nj ury” as a t or n ligament in hi s right wrist, incurred on January 19, 1999, and st ated that he becam e tot al ly dis abl ed on May

18, 19 99 , be ca us e o f an infe ct io n in his wrist foll

owing a n operation. Pla

in tif f then submitt ed a n at t ending phy si ci an statement, verifi

ed by Dr . Sc hen

ck, which also confi

rmed that his em

ploy me nt activ ities were f

irst restricted

on May 18, 1999. Subsequ ent to his r et en t io n o f co un se l, pla int iff ha s s t ea dfa st ly
con te nded that t he May

18, 1999, inf

ection was a

“n ew” a n d in dep e ndent inju ry. I f we we r e t o ac ce pt pla int iff’s co nt en t io n, his di sa b i l i ty w oul d axio matica lly

oc cur wit hin the 9 0- day limi t at ions pe riod be twe en i njury an d di sa bi l i ty . How ever, weca

nn ot acceptt his
con ten ti on because it ignores the causati

ve ef fect of the J

anuary 19, 19 99 , a cc i den

t. The co nt ro lli

ng prin ci ple s are widel

y recogni zed. The sec onda ry re su l ts of an ac ci de nt d o not b rea k the c au sa

l con ne cti on th ere to. “Ac co r di ng ly, the f

act tha t an i ns ured i ncurs an i nf ection or disease follow ingan acci

dent does not b

rea k the th rea d of cau sat ion fro m the
acc ident to the ulti

ma te result where such

in fect ion o r d isease is the
r es ult of the accident.” 10 Couch

on Insuranc e 3d §139:30, at 139–68-13- through 13 9– 69 (1 99 8) . I n o t her wo rd s: “I f *** t he in sured has recei ved an in jury covered by

the contract whi

ch h as necess itated an ope ra ti on, t he pe r fo r man ce o f t he o pe r at io n d o es no t , in it se lf , con sti tute an i n de pen den t, inter vening ca use nor pr event t he ac cident f rom rem ai ni ng th e proxi mate ca use of death [or di sab i l i

ty]. ” 1B J. Appl em an & J. Appl em an, Insuran

ce Law & Practice §412, at175-76 (1981 ). Fur

ther:

“ Disa b i l i ty or dea t h re sult ing fro m the med ical tr eat ment of a covered acci

dental in jury is regarded as hav

in g been
cause d by su ch inju ry and co mpe nsa ble un de rt he ac cid en t po licy, if the treatment admi

ni stered was neces sary

or pro per because of i

nj ury. W hether a particul ar surgica l act performed is o ne wh ich co uld be co nsid e red an ac ci de nt, i n l i gh t of subs equ ent de ve lo pme nt s, is somethi ng wh ic h usu ally m ust be determi ned under the f

acts of ea ch dif

ferent case.” 1B J. Appl em an & J. Appl em an, Insuran

ce Law & Practice §414, at 181 (1 981). In ot her words, where an a cci dental in jury le ads to medica l
com pl i ca ti on s, wh i ch i n tur n l ead to th

e c ov er ed l oss , the “ ac ci

den t” i s t he eve nt t hat cau sed t he o riginal injury–t he “ac cident ” is no t t he de ve lo pment of m

edi cal com pli cations. Ju rr

ens v . H ar tfo rd Li fe Insurance

Co. , 19 0 F

. 3d 91 9, 92 3 ( 8t h C ir. 19 99 ) ( ap ply ing Sou th Dakota l aw). Applying these pri nci ple s to t he presen

t case, t her e is no genu ine factual is sue re gar ding t he ca usa t iveeff ect of plai ntif f’ s Jan uary 1999 inju ry. It c an

n ot go u n n oti ce d th

at def en da n t r epeat edl

y a dvi sed pla int iff t hat t her e wa s no t hingde fen da nt co uld do un de r t he t er ms of t he policy to al ter i ts b en ef i t de term i na ti on ba se d o n t he len gt h o f t ime report ed betwe en t he da t e o f his injur y, Janu ar y 19, 199 9, and t he onsetof his tot al

dis abi li ty, May 18, 1999. Def

endan t r ep ea t ed ly advi sed pla in tif f, through h i s c ounse l , that to be

con si de red el i gi bl e f or lifet ime bene fi ts under the poli cy , plai ntif f would need to provide doc um en tation to supporta fi

ndi ng that he b ecam

e di sabl ed wi thin 90 da ys of h i s i n j ur y . D ef en da n t also s pe ci f i ca l l y aske d p l ai

n ti f f to conf i rm whether the da te of dis abi li ty that plai

ntif f provi ded o n his cla im fo r m, May 18, 199 9, was

i n f act the corre ct date th at h

i s d i sa b i l i ty
comm enced. Plaint iff

did no t –and co uld no t –pr ovid e any proof t o t he
co nt r ar y.-14- Indeed, p laint if

