Daily Kennebec journal. [microfilm reel] (Augusta, Me.) 1870-1975, 1904-12-20

cupation, profession or other re-
rnunerative employment" and that
such Il disability entities him
to the indemnity promised, although
not such as 10 require absolute and
necessary confinement 10 the house"
II is furthermore insisted that there is
no case Of iritis which in any degree
Of severity or at any stage of its pro-
"ress requires absolute and necessary
confinement; to the house" and that if
this requirement in the policy is to be
construed as 4 condition precedent to
the right of recovery the promise OF
Indemnity for that disease upon such
Il condition would be entirely nugatory
and .lolusive
ii must be admitted that if confine-
.nent to the house would not be proper
treatment Cor any case OF iritis, the
two clauses in the policy providing an
indemnity for that disease, and at the
same time imposing Il condition of alb
solute confinement to the house. would
be mutually destructive and render the
contract amendaDle to the plaintiffs
criticism.
When. the proposition set up by the
plaintiff, that there is no case of iritis
requiring absolute confinement to the
house, is examined in the light of the
positive testimony and subjected to the
Test of sound reason it cannot be re-
@arded as established by the evidence
in this case. But 1t is conceded, tina,
the plaintiffs case was rot such as to
require absolute confinement to the
house. and he appears to have made :,
vision of the policy must therefore be
accepted as 4 valid one.
An examination Of the several
clauses relating 10 Indemnity for sick
ness in comparison with all the other
provisions of the policy, leaves no room
for doubt that absolute and necessary
confinement to the house" was intend
cd to be a conclusive test of liability.
and not merely an evidentiary fact
bearing upon the. question of sickness.
The second condition in the same
clause has significance mon this ques-
ton. viz: "TnlcsS the period of total
diSa biity under the health provisions
shall continue for four or more weeks.
no claim shall be allowed for the first
seven days disability" SO in regard
to 'Convalescent indemnify" IF the
insured has been confined to the house
FOR seven consecutive days and there
after permitted to leave the house by
the physician in charge" one-haf OF
The indemnity is recoverable. These
several conditions recognize the fact
that the neral hazard is undoubtedly
much greater III health insurance than
in accident insurance. for the obvious
reason that in a large proportion of
cases of disease the symptoms are only
subjective. while in cases of accident
the evidence is more commonly object
i've. They recognize the fact that with
Hnguarded health policies, slight i'll
nesses may tempt the Insured to seek
relaxation from ordinary labor at the
expense of the company In order
therefore that the premium rates may
not be so high as to to be essentially
prohibitive. and as a matter of justice
to all of the policy holders, mutual
association is compelled to safeguard
its health policies aSaiSt the danger
of all such malinGering by making the
contract expressly subject to certain
absolute requirements and conditions.
The defendant cOmpany had 4 right to
frame its health policy upon the as
sumption that confinement to the house
would be found so tedious and irk-
some that few would submit 10 it ex-
cept under compu'sinn Of a severe i'll
ness. 1t had right to make absolute
and necessary confinement to the |
house" conclusive test of the disa-
bility, and a condition precedent to the |
right Of recovery. 1t has inserted this |
condition in the contract in plain and |
unambiguous language. and it is not |
suggested that any principle of public |
policy is thereby contravened. To hold |
that this requirement is not a condi- |
ton precedent is to defeat the obvious |
intention disclosed by the terms en- |
rloyed. and to substitute for the plain !
tiff's policy contract not made by the |
parties.
II is accordingly the opinion of the |
court that the entry must be,
Judgment for the defendant
Reed, Dec. 18th 1904.