Court Opinion

ID: 9736021
Source: CourtListenerOpinion
Date Created: 2023-08-26 18:40:18.240441+00
Date Added: 2024-06-11T18:27:03.389003
License: Public Domain

BURKE, J., dissenting: The rule is well established that where provisions of an insurance policy are inconsistent or ambiguous, they are to be construed liberally in favor of the insured. This rule does not authorize “a perversion of language or the exercise of inventive powers for the purpose of creating an ambiguity where none exists.” Maryland Cas. Co. v. Holmsgaard, 10 Ill App2d 1, 10, 133 NE2d 910; Zitnik v. Burik, 395 Ill 182, 187, 69 NE2d 888. The provisions of the policy are to be construed together. All the provisions of the policy contain limits. The “daily hospital indemnity” provision is limited to 30 days at $6 per day, and 90 additional days of hospital confinement at $3 per day. The “surgical” rider lists over 70 types of operations and states a fixed amount of the indemnity for each. In insurance policies, as in other contracts, the benefits depend upon the terms and the premiums paid. Health and accident policies are issued at different premiums with correspondingly varying benefits. For example, the policy sued upon in Count II contains a provision to pay certain expenses incurred during hospitalization but “not to exceed in the aggregate the Maximum Miscellaneous Hospital Expense Accident or Sickness stated in the Schedule . . .” which is $100. That policy was issued in 1959 for an annual premium of $68.60 as compared to the policy in Count I which was issued in 1948 for an annual premium of $20.40. The language in the policy clearly informs the insured of the benefits he can expect and defines the risk undertaken by the insurer. The clause which plaintiff claims entitles him to unlimited payments during a stay in a hospital provides in clear and unambiguous language for payment of certain hospital expenses up to an aggregate amount of four times the daily hospital rate as specified in the policy. When read in an ordinary and reasonable fashion, the provision contains a list of items payable, the last of which is ambulance service. To say that the limitation of “four times the daily hospital indemnity” applies only to one item ignores the words “in the aggregate.” The word “aggregate” according to Webster’s New International Dictionary, means “a mass, assemblage, or snm of particulars”; and also “formed by a collection of particulars into a mass or sum . . . .” Tbe phrase “in the aggregate” is defined as “collectively; together.” See also Chapin v. Wilcox, 114 Cal 498, 46 P 457, 458; In re Curley’s Will, 272 NYS 489; In re Miller’s Estate, 168 A 807, (Pa Superior). Unless the limitation applies to expenses incurred for all of the items listed, the words “in the aggregate” would be rendered meaningless. It is a basic rule of construction of contracts that effect and meaning be given to every word, clause and term employed by the parties. Belanger v. Seay & Thomas, Inc., 28 Ill App2d 266, 271, 171 NE2d 418; Konrad v. Hartford Accident & Indemnity Co., 11 Ill App2d 503, 526, 137 NE2d 855. The trial judge was right in deciding that the insurer satisfied its obligation by paying four times the daily hospital indemnity for each of plaintiff’s confinements. The judgment is consistent with the other benefits of the policy which have a maximum limit and with the modest premium charged. The judgment should be affirmed.