f’ s own m

edi cal expert, Dr. Coe, cl early

negates plain tiff ’s co nt ent ion. Throughout hi s c om pre he ns i ve rep ort, D r. C oe ref ers o nly t o o ne inju ry–p laint iff’s wr is t inj ur y i ncurred i n a work
acc ident on J anua ry 19 , 1 999 . Ac co rd ingto Dr. Coe , f rom t ha t sing le i nj ury f l owe d p l ai

n ti f f ’s re su l ti n g sy m ptom s a n d tr ea tmen t t he re o f, whi ch inclu de d s ur ge ry, and t he d eve lo pme nt o f t he infect ion and pl ai ntif f ’sdi sab i l i ty. Dr. Co e sp ecifically conclud ed t hat t her e wa s “a causal r ela t io nsh ip b et we en t he inju ry s uf f ered b y Mr. Ri ch at work f or H&W Mo t or Exp re ss o n Janu ar y 19, 199 9, and his c ur re nt symp t o ms an

d s tate of impairment .” Plaint iff

canno t make t he da

te of di sa b i l i ty ea rl i er, an d h i s a ttem pt to m ake the d ateof

in jur y l ater
ca nn ot succ ee d b as ed

on thi s rec ord. See, e.g. , Jurrens , 190 F.3d at 922-2 3 (a ff

irming summary judg ment fo r d efenda nt insure r a nd
re ject ingpla int if

f’ s co nt ent ion t hat infect ion r esu lting fro m accide nt was i tself accident that came wi

thin policy lim itat ions p er iod , no t ing that plai ntif f’ s own expert witnes s i dentif

ie d in itial accident as cause of i nj ury ).

B. I l l ne ss , Dise as e, or

Tre atm en t Th ere f or Furth er, even if pla i nt iff co uld amend t he da t es o f inj ur y and di sa b i l i ty so as t o co me w it hin t he 90

- da y limita t io ns p er io d, his cla im f orli feti me ben efi ts fai l s nonet heless. We conclude t hat plaintiff ’s cla im for lif etim e ben efi ts fai ls because hi s alle g ed new

and indepe ndent in

jury , occurring on May

18, 199 9, fell within the policy excl us i on fo rinju ry re su lt ing fr o m illnes s o rdis ea se , o rmed ic al or surg i cal treatm en t theref or. The appe ll

ate cou rt held that p lai

ntiff ’s al le ged “n

ewin jury ” was not an “a cci den tal ” i nj ury t hat was co gnizable by

the policy ’s gen

eral gr ant of coverage. Acc ordingl y the appella te cour t did n ot consider whether the inj ury was excl

uded as a direct o r indi

rect r esu l t of infir mit y, il

ln ess, or diseas e, or medi cal or surgical

treatm en t theref or. Assigning err

or to thi s r ea son

i ng , pl ai nti f f con tends t ha

t in j ury re sult ingfrom

surgery c an consti

tut e an “ accident” under Il li nois la w. Considered

in isolation, plaintif

f’sconten tion i s un rem arkabl e. In Christ v. Pacific Mutual Lif

e Insurance Co. , 31 2 I ll. 5 25 ( 19 24 ) , t his courtrev i ew ed the de f i ni ti ons an d a ppl i ca ti ons of t he ter m “ ac ci den t” in in surance cases, an d adopted t he v

ie w of the Uni

ted St at es Su pr eme-15- Courtin United Sta tes Mutual Accident A ss’n v. Ba rry , 131 U.S. 100, 33 L. Ed. 60, 9 S. Ct. 755 (1 889). Under the rule adopt ed in Ill in ois: “[I] f an ac t is per for med wit h t he inte nt ion o f acco mplishing
a cer t ain res ult , a nd

if, in th e a ttem pt to a cc om pl i sh th at res ul t, another re sult , u nintend ed a nd une xp ected, and no t t he rational and p ro bable co nseq uenc e o f the i n ten de d act, i n f ac t,
occur s, such

un i nte nd ed res ul t i s deemed

to be ca use d by accidental me ans.” Yates , 415 Ill . at 19. In Christ , t he in

sured comm

itted an i ntentiona l act of drin

kin g water f rom a fauc et . H ow ever , be cau se o f an unk now n defec t in the va lve
o f the water pipes, h

e drank poll

uted water and contract ed t y ph oi d fev er , from wh ich he died . T his co ur t dee med t he unfo re see n and
unex pectedoccurren ce in the a ct pr ece ding t he injury t o r ende r t he i nj ury “acc ide n tal.” Yates , 415 Ill . at 20 (discussi ng Christ). See Carney , 359 Ill . App. 3d at 82 ( finding insure d’s injur y to be “acci dental bo dily inju ry” u nd er t er ms of di sab i l i ty i ns uran ce pol i cy ). In the prese nt ca se, Christ appe ar s co nclusive o n t his po int and in dic ates t hat pla int iff

in curred “acci

dental bodil y i nj ury.” See Reid v. Aetna Life Insurance Co. , 44 0 F. Supp. 1182, 1183 (S. D. Ill . 1977) (a pplyingI ll i

noi s law), aff ’d without op. , 588 F .2d 835 (7th C i r. 19 78)

