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GALVIN v. OCCIDENTAL LIFE INSURANCE COMPANY CALIFORNIA (06/17/65)

decided: June 17, 1965.

GALVIN, APPELLANT,
v.
OCCIDENTAL LIFE INSURANCE COMPANY OF CALIFORNIA



Appeal from judgment of Court of Common Pleas of Allegheny County, July T., 1960-C, No. 359, in case of Anna Marie Galvin v. Occidental Life Insurance Company of California.

COUNSEL

Herbert M. Lurie, with him Stokes, Lurie & Tracy, for appellant.

John H. Scott, Jr., with him Reed, Smith, Shaw & McClay, for appellee.

Ervin, P. J., Wright, Watkins, Montgomery, Jacobs, and Hoffman, JJ. (Flood, J., absent). Opinion by Montgomery, J. Dissenting Opinion by Hoffman, J. Jacobs, J., joins in this dissenting opinion.

Author: Montgomery

[ 206 Pa. Super. Page 63]

Plaintiff-appellant's husband was killed in the course of his employment in the milk industry of the Greater Pittsburgh area. He had been a member of the Milk and Ice Cream Salesmen, Drivers, and Dairy Employees Local No. 205, and was qualified for insurance coverage under a policy of group insurance dated October 18, 1954, issued by the Occidental Life Insurance Company of California, defendant-appellee, to The Trustees of the Greater Pittsburgh Dairy Industry. The policy provided several coverages: (a) ordinary life insurance, (b) accidental death and dismemberment insurance, (c) disability due to pregnancy, and (d) disability due to accident and sickness other than pregnancy.

Following her husband's death appellant made claim for benefits payable under the ordinary life coverage and received same in the sum of $5,000. She made a further claim for an additional $5,000 under the accidental death and dismemberment coverage, but payment of this was refused by the appellee. Suit was thereupon entered for the collection of this additional amount and proceeded to trial before judge and jury. After taking testimony the lower court dismissed the jury and as a matter of law rendered judgment for the defendant, basing the judgment on its interpretation of the policy. This appeal followed.

[ 206 Pa. Super. Page 64]

In refusing payment defendant relies on paragraph thirteen of the policy which reads as follows: "13. General Limitations. Unless exceptions to the following General Limitations are made under the Insurance Schedule Provisions, the policy does not insure and no benefits shall be payable for or on account of: (1) any bodily injury or sickness for which the person on whom claim is presented is not under the regular care of a licensed physician and surgeon; (2) dental services of any kind; (3) eye refractions; (4) any bodily injury or sickness for which the person on whom claim is presented has or had a right to compensation under any Workmen's Compensation or Occupational Disease law; (5) any bodily injury which arises from or is sustained in the course of any occupation or employment for compensation, profit, or gain."

These general limitations were specifically excepted from ordinary life coverage but not from the other coverages. It is defendant's contention that they are applicable to all coverages except that of ordinary life insurance.

In construing the policy it must be read in its entirety and the intention of the parties gathered from a consideration of the entire instrument. Smith v. Cassida, 403 Pa. 404, 169 A.2d 539 (1961), and it must be construed in a way as to give effect to all of its provisions. Quigley v. Western and Southern Life Insurance Company, 136 Pa. Superior Ct. 27, 7 A.2d 70 (1939).

The policy was issued on an application, made part of the contract, which provided that the "Accidental Death and Dismemberment for Individuals only" was "Non-Occupational only." Considering the application alone, it would seem reasonable to conclude that the general limitations were applicable to the accidental death and dismemberment ...


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