Case ID: sw2d_704/html/0205-01.html
Source: Caselaw Access Project
Author: {"author": "WINTERSHEIMER, Justice,", "license": "Public Domain", "url": "https://static.case.law/"}
Date Created: 2024-08-24T03:29:51.129683

Teresa FRYMAN, Guardian For Samantha FRYMAN and Sabrina Fryman, Minor Infants, Appellant, v. PILOT LIFE INSURANCE COMPANY, Appellee.
    Supreme Court of Kentucky.
    Feb. 6, 1986.
    Robert S. Walker, III, Wyatt, Tarrant & Combs, Lexington, for appellant.
    David L. Huff, Larry C. Deener, Land-rum & Patterson, Lexington, for appellee.
   OPINION OF THE COURT

On May 23, 1981 William Fryman was killed in a motorcycle accident. It is undisputed that at the time of the accident Fry-man had a blood alcohol level of .20 and was operating his motorcycle at an excessive rate of speed. Fryman had been covered by a group life policy issued from the appellee, Pilot Life Insurance Company, through Fryman’s employer. The policy provides $10,000 basic life coverage with a double indemnity provision where death is caused solely by “external, violent and accidental means.”

The issue submitted to the trial court was whether Fryman’s death fell within the definition of “accidental” death so as to entitle his estate to the extended coverage. The trial court held that Fryman’s wreck was by “accidental means” since there was no allegation or inference that the wreck was designed or planned in advance. The Court of Appeals reversed, holding that death is not caused by accidental means if it is a foreseeable result of a voluntary and unnecessary act or course of conduct of the insured. We reverse.

We are of the opinion that Fryman’s death was accidental within the terms of the policy in question. The words “accident”, “accidental”, and “accidental means”, as used in insurance policies, have never acquired a technical meaning in law, and must be interpreted according to the usage of the average man and as they would be read and understood by him in the light of the prevailing rule that uncertainties and ambiguities must be resolved in favor of the insured. Donohue v. Washington Nat. Ins. Co., 259 Ky. 611, 82 S.W.2d 780 (1935). An accident is generally understood as an unfortunate consequence which befalls an actor through his inattention, carelessness or perhaps for no explicable reason at all. The result is not a product of desire and is perforce accidental. Conversely, a consequence which is a result of plan, design or intent is commonly understood as not accidental.

Although there is no Kentucky case law directly on point, efforts have been made in the past to define “accident” and “accidental means” within the context of double-indemnity provisions in life insurance contracts. See e.g. Donohue, supra; Kentucky Central Life Insurance Company v. Willett, Ky.App. 557 S.W.2d 222, (1977).

In the Willett case, the decedent attempted to wrestle a gun away from an assailant and in the ensuing struggle, was killed when the gun discharged. The court held that the death was not “accidental” since the decedent demonstrated a reckless disregard for an obvious danger and thereby contributed to his own injury. The fundamental flaw with such a rule is that it subjects contract terms to analysis under tort principles, such as fault and foreseeability.

It has also been argued that Kentucky courts have long been willing to imply intent in criminal cases and that it would be incongruous to refuse to do so in a contract case. Once again, we are reluctant to analyze contract terms under principles which have technical meaning in other areas of the law.

We are therefore of the opinion that unless otherwise excluded by the terms of the life insurance policy, a death is accidental absent a showing that the death was a result of plan, design or intent on the part of the decedent.

Just as principles of tort law and criminal law have no application to the contract issue in question; our decision likewise has no application to those areas of law.

Therefore, we conclude that the death in question was accidental within the terms of the policy and the extended benefits are payable.

The decision of the Court of Appeals is reversed and the judgment of the Nicholas Circuit Court is affirmed.

STEPHENS, C.J., and AKER, GANT, LEIBSON and VANCE, JJ., concur.

WINTERSHEIMER, J., files a dissenting opinion in which STEPHENSON, J., joins.

WINTERSHEIMER, Justice,

Dissenting.

I respectfully dissent because I believe that double indemnity benefits should not be awarded under the circumstances presented in this case. In my view, any reasonably prudent person of ordinary intelligence should be able to anticipate that there is a likely risk of death when a person drives a speeding motorcycle while drunk. Consequently, such conduct is not within the definition of death by accidental means recognized in Kentucky. The conduct falls within the reckless disregard for an obvious danger category.

The issue is whether the beneficiaries under a life insurance policy are entitled to double indemnity. The deceased, by virtue of his employment, was covered by a group life insurance policy provided for basic life coverage and a double indemnity provision for accidental death. The question is whether his death was caused by accidental means.

It has been said that one who intentionally or negligently becomes intoxicated is held thereafter to the same standard of conduct as if he were sober. Prosser & Keeton, The Law on Torts § 32 (5th ed. 1984). I am persuaded by the holding in a Tennessee case which provides that it can be assumed that the danger of injury or death as a result of operating a motor vehicle while intoxicated is a foreseeable one and that, the death is not caused by accidental means within the definition of an insurance policy. It is a foreseeable result of a voluntary and unnecessary act or course^of conduct of the insured. Hobbs v. Provident Life and Accident Insurance Co., 535 S.W.2d 864, 866 (Tenn.1975). The /decision of the Court of Appeals is a proper application of well-established legal principles in Kentucky to the particular facts of this case.

The long-standing definition of accidental means may be found in Donahue v. Washington National Insurance Co., 259 Ky. 611, 82 S.W.2d 780 (1935). It involves a sudden and unexpected event. Later, this Court in National Life & Accident Insurance Co. v. Jones, 260 Ky. 404, 86 S.W.2d 139 (1935), reiterated the definition of accident by saying that every person must be held to the natural and probable consequences of their deeds. These definitions have been followed in Kentucky Central Life Insurance v. Willett, Ky.App., 557 S.W.2d 222 (1977), which restated the general rule to the effect that it is not accidental if the consequences of an act can be reasonably anticipated or is the natural and probable consequence.

In addition to Tennessee, Michigan has come to a similar conclusion. See Collins v. Nationwide Life Insurance Co., Mich.App., 282 N.W.2d 8 (1979). Here the facts were stipulated that the decedent was highly intoxicated with a blood alcohol level of .20 percent which is approximately double the amount necessary for presumed intoxication under the criminal law.

The tragedy that occurred in this situation is one which is repeated on a daily basis throughout our nation. Any person who operates a motor vehicle in a highly intoxicated condition at an excessively high rate of speed should know the probable consequences of such conduct. They are voluntarily and unnecessarily engaging in activity that will likely lead to death. Such conduct clearly shows a reckless disregard for the life of the person so acting as well as for the lives of all other users of the public roadways.

I would affirm the decision of the Court of Appeals.

STEPHENSON, J., joins in this dissent.