. A cc ordi

n gl y , pl ai n ti f f wou l d b e en ti tl ed to li f eti me d i sa b i l i ty b en ef i ts absen t any li mi tations or excl

usi ons i n the poli cy . Indeed , re ading t he po licy a s a wh o le, t he ex clu sio n w o uld be superf luous if it lim ited loss es w hich the po licy’s gene r al in su ri ng cl au se di d n ot
cove r. “A n excl us i oni n a n i ns ura nc e p ol i cy

serv esthe

pur pos e of t aking ou t per so ns o r e vent s o t he rwis e incl uded wi thin the defi ned scope of coverage.” General Insurance Co. of

Amer ica v . Rober t B. McManus, Inc. , 272 Il

l . Ap p. 3d 51 0, 514 ( 1995) ; accord Hammer v. Lumbe rman ’s M

utual Casualty Co. , 214 Conn. 573, 588-89, 573 A.2d 699 , 7 06 ( 199 0) (c ollect ing aut hor ities) . T her efo re , t he is sue is whether ornot th e i njury f al l s wi thi n th e p ol i cy excl us i on f ori l l ne ss or dis ease, or medical

or surgical

trea tm en t therefor. See Litman v. Monumental

Life Insurance Co. , 289 Il l . Ap p. 3d 18 1, 184 ( 1 9 97) (ide nt ify ing di sp osi ti v e iss ue as wh eth er i n su re d’ s dea th occurred as r es ult of med i ca l tre atm en t, for whi ch acci dental death poli cy excl uded
cove rage) ; Reid, 440 F. Supp. at 1183 (sam e). The Christ

and Carney
ca se s, up on

wh i ch pl ai n ti f f re l i es , a rei n appos i te because

they do not-16- involve a pl ai

ntif f’ s i nj ury that resul

ted from m

edi cal or surgical tre atm en t. Viewing the May

18, 1999, staph in

fect ion a s a new a nd indepe ndent in

jury , there can be no cr edible disp ut e t hat t he in jury was t he re sult of su rg ical tr eat ment. Acco rd ingly, unde r t he t er ms of t he pol icy, we m

ust deem the i

nj ury to be a si

ckness , and concl

ude t ha t defend ant co rr ec t ly ad minist er ed pla int iff’s cla im as su ch

. T his r es ult is mad e c lea rsimp ly by r eading the po licy exclusion in light o f the undi sputedfact s, inse rt ed w ith br ack et s: “I nju r y [ May 18, 1999, infect ion] whi

ch is a di r ec t o rind ir ec t r es ul t o f p hys ica l * ** infir mit y, il ln ess, or dise as e of

any kind [ t ear of t he r ight sca pho lunat e ligament wi th s egmen

tal i ns tab i l i ty], or m edi cal orsur gical t re at ment the ref or [t he May 18, 1999, wrist sur ger y] ** * will bedeem ed to be Si ckn ess .” Acco rd ingt o t he po licy, an insu r ed wh o su st ain s “a cc ide nt al b o dily inju ry” while the po licy i s i n f orc e is e n ti tl ed to li f eti me d i sa b i l i ty benef its. As a court construed a si

m i l ar poli cy : “ Anaccident is

an unint ende d o ccu rr ence . I f such ha ppe ns du r ing med ica l t r ea t men t , it is st ill an ac cident , bu t it is no t a r is k assum ed by the in surance co mpany under the terms of

the poli cy .” Wh et se ll v. Mu tu al

Li fe Insurance

Co. of New York

, 669 F.2d 955, 957 (4t h Ci r. 1982) (a pplyingSo ut h Caro li

na law); a ccord Dinkow itz v. Prudential Insurance

Co. of America , 90 N.J. Super. 181, 188- 89, 216 A.2d 613, 618 (L aw Di

v. 19 66). Po inting t o t he sp ec ific lang ua ge o f t he p o licy limita t io n, pla int iff argues t ha t t he po li cy

do es no t co nsider injury fro m surg er y for a ny rea son t o be a “sickne ss. ” Acc or ding to plai ntif f: “B y simply omit t ing th e ter m ‘t he r efo r ’ a ft er ‘me dic al o rsu r gic al t r ea t men t ’ t his c o uld have be en ac com pl i sh ed . De f en da nt c an not be correc t tha

