Opinion ID: 1494321
Heading Depth: 1
Heading Rank: 2

Heading: Were the Appellant's Injuries Accidentally Suffered within the Meaning of the Policy?

Text: The appellee contends, quite aside from questions arising as to the time of the occurrence of the injuries, that the injuries sustained by the appellant were not accidentally suffered by her by reason of her treatments, within the terms of the policies. The appellee refers to clauses V and VI of the policies which provide coverage only for claims for bodily injuries accidentally suffered and that such injuries must be sustained by reason of accidents. Now there is no doubt that the appellant's injuries were caused by a too continuous application of X-rays. The injuries incurred by Mrs. Shaw, argues the appellee, were not accidentally suffered by her within the terms of the policies, but were the accidental result of treatments which she bought and paid for. The appellee's argument in this connection may be stated as follows: Since the appellant intended to submit herself to the radiation applied by the assured by their Tricho machine, she did so, and the radiation from the Tricho machine being applied with the intention of applying it, her injuries were not accidental and therefore were not within the terms of the policy. The appellee contends that the principle enunciated by the Supreme Court in the case of Landress v. Phoenix Mutual Life Insurance Company, 291 U.S. 491, 54 S.Ct. 461, 78 L.Ed. 934, 90 A.L.R. 1382, relieves it of liability within the terms of the clauses of the policies referred to. In the cited case the assured suffered a sunstroke while playing golf. He had two policies of insurance upon his life. The beneficiary of the policies sought recovery of amounts stipulated in one policy to be paid if death should result directly and independently of all other causes from bodily injuries effected through external, violent and accidental means, and not directly or indirectly, wholly or partly from disease or physical or mental infirmity [page 462], and in the other policy, if death should result from bodily injuries effected directly and independently of all other causes through external, violent and accidental means. Mr. Justice Stone, delivering the opinion of the Supreme Court, distinguished between accidental external means and accidental result. He stated: The stipulated payments are to be made only if the bodily injury, though unforeseen, is effected by means which are external and accidental. The external means is stated to be the rays of the sun, to which the insured voluntarily exposed himself. Petitioner's pleadings do not suggest that there was anything in the sun's rays, the weather, or other circumstances external to the insured's own body and operating to produce the unanticipated injury, which was unknown or unforeseen by the insured. We do not intimate that injuries resulting from as impalpable a cause as the inadvertent introduction into the body of noxious germs may not be deemed to be effected by external accidental means. See Western Commercial Travelers' Ass'n v. Smith (C.C.A.) 85 F. 401, 40 L.R.A. 653; Jensma v. Sun Life Assur. Co. (C. C.A.) 64 F.2d 457. Nor do we say that in other circumstances an unforeseen and hence accidental result may not give rise to the inference that the external means was also accidental. Compare Jensma v. Sun Life Assur. Co., supra; Gustafson v. New York Life Ins. Co. (D.C.) 55 F.2d 235. But, in the light of such knowledge as we have, no such inference can arise from the bare allegation of death by sunstroke, compare Pope v. Prudential Ins. Co. (C.C.A.) 29 F.2d 185; Ryan v. Continental Casualty Co. (C.C.A.) 47 F.2d 472, with no indication that some unforeseen or unintended condition or combination of circumstances, external to the state of the victim's body, contributed to the accidental result. The petitioner has thus failed to plead facts establishing the liability defined by the policy. We think that the cited case does not rule the case at bar, since the conditions of recovery stipulated in the policies in the cited case differ substantially from those in the policies in the case at bar. The policies in the instant case do not contain provisions stipulating that recovery may be had for bodily injuries effected directly and independently of all other causes through external, violent and accidental means. The pertinent provisions of the policies in the case at bar are that the injuries must be accidentally suffered,   by reason of, or resulting from work, treatment, or operation and/or the use of any preparation and/or appliance used in connection with the business of the Assured or, demonstrated by an employee of the Assured at the location named in Item No. 4 of the Schedule of Statements. Upon the Schedule of Statements the location of the place where the operations of the assured were to be conducted is stated to be No. 270 Madison Avenue, New York City, where the appellant received her treatments at the hands of the assured or their employees, and the Description of Operations contained in the Schedule of Statements refers to Hypertrichosis operations by means of a Tricho Machine. Hypertrichosis is defined by Webster's New International Dictionary simply as excessive growth of hair. In other words, the appellee specifically insured the assured for damages on account of bodily injuries sustained by any person not an employee of the assured received while that person was subject to operations by a Tricho machine operated by the assured or their employees, for the removal of excess hair. It follows therefore that the injuries to the appellant, if incurred within the period covered by the policies, were precisely within the coverage of the policies. In short, the policies were designed and intended to protect the assured physicians from liability for suits arising from the use of a Tricho machine for remedying a condition of hypertrichosis. Other grounds of distinction between the Landress Case and that at bar occur to us. The appellee contends that the appellant received only the treatments which she had bargained for and that her complaint goes solely to the after-effects of the treatments. It states its position in this connection as follows: Rather than her injuries being accidentally suffered they were, in fact, a perfectly natural result of excessive X-ray treatment which she voluntarily submitted to. The appellee claims therefore that within the meaning of the Landress Case, though the result to the appellant was accidental the cause of that result was not. We think however that in the case at bar it can be demonstrated not only that the result to the appellant was an accident, but the cause of that result was accidental as well. An example will aid. A physician gives a patient an overdose of medicine which, beneficent in proper doses, is nearly lethal as given. From it the patient suffers most serious consequences. An insurance policy insures the patient against bodily injuries accidentally suffered. The patient intended to receive the dose within his body and his physician intended to place it there, but the cause that placed the excessive quantity of the medicine into the dose is seen to be accidental. The result was accidental also. This example, we think, distinguishes itself from the Landress Case because it is obvious that the physician did not intend to expose the patient to the effects of an overdose of medicine. In the Landress Case, upon the other hand, the golfer intended to submit himself to the radiation of the sun, no matter what that force of radiation was. He received all radiation that the sun could give and he intended to receive it all. In the case at bar it does not appear that the assured intended to treat the appellant with an excess of X-rays nor does it appear that she intended to receive such treatments to an extent which would injure her. On the contrary, there is evidence to support the conclusion that the assured intended to remove the appellant's superfluous hair without injury to her and that that was her intention in receiving the treatments. The intention of the parties to the contract serves to determine whether or not the appellant's injuries were accidentally suffered within the provisions of the policies. The question of the sufficiency of the evidence to go to the jury was determinable under the law of the forum and there was sufficient evidence to go to the jury upon the point stated. Dickinson v. Erie R. Co., 85 N.J.L. 586, 90 A. 305; Lancaster v. Highlands Finance Corp., 117 N.J.L. 476, 189 A. 371; Israel v. Travelers' Ins. Co., 116 N.J.L. 154, 182 A. 840. The substantive rights of the parties are governed by the law of New York, since the cause of action arose there. The decisions of the courts of that state, however, indicate plainly that the evidence presented was sufficient to show the existence of a cause of action in the appellant. Gallagher v. Fidelity & C. Co., 163 App.Div. 556, 148 N.Y.S. 1016, affirmed 221 N.Y. 664, 117 N.E. 1067; Lewis v. Ocean Accident & G. Corp., 224 N.Y. 18, 120 N.E. 56, 7 A.L.R. 1129; Silverstein v. Metropolitan Life Ins. Co., 254 N.Y. 81, 171 N.E. 914.