Court Opinion

ID: 9645025
Source: CourtListenerOpinion
Date Created: 2023-08-22 21:10:59.261252+00
Date Added: 2024-06-11T18:11:22.094943
License: Public Domain

Eldridge, J.,

concurring:

I agree with the result reached in this case, but I cannot subscribe to all of the reasoning in the majority’s opinion.
I
Initially, the majority focuses on the question of whether or not Mrs. Aufenkamp’s death was an "accident” for purposes of the coverage clause of the insurance policy. This issue was not the basis for the insurer’s opposition to the motion for summary judgment, and it was not raised on appeal. The Court is injecting, on behalf of an appellant, an issue into the case which neither side has raised. The appellant insurer has acquiesced, for purposes of its opposition to the motion for summary judgment, and for purposes of this *517appeal from the order granting summary judgment, in the idea that the suicide was an "accident” for purposes of the coverage clause.
It might be that the appellant’s acquiescence regarding the coverage clause issue was not inadvertent, as the insurance company may have determined, by investigation, that the deceased was insane and that, therefore, the death was accidental. At any rate, parties to litigation have a right to limit the disputed issues, as long as they are not "jurisdictional.”
After it has been determined that summary judgment was improper, because the trial judge improperly resolved the issues raised in the summary judgment proceeding, I would have no objection to pointing out that other pertinent issues may be raised by either side at the trial, including the coverage clause issue, if one or the other side so desires. However, I do not believe that the Court, on its own, should inject this as a "threshold” question. The reversal in this case should be based entirely upon our disagreement with the trial court’s ruling.
II
In my opinion, the central issue in this case is whether § 410 of the Insurance Code, Art. 48A, applies to the accidental death provision of this contract of insurance. In deciding this question, the majority seems to proceed upon the theory that by defining terms in §§ 62-73, the Insurance Code divides insurance policies into exclusive substantive categories. Thus the initial determination, according to the majority, must be to decide into which exclusive category the policy fits, and then to determine whether or not a particular code provision applies to that category. Here, the Court finds that a policy covering assorted risks, including accidental death, fits into the exclusive category of "Health Insurance” (Art. 48A, § 66). The majority further finds that Art. 48A, § 410, was not intended to apply to policies of "Health Insurance,” and thus it does not apply here.
*518While I agree with the result, I do not agree with the majority’s approach. I doubt that the Legislature, in enacting statutory definitions, intended to categorize every insurance policy into an exclusive type. There is nothing in the Insurance Code implying this, and it is illogical. A homeowner’s insurance policy, for example, may cover losses by fire, liability, theft, etc. Obviously those provisions of the Code relevant to fire insurance would govern some portions of the policy, and those provisions of the Code concerning other types of insurance would govern other portions. In any case, it would be impossible to call the policy one of fire or of liability or of theft, and it is obvious that nothing would be served by such a categorization. The categorization question should not even be asked because it is irrelevant to the real issue of whether or not the legislature intended a specific statutory provision to apply to a particular policy provision.
In this case, the majority uses the categorization approach, concludes that the entire policy is one of "Health Insurance” under Art. 48A, § 66, and not "Life Insurance” under Art. 48A, § 63, decides that Art. 48A, § 410, does not apply to "Health Insurance,” and thus decides that § 410 does not apply to Mr. Aufenkamp’s policy. I prefer to examine the policy provision (without artifically categorizing it) and the statute, and to determine whether the Legislature intended that the latter apply to the former.
The statutory definition of life insurance contained in Art. 48A, § 63, is "insurance on human lives,” including also certain specified benefits. This definition is not "technical”; it corresponds to the ordinary, commonly understood, meaning of the term "life insurance.” The insurance policy in the instant case includes a provision for an accidental death benefit. The death benefit clause is clearly a form of insurance on a human life and falls within the very general definition of "life insurance” in § 63.
However, the death benefit provision in this policy is not the type of life insurance to which all provisions of the Code referring to "life insurance” can rationally be held to apply. *519Specifically, it is clear that many, if not all, of the sections in the life insurance subtitle of the Insurance Code, i.e., subtitle 23, §§ 386-416, were not intended to apply to everything that comes within the broad general definition of "life insurance” in § 63.
Art. 48A, § 386, setting forth the scope of the life insurance subtitle, makes no reference to the broad definition in § 63. The scope of this subtitle can be ascertained by examining the provisions of the subtitle. Section 388 provides that "[n]o policy of life insurance,... shall be delivered or issued in this State” unless the policy contains all of the provisions required by §§ 389-399. However, many of the provisions required by §§ 389-399 could logically be applicable only to a "general” life policy, and not a "limited” life insurance policy or provision, even though both may fall within the definition of § 63.