t In j ury f rom surg ery for any

reason i s de eme d a Sic kness because that i nte rpreta ti on r en de r s ‘ t he r efo r ’ me an ing les s. ” T his a r gu men t is
unavaili ng. The po licy exclusion a t issue in Din kow itz was su b sta n ti ally simila rt o t he limit at io n in t his c as e: “N o su ch be ne fit sha ll be p aya ble if su ch d ea t h r es ult s * ** dir ec t ly or indir ec t ly fr o m bo dil y o rmen t al inf

irmit y o rdis ea se in a ny fo r m, o r med ic al o r surgic al tre atm en t therefor .” (Em

phasi s ad ded.) Dinkow

itz , 90 N. J. Super

. at 183, 216 A.2d at 614 . T he co ur t in Dinkow itz enfo rc ed t he coverage excl

usi on in accord with the m

aj ority rul e.-17- Indeed, “[i

]t appears that every court that has consi dered si mi la r ex clu sionary

cl auses h

as hel d such provi si ons to exclude f ro m coverage de at h [ o rdis ab ili ty] cause d by var iou s mishaps o ccu rr ing dur ingthe

cou rs e of m edi cal treat me nt.” Whets ell , 669 F.2d at 956 n.1 (collectin

g cases); s ee Lit

m an , 289 Ill . App. 3d at 184-87 (discu ssing cases ); Hammer , 214 Conn. at 589-91, 573 A.2d at 707 (c ollect ingc ases) ; Pitman v. Com mercial Travell ers’ Eastern Accident A ss’n , 28 4 Mass. 467, 470, 188 N.E. 241, 243 ( 1930) (finding t hat dea t h of insur ed fr om t et anus infect ion d ur ingsurg ery fell wit hin ex ce pti on to ac ci de nt p ol i cy

f or s urg i cal

ope rati on or me dic al treatm en t); J . Z i tt er, A

nn otation , What Constitutes Medical or Surgical T r eatment, or the Like, Within Exclusionary Clause of Acciden tPolicy or Accidental-Death Feature of Lif e Policy , 56 A .L .R .5t h 471 (1998). Plai

ntif f poi nts to no case that has hel

d me dic al mishaps to be co vered under such excl usions. Pla int iff in sist s t hat ou r c onc lusion is inco nsist ent wit h t he
reas onab l e ex

pectati ons of an i ns ured. H owev er: “The p ar t ies t o a n insura nce c ont ra ct may incor po ra t e in i t such pro vi sions, no t in vio lat io n o f law , as t he y cho o se ; a nd it is the dut y of t he court s to co nstrue and en force the contract
as ma de . W e a

re n ot wa rra nte d, u nd er th e c l oak of
co nst ru ct ion, i

n mak i n g a n ew con tra ct f or th e part i es.” Pioneer Life Insurance , 374 Il l . at 590 (c oll

ecti ng c ase s). Rea ding t he po licy as a wh ol e, th e a ve rag e p ol i cy

hol de r cou l d n ot
r ea so na bly

re ach a c on cl us i on of cov erag e i n th es e particul

ar ci rcumstances in ligh t o f t he po licy limit at io n. Ap ply in g pl aintif f’s
con ten ti on wo uld r ende r t he po licy l imi t at ion meaning l ess, and read i n to t he in surance contract somethi

ng that is not t here. See Hammer , 214 Conn. at 591, 573 A.2d at 707. We f urth er ob ser ve tha

t plai nti f f ca nn ot cl ai m su rpr i se or unfai rness by our holdi ng. The i nsuran ce appl ic ation i tself shows that pla int iff wasqui te awa re , du ring t he ap plicat ion p ro ces s, t hat t he policy would l im it ben ef i ts t o five year s for a sick ness a s de fined by t he po licy. Fur t her , w hen de fendant acc ept ed t he ap plicat ion and t he in surance co nt ra ct wa s fo rme d, t he p o licy affo rd ed pla int iff a 10-day “f ree l ook”pe r io d, du r ing wh ich t ime h e c oul d c an ce l th e p oli cy

i f i ts t er ms and condi

tions were un

acceptable. Ho we ve r , pla int iff no t o nly-18- chose t o p ur chas e and kee p t he policy , but re ce i v ed di sa b i l i ty b en ef i ts fo rfive yea r s, pu r su an t t o t he po licy. The re bei ng no gen uin e i ssue of ma terial fact, we concl

ude that defend ant is

entitled to a judgm

ent as a m atter of law base d

on ei ther of the two above-discus sed poli cy limit at io ns. Ac co r din gly, we ho ld that t he ap pe llat e c o ur t pr o pe r ly en t er ed su mmar y jud gme nt in f av or of de f en da n t.

III. CONCLUSION Fo r t he fo re go ing re aso ns, t he judg ment of t he ap pe llat e c o ur t is aff irm ed.
Aff irmed.