{
  "id": 2537809,
  "name": "J. Joseph Daly, et al., Plaintiffs-Appellants, v. Golden Rule Life Insurance Company, an Illinois Corporation, Defendant-Appellee",
  "name_abbreviation": "Daly v. Golden Rule Life Insurance",
  "decision_date": "1968-04-24",
  "docket_number": "Gen. No. 52,216",
  "first_page": "138",
  "last_page": "142",
  "citations": [
    {
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      "cite": "95 Ill. App. 2d 138"
    }
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  "court": {
    "name_abbreviation": "Ill. App. Ct.",
    "id": 8837,
    "name": "Illinois Appellate Court"
  },
  "jurisdiction": {
    "id": 29,
    "name_long": "Illinois",
    "name": "Ill."
  },
  "cites_to": [
    {
      "cite": "148 NE2d 9",
      "category": "reporters:state_regional",
      "reporter": "N.E.2d",
      "opinion_index": 0
    },
    {
      "cite": "16 Ill App2d 159",
      "category": "reporters:state",
      "reporter": "Ill. App. 2d",
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      "case_paths": [
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    {
      "cite": "197 NE2d 153",
      "category": "reporters:state_regional",
      "reporter": "N.E.2d",
      "opinion_index": 0
    },
    {
      "cite": "46 Ill App2d 413",
      "category": "reporters:state",
      "reporter": "Ill. App. 2d",
      "case_ids": [
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      ],
      "opinion_index": 0,
      "case_paths": [
        "/ill-app-2d/46/0413-01"
      ]
    },
    {
      "cite": "218 NE2d 225",
      "category": "reporters:state_regional",
      "reporter": "N.E.2d",
      "opinion_index": 0
    },
    {
      "cite": "72 Ill App2d 267",
      "category": "reporters:state",
      "reporter": "Ill. App. 2d",
      "case_ids": [
        2585091
      ],
      "opinion_index": 0,
      "case_paths": [
        "/ill-app-2d/72/0267-01"
      ]
    }
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  "analysis": {
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  "last_updated": "2023-07-14T16:15:57.800656+00:00",
  "provenance": {
    "date_added": "2019-08-29",
    "source": "Harvard",
    "batch": "2018"
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  "casebody": {
    "judges": [],
    "parties": [
      "J. Joseph Daly, et al., Plaintiffs-Appellants, v. Golden Rule Life Insurance Company, an Illinois Corporation, Defendant-Appellee."
    ],
    "opinions": [
      {
        "text": "MR. JUSTICE DRUCKER\ndelivered the opinion of the court.\nPlaintiffs appeal from a summary judgment in favor of defendant in their suit under a contract of insurance for expenses of $300 incurred in a Caesarean delivery. The sole issue raised on this appeal is whether the insurance contract, fairly construed, provided compensation for these expenses which were incurred after the policy\u2019s termination.\nPlaintiffs\u2019 complaint alleged that plaintiff Kathleen A. Daly had become pregnant in May of 1965 when the insurance policy was in effect, and that a Caesarean delivery was performed on February 11, 1966. Defendant\u2019s answer admitted the facts but denied liability asserting that plaintiffs\u2019 policy was a group policy; that it contained a provision stating that the company could refuse to renew if renewal was refused to all policies held by members of the group; that the employer of the group members had instituted a new insurance plan because of which a majority of the members of the group had terminated their coverage with defendant and that defendant had exercised its option to refuse to renew the remaining policies on or before October 31, 1965. Plaintiffs\u2019 reply to these defenses contested defendant\u2019s construction of the insurance policy.\nPlaintiff does not question the right of the defendant to terminate the policy under the circumstances recited in the answer and defendant\u2019s motion for summary judgment. The only question on appeal is \u2014 does this insurance policy provide coverage for expenses incurred in a pregnancy after the termination of the policy where conception took place while the policy was still in force? The policy provides initially that defendant:\nHEREBY INSURES the person listed on line 1 of the Family Group Schedule (herein called the Insured) against loss occurring while this Policy is in force for which a specific sum is specified in the Schedule of Benefits, which loss is incurred by the Insured and the eligible members of the Insured\u2019s family, if any, named in the Family Group Schedule below (all of whom, including the Insured, are hereafter called the Family Group and shall individually be called a \u201cCovered Person\u201d), resulting from accidental bodily injuries sustained while this Policy is in force (hereinafter referred to as \u201csuch injuries\u201d), or caused by illness which is contracted while this Policy is in force (hereinafter referred to as \u201csuch illness\u201d), in the manner and to the extent herein provided. (Emphasis ours.)