Opinion ID: 77943
Heading Depth: 2
Heading Rank: 2

Heading: Construction of the Policy Claim

Text: MEGA contends that Mr. Pieniozek should not recover under the policy's $300,000 AD&D rider because no autopsy was performed. After considering the common meanings of autopsy, the district court construed the contractual language against MEGA, the drafter, held that the coroner's investigation and report constituted an autopsy, and granted summary judgment for Mr. Pieniozek. The coroner, Ballard, performed a postmortem examination and indicated that Mrs. Pieniozek died of closed head trauma as a result of a motor vehicle accident. (R.2-17 Ex. E.) His report says that no autopsy was performed, and he testified that he did not perform an autopsy. In fact, Ballard testified that he is not qualified to perform either type of autopsy authorized by the Alabama Department of Forensic Sciences. He testified that he did not request that an autopsy be performed on Mrs. Pieniozek's body because everybody involved, including himself, the hospital, and law enforcement, agreed that her death was accidental. MEGA argues that the language in the AD&D rider, which provides a death benefit in the event of accidental bodily injury, independent of all other causes, which is supported by an autopsy (R.2-17 Ex. D at 2) (emphasis added), proves that the parties contemplated that this autopsy would rule out all other causes of death. Ballard testified that his examination did not rule out other potential causes of death, such as heart attack, cardiac arrest, stroke, aneurysm, or blood clot. Essentially, MEGA contends that the language in the AD&D rider was unambiguous and that it is entitled to summary judgment on this issue. The issue whether a contract is ambiguous or unambiguous is a question of law for' a court to decide. State Farm Fire & Cas. Co. v. Slade, 747 So.2d 293, 308 (Ala.1999). In determining whether a term is ambiguous, an isolated sentence of the policy should.not be construed alone, but in connection with other provisions of the said policy in order to arrive at a construction reasonably calculated to accomplish the intent and purpose of the parties. N. River Ins. Co. v. Jackson, 278 Ala. 604, 179 So.2d 731, 733 (1965). [W]here questions arise as to the meaning of an undefined word or phrase, the court should simply give the undefined word or phrase the same meaning that a person of ordinary intelligence would give it. Twin City Fire Ins. Co. v. Alfa Mut. Ins. Co., 817 So.2d 687, 692 (Ala.2001). This means that we should give the disputed term the meaning that a reasonably prudent person applying for insurance would have understood, Slade, 747 So.2d at 308, and the term's customary and normal meaning. Sullivan v. State Farm Mut. Auto. Ins. Co., 513 So.2d 992, 994 (Ala.1987). Since MEGA did not attempt to define autopsy in the AD&D rider, we, like the district court, look to common dictionary definitions in order to determine the customary and normal meaning of autopsy that a reasonably prudent person applying for insurance would understand. Some definitions include only a comprehensive, internal examination, see Oxford English Dictionary (2d ed. 1989) ([d]issection of a dead body, so as to ascertain by actual inspection its internal structure, and esp. to find out the cause or seat of disease; post-mortem examination), while others require only a post-mortem examination, such as the one performed here, see Webster's Third New International Dictionary (1981) (post-mortem examination, necropsy). Even though [a]n undefined word or phrase in an insurance policy does not create an inherent ambiguity, Twin City, 817 So.2d at 692, we nevertheless hold that the term autopsy in the AD&D. rider presents an ambiguity in its terms. It is unclear whether a reasonably prudent person applying for insurance would have understood autopsy to mean either a full dissection or, on the other hand, a postmortem examination. The terms of an insurance policy are ambiguous only if the policy's provisions are reasonably susceptible to two or more constructions or there is reasonable doubt or confusion as to their meaning. Slade, 747 So.2d at 308-09. Since autopsy here is susceptible to two general constructions, we hold that the district court properly determined that it was ambiguous as a matter of law. As an alternative to granting it summary judgment on this issue, MEGA urges us to remand to the fact-finder the question of whether an autopsy, within the meaning of the AD&D rider, was performed. In support of its position, MEGA cites Extermitech, Inc. v. Glasscock, Inc., where the Alabama Supreme Court said, Where factual issues arise, the resolution of the ambiguity becomes a task for the jury. 951 So.2d 689, 695 (Ala.2006) (quoting Alfa Life Ins. Corp. v. Johnson, 822 So.2d 400, 404-05 (Ala.2001)) (internal quotation marks omitted). The existence of an ambiguity in a contractual term, however, does not automatically require that we remand for the fact-finder to resolve the ambiguity. [I]f the trial court finds the contract to be ambiguous, it `must employ established rules of contract construction to resolve the ambiguity.' If the application of such rules is not sufficient to resolve the ambiguity, . . . the resolution of the ambiguity becomes a task for the jury.  Johnson, 822 So.2d at 405 (emphasis added) (citations omitted); see also Extermitech, 951 So.2d at 694 (Some of this Court's decisions indicate that, once the court determines that a contract is ambiguous, it is for the finder of fact to resolve, the ambiguity. However, . . . the court, as a matter of law, should apply rules of construction and attempt to resolve any ambiguity in the contract before looking to factual issues to resolve the ambiguity.); Am. & Foreign Ins. Co. v. Tee Jays Mfg. Co., 699 So.2d 1226, 1228 (Ala.1997) (If the policy is unclear, and ambiguous in its terms, . . . then it must be interpreted and construed under well-settled rules of construction applicable to all contracts.); Vesta Fire Ins. Corp. v. Liberty Nat'l Life Ins. Co., 893 So.2d 395, 404 (Ala.Civ.App.2003) ([A] court is to evaluate the contract on its face and apply rules of contract construction in an effort to resolve ambiguities before submitting the case to a jury.). It is . . . the province of the court, not the jury, to construe a policy, even though ambiguous and unclear. . . . Home Indem. Co. v. Employers Nat'l Ins, Corp., 564 So.2d 945, 947 (Ala.1990) (quoting Upton v. Miss. Valley Title Ins. Co., 469 So.2d 548, 555 (Ala.1985)) (emphasis omitted) (internal quotation marks omitted). Any ambiguity in an insurance contract should be strictly construed against the drafter and liberally in favor of the insured. See Twin City, 817 So.2d at 695; Home Indem., 564 So.2d at 947; Guaranty Nat'l Ins. Co. v. Marshall County Bd. of Educ., 540 So.2d 745, 748 (Ala. 1989); 2 Eric Mills Holmes & Mark S. Rhodes, Holmes's Appleman on Insurance § 6.1 (2d ed. 1996). The district court properly applied rules of contract construction in construing the meaning of autopsy against MEGA. Since doing so resolved the ambiguity, assistance from a fact-finder was not necessary and summary judgment on this issue was appropriate. Ballard determined that the cause of Mrs. Pieniozek's death was head trauma resulting from the automobile accident. Even though Ballard did not consider his examination to be an autopsy, MEGA's AD&D rider did not incorporate his conception of the term. If MEGA wanted to require a more comprehensive, definitive definition of autopsy, it should have defined the word autopsy in the AD&D rider. It did not do so. MEGA cannot argue that an autopsy was not performed according to an accepted definition of the term. MEGA's argument that there was no autopsy performed does not preclude Mr. Pieniozek's recovery under the AD&D rider.