Opinion ID: 2101175
Heading Depth: 1
Heading Rank: 2

Heading: Policy Exclusion Issue

Text: The appellant's second point on appeal is: The trial court erred in finding that Mary Brown's death was not an accidental bodily injury and that the policy exclusion for illness or disease applied to death caused by anaphylactic shock resulting from an allergic reaction to a drug. The insurance policy at issue here is a contract. When the meaning of the language used in a particular contract does not depend upon disputed extrinsic evidence, its construction and effect are to be determined by the court as a question of law. Arkansas Rock & Gravel Co. v. Chris-T-Emulsion Co., 259 Ark. 807, 536 S.W.2d 724 (1976). Here, there is no disputed extrinsic evidence upon which the meaning of the contract depends. Thus, we proceed to a review of the appellant's second point on appeal. Policy number GSR 19971 states in pertinent part, The loss must result directly and independently of all other causes from accidental bodily injury and, under a section entitled exclusions, the policy states that it will not pay for losses caused by illness, disease, or bodily infirmity. Mary Brown's death resulted from anaphylactic shock, which resulted from an injection of Rocephin, an antibiotic with which she had been previously injected without incident. The appellee relies on our holding in Duvall v. Massachusetts Indemnity & Life Insurance Co., 295 Ark. 412, 748 S.W.2d 650 (1988), to support its argument that Brown's death was the result of a disease and not an accidental bodily injury. The decedent in Duvall collapsed and died while cutting wood. An autopsy determined that his death resulted from Marfan's Syndrome, a congenital heart disease. The policy in that case read, The term `injury' as used in this policy shall mean accidental bodily injuries from which loss results directly and independently of all other causes. . . . Duvall, 295 Ark. at 415, 748 S.W.2d at 652. This is language very similar to the contested language in the present case. In Duvall , we defined the terms accident or accidental as something happening by chance, unexpectedly taking place, not according to the usual course of things, or not as expected. Id. We also noted that the term bodily injury usually indicated injuries caused by external violence and not disease. Id. In that case we also heeded Justice Cardozo's advice in Landress v. Phoenix Mutual Life Insurance Co., 291 U.S. 491, 54 S.Ct. 461, 78 L.Ed. 934 (1934), to avoid the Serbonian Bog of attempting to distinguish between accidental means and accidental results in insurance cases, and we make no such distinction. In deciding what events qualify as accidental, we endeavor to adopt the objective perspective of the average person who takes out a policy of accident insurance. Duvall, 295 Ark. at 419, 748 S.W.2d at 653. During the second half of the last century, insurance companies, when defining coverage for accidental loss, began to employ the more liberal terms accidental bodily injury as opposed to the accidental means language which was in general use in the early part of the twentieth century. William Eckert, Sickness and Accident Insurance, 11 ARK. L.REV. 1 (1957). Some courts construed accidental means to allow recovery only when the means which led to an injury were accidental in themselves, while some courts allowed recovery if the result was accidental, even if the means were not. 1A J. APPLEMAN & J. APPLEMAN, INSURANCE LAW AND PRACTICE § 360 (1981). To illustrate, in the present case, the means which brought about the anaphylactic reaction was an injection of an antibiotic, intentionally administered, and thus it was not accidental. However, the result of that injection, an anaphylactic reaction, was accidental. We have declined to participate in this pedantic practice, and we make no distinction between accidental means and accidental results, but instead adhere to the definition of accidental listed above, in an attempt to make our definition comprehensible, accessible, and therefore useful to the ordinary person, in this case, the ordinary person who purchases life insurance. Applying these principles to the present case, Mary Brown's death qualifies as something happening by chance, unexpectedly taking place, not according to the usual course of things, or not as expected, as judged from the objective perspective of the average purchaser of insurance. It resulted from the introduction of an external substance, Rocephin, into her circulatory system. The statistical probability of death as a result of such an injection is very low, and it is an unexpected occurrence very much outside the usual course of things. The policy also explicitly excludes deaths caused by bodily infirmity or disease from its coverage. Our holding in Duvall assumes that deaths resulting from disease are not the result of accidental bodily injury. In Duvall , we stated, In this case there was a disease and nothing out of the ordinary that intervened to cause Duvall's death. It is undisputed that Duvall, while engaged in his regular employment, died from Marfan's Syndrome, a disease; therefore his death was not accidental under the policy. Duvall, 295 Ark. at 419, 748 S.W.2d at 653. Thus, if the appellee is correct in its contention that an anaphylactic reaction to an injection of an antibiotic is a disease, then Brown's death is not covered under the policy as either an accidental bodily injury or as a disease. The appellee cites no legal authority to support its argument that an allergic reaction qualifies as a disease, but does state that it is considered a disease by medical science. The appellant offers affidavits by two physicians stating it is not a disease, as well as a citation to J.A. Bryant, Jr., Annotation, What Conditions Constitute Disease Within Terms of Life, Accident, Disability, or Hospitalization Insurance Policy, 61 A.L.R.3d 822 (1975), which states that hypersensitivity to a drug does not constitute a disease. Additionally, 46 C.J.S. Insurance § 884 (2006), states: The words bodily infirmity or disease, as used in a provision exempting the insurance company from liability for injuries caused thereby, refer only to an ailment or disease of a settled character, or one so considerable or significant that it would be characterized as such in the common speech of men, or some physical disturbance to which insured is subject, and of which the attack which caused his injury is in some measure a recurrence. They do not include a mere temporary infirmity or weakness, or a wound or hurt producing an injury and immediate functional disturbance, or normal physical changes that inevitably accompany advancing years, or insanity; nor do they extend to or include accidental injuries. We have held that insurance policies are to be strictly construed against the insurer, who chooses the language. Southall v. Farm Bureau Mut. Ins. Co., 276 Ark. 58, 632 S.W.2d 420 (1982). Also, we have stated, if a reasonable construction may be given to the contract which would justify recovery, it would be the duty of the court to do so. Smith v. Prudential Prop. Cas. Ins. Co., 340 Ark. 335, 10 S.W.3d 846 (2000). It would be anomalous and inconsistent for us to adopt the perspective of the average purchaser of insurance when defining accidental bodily injury and to then apply a hypertechnical definition of disease or bodily infirmity when the terms are used in the same policy. We do not think that the average purchaser of insurance would consider an allergic reaction to an antibiotic to be a disease or bodily infirmity, and using a strict construction as we are required to do by our precedent, we conclude that for the purposes of insurance policies, it is not. If an insurance company wishes to exclude allergic reactions to drugs from coverage under a particular policy, it may do so by the use of specific language, but it cannot accomplish this result by the use of the terms disease or bodily infirmity. We reverse the decision of the trial court granting summary judgment, and remand with the instruction to apply Arkansas law to the insurance contract between Aurora and Mary Brown, and for further proceedings. Reversed and remanded. GLAZE, J., not participating.