\nPlaintiffs assert that the Caesarean operation was caused by an illness contracted while the policy was in force. Since pregnancy benefits are included in the Schedule of Benefits, \u201cillness\u201d covers pregnancy. Plaintiffs, however, contend that it is a sufficient precondition to recovery that the loss be a result of an illness contracted while the policy was in force. It is apparent that the clause \u201cor caused by illness which is contracted while this Policy is in force\u201d qualifies the clause \u201cagainst loss occurring while this Policy is in force.\u201d We believe that these clauses read together require both that the loss occur and that the illness be contracted while the policy is in force.\nPlaintiffs also argue that the section entitled \u201cPregnancy Benefit\u201d should be treated as a separate matter. However, this section appears under the general heading \u201cSchedule of Benefits\u201d and is not an assumption of liability separate from the insuring clause heretofore discussed.\nPlaintiffs\u2019 next contention is that a paragraph appearing in a section of the policy entitled \u201cExceptions And Reductions\u201d actually expands the coverage of expenses resulting from pregnancy. The paragraph reads:\nThe Policy shall cover Pregnancy, childbirth, miscarriage or complications arising therefrom only under the Pregnancy Benefit and only in respect to the Member or the Member\u2019s spouse, and provided the loss occurs 9 months after the effective date of coverage of the Member or spouse for whom claim is made. There shall be no coverage under the policy for loss resulting from pregnancy, childbirth, miscarriage or complications arising therefrom in respect to any Member or such Member\u2019s spouse unless the Family Premium, has been paid in respect to the Member and the Member\u2019s dependents for a period of 9 consecutive months prior to the occurrence of such loss.\nPlaintiffs interpret the clause \u201cprovided the loss occurs 9 months after the effective date of coverage\u201d to mean that, regardless of any other policy provisions, a pregnancy loss will be compensable, if it occurs nine months after the policy is terminated. However, this interpretation would make ineffective the requirement that the premiums be paid \u201cfor a period of 9 consecutive months prior to the occurrence of such loss.\u201d We believe that these provisions mean that the policy must be in effect at least nine months before the pregnancy loss and that it must not have lapsed in the intervening period. In Bartulis v. Metropolitan Life Ins. Co., 72 Ill App2d 267, 218 NE2d 225, where plaintiff sought to recover for hospitalization, after termination of the policy, for illness incurred prior to termination, the court denied recovery stating at page 271:\nWe cannot agree with the plaintiff that liability arose when the injuries were sustained. The coverage was not for expense caused by injuries sustained during the life of the policy, but for the cost of hospitalization and surgery obtained during the life of the policy. We recognize the rule that insurance contracts are construed in favor of the insured, but construction does not degenerate into a perversion of plain language to create an ambiguity where none exists or to father a contract obligation where none is stated or reasonably implied. Miller v. Madison County Mut. Automobile Ins. Co., 46 Ill App2d 413, 197 NE2d 153; Thompson v. Fidelity & Casualty Co. of New York, 16 Ill App2d 159, 148 NE2d 9. Nor does either justice or public policy compel a different result.\nThe judgment in favor of defendant is affirmed.\nAffirmed.\nMCCORMICK, P. J. and ENGLISH, J., concur.",
        "type": "majority",
        "author": "MR. JUSTICE DRUCKER"
      }
    ],
    "attorneys": [
      "John W. Daly, of Chicago, for appellants.",
      "Arthur J. Hessburg, of Lawrenceville, and Fred Carman, of Chicago, for appellee."
    ],
    "corrections": "",
    "head_matter": "J. Joseph Daly, et al., Plaintiffs-Appellants, v. Golden Rule Life Insurance Company, an Illinois Corporation, Defendant-Appellee.\nGen. No. 52,216.\nFirst District, Fourth Division.\nApril 24, 1968.\nJohn W. Daly, of Chicago, for appellants.\nArthur J. Hessburg, of Lawrenceville, and Fred Carman, of Chicago, for appellee."
  },
  "file_name": "0138-01",
  "first_page_order": 144,
  "last_page_order": 148
}