Supreme Court of Canada
Continental
Casualty v. Roberge, [1955] S.C.R. 676
Date: 1955-06-28
Continental Casualty Company (Defendant) Appellant;
and
Theodore Roberge
(Plaintiff) Respondent.
1955: June 10; 1955: June 28.
Present: Taschereau,
Rand, Kellock, Fauteux and Abbott JJ.
ON APPEAL FROM THE COURT
OF QUEEN’S BENCH, APPEAL SIDE, PROVINCE OF QUEBEC
Insurance—Sickness—Total
disability—Whether insured confined to his house.
The respondent sought to
recover under a contract of accident and sickness insurance on the ground that
during the period in question he was totally incapacitated and was “nécessairement,
strictement et continuement retenu dans la maison”, within Clause A of Part 4
of his policy. The evidence disclosed that he was totally incapacitated during
that time and that, although confined to the house, he made numerous visits to
his doctor on the occasion of which he also visited each time the offices of
his insurance company; that he went out each day for a short walk ; that he was
able to drive his car, although he did not do so in fact; that he regularly
visited a store nearby and called at least once at the office of his lawyer.
Both the trial judge and the majority in the Court of Appeal held that he was
entitled to the benefit of the clause.
Held: The appeal should be allowed. The words “nécessairement,
strictement et continuement retenu dans la maison” in the clause must be given
the natural, ordinary meaning which they bear in relation to the context, and on
the facts established the respondent was not entitled to recover under that
clause. Otherwise, Clause B of Part 4, dealing with the case when the insured
is not confined to the house, would be meaningless and inoperative.
APPEAL from the judgment of the Court of Queen’s Bench,
appeal side, province of Quebec ,
affirming, Casey J.A. dissenting, the judgment at trial.
A. Tourigny,
Q.C. and L. P. de Grandpré, Q.C.
for the appellant.
A. Sabourin, Q.C. for the respondent.
The judgment of the
Court was delivered by:—
Abbott
J.:—This appeal involves the
interpretation of a contract of accident and sickness insurance issued by
appellant in favour of respondent.
[Page 677]
The facts are not
disputed and it is common ground that if the respondent was confined to his
house, within the meaning of Clause A of Part 4 of the policy contract, the
appeal should fail and that, if he were not so confined, the appeal should be
maintained and the respondent’s action dismissed.
The relevant clauses of
the policy read as follows:—
|
PARTIE 4
|
PERTE DE TEMPS PAR MALADIE
|
|
$100
(Par Mois)
|
A. INCAPACITE
TOTALE LA VIE DURANT AVEC SEJOUR FORCE A LA MAISON. Lorsqu’une maladie rend
l’assuré absolument, nécessairement et continuement incapable et l’empêche de
vaquer à toute occupation ou emploi, et durant lequel temps l’assuré est sous
les soins et régulièrement visité par un médecin, chirurgien ou ostéopathe
qualifié, autre que lui-même, l’assureur paiera l’indemnité mensuelle contre
les maladies pour la période que’ l’assuré sera ainsi incapable, et durant
laquelle il sera aussi en raison de la dite maladie nécessairement,
strictement et continuement retenu dans la maison.
|
|
$100
(Par Mois)
|
B. INCAPACITE
TOTALE SANS SEJOUR FORCE A LA MAISON. Lorsqu’une maladie rend l’assuré
absolument, nécessairement et continuement incapable et l’empêche de vaquer à
toute occupation ou emploi, et durant lequel temps l’assuré reçoit les soins
et services d’un médecin, chirurgien ou ostéopathe qualifié, autre que
lui-même, l’assureur paiera l’indemnité mensuelle contre les maladies pour la
période que l’assuré sera ainsi incapable, telle période ne dépassant pas un
mois, quoique non retenu dans la maison.
|
The italics are mine.
It is conceded that during the period for which indemnity of
$100 per month is claimed, the respondent, as a result of a throat affliction
was totally incapacitated within the meaning of the policy. He was confined to
his house most of the time but it is also common ground that during the period
in question he made numerous visits to Montreal to see his doctor and on the
occasion of each of these visits also went to the offices of the Insurance
Company appellant. In addition to these trips to Montreal, respondent went out
of his house each day for a short walk, was able to drive his car, although
there is no evidence that he did in fact do so, regularly visited a store
nearby, and on at least one occasion called at the office of his lawyer. On
these facts the learned
[Page 678]
trial judge and a
majority of the Court of Queen’s Bench held
that respondent during the period in question was “nécessairement, strictement
et continuement retenu dans la maison” as provided in Clause A of Part 4 of the
contract.
Had the respondent left his house for the sole purpose of
receiving medical treatment which might only be obtainable elsewhere, it is
perhaps not unreasonable that a condition such as that contained in the clause
in question should be broadly interpreted so as to permit such visits. A
provision substantially identical to the one in issue in this appeal was so
interpreted by Campbell J. in Mitchell v. Occidental Life , but it is
significant that the learned judge, p. 343, described visits of this kind as
“exceptional and temporary absences from the house, especially when ordered or
recommended by the attending physician.”
A similar question arose
in the case of Guay v. Provident Accident and Guarantee Co. , decided by the Court of Review. In that case
the insured was totally incapacitated and for a week was confined to the house
except for visits to his doctor’s office. During a subsequent six weeks’ period
he took exercise in the open air and visited the office of another doctor for a
minor operation not related to his incapacity. The policy called for payment of
$25 per week while the insured was necessarily confined to the house and of
$12.50 per week while he continued to be incapacitated although not necessarily
to the extent of confining him to the house. He was held entitled to recover
the full rate of $25 for the week during which he was confined to the house
except for visits to his doctor and $12.50 per week for the subsequent six
weeks’ period.
I find it unnecessary to
determine in this case whether visits by respondent to his doctor for the sole
purpose of obtaining medical treatment could be brought within the terms of
Clause A of Part 4 since it is clear on the evidence that respondent was permitted
a very considerable freedom of movement by his physician and did in fact leave
his home daily.
The words “nécessairement,
strictement et continuement retenu dans la maison” in the clause in question must
be given the natural, ordinary meaning which they bear in relation to the
context in which they stand and I am unable
[Page 679]
to agree with the conclusion reached by the Courts below
that on the facts established in this case the respondent was entitled to
recover under Clause A of Part 4 of the policy. As Mr. Justice Casey has
pointed out in his dissenting judgment, to do so would render meaningless and
inoperative Clause B of Part 4 of the policy.
The appeal should be maintained and the action and
incidental demand of the respondent dismissed, with costs throughout.
Appeal allowed with costs.
Solicitor for the appellant: A. Tourigny.
Solicitors for the respondent : Sabourin &
Sabourin.