For example, § 392 provides that if an insured’s age has been misstated, coverage under the policy will be for the amount that the premium paid would have purchased had the age been properly stated. Under the categorization approach of the majority, this provision would presumably apply to a policy insuring only against accidental death, because such policy would come within the defined category of life insurance under § 63. Since age is largely irrelevant to accidental death risks, the Legislature could hardly have intended the result which the majority opinion necessarily implies — that § 392 would apply to an accidental death policy because it is a form of "insurance on a human life.” The more reasonable interpretation is that § 392 was meant to apply to "general” life insurance in which age is a factor in determining premiums, and not to limited life policies in which age is largely immaterial, although they both may come within the § 63 definition.
Similarly, the legislature rationally could not have intended that § 410 apply to all policies of insurance on a human life. A more reasonable interpretation is that the restrictions in § 410, including that against suicide exclusions in § 410 (a) (5), were meant to apply to "general” *520policies of life insurance. No doubt the restrictions were designed to prevent insurers from marketing purportedly general policies of life insurance which, in the fine print, excluded various contingencies of death.
If the appellee’s interpretation of Art. 48A, § 410, were correct, an insurance company could not provide coverage for accidental death benefits in a policy that would not permit recovery for death by natural causes, since this is not one of the permitted restrictions of § 410 on the manner of death. I agree with the majority that it is apparent that this was not the legislative intent. The legislature did not intend that every policy, happening to provide some type of insurance on a human life, be subject to all of the provisions which would apply to a full-blown general life insurance policy.
To reiterate, I disagree with the majority’s general approach that insurance must be all one type or another. The policy here has a feature which fits within the statutory definition of "Life Insurance” (§ 63) and has other features which coincide with the definition of "Health Insurance” (§ 66). But these features do not mean that the policy as a whole is either life insurance or health insurance and not both. I do not believe that in merely defining statutory terms, the General Assembly intended to categorize all policies of insurance into exclusive pigeon holes. The question which must be asked in each case is whether the Legislature intended a particular statutory provision to apply to a particular policy provision. The answer is not found by calling the policy one thing or another. Thus, § 410 (a) (5) does not apply to Mr. Aufenkamp’s policy, not because that policy is "Health Insurance” and not "Life Insurance,” but because it is very clear that the Legislature did not intend that limited life insurance policies, covering only death by accidental means, be subject to § 410.
Ill
Finally, I believe that the majority’s approach to the requests for admission may seriously undercut the value of this pretrial discovery procedure.
*521In this case, appellant INA responded affirmatively to a request for admission and interrogatories asking whether an application had been made for a policy of "life insurance,” and whether such policy had been issued and was in effect at the time of Mrs. Aufenkamp’s death. Yet, as I read the majority opinion, INA is not in any way bound by these answers because "life insurance” is a term defined by law. However, answers to requests for admissions will normally involve words that may be defined by law. But those words, nevertheless, may have a plainly understood meaning, and I believe that the party answering is bound accordingly (unless the question or answer indicates a specialized meaning).
As I previously pointed out, § 63 of Article 48A defines "life insurance” in a manner that corresponds with common usage of that term. There is no reason why INA should not be bound by this admission in accordance with the commonly understood meaning of the words. While the question of whether a policy of life insurance was issued and in effect may have a legal aspect, I think it is clear that the question was basically factual, designed simply to eliminate the issue of whether a policy had been issued. In light of INA’s affirmative answers, I do not believe that INA could later deny that some type of life insurance policy had been issued and was in effect. See Murnan v. Joseph J. Hock, Inc., 274 Md. 528, 534, 335 A.2d 104 (1975), where Judge Levine stated for the Court:
"In short, if Rule 421 is to fulfill its unquestioned function, to eliminate the need to prove factual matters at trial which the adversary cannot fairly contest, the admission produced by the rule must be conclusively binding. A contrary interpretation would reduce the rule to a 'useless appendage.’ ”
However, as indicated earlier, I do not believe that everything which comes within the commonly understood meaning of "life insurance,” as embodied in § 63, is subject to the life insurance subtitle of the Code and particularly *522§ 410. For this reason, appellant’s responses did not constitute an admission that the limitations on coverage imposed by § 410 are applicable to the type of life insurance involved here. In other words, I believe that INA is bound by its statements that it had issued a current "life insurance” policy on the decedent as provided by the broad and commonly understood definition set forth in § 63. Nevertheless, because § 410 refers to a more limited use of the term "life insurance,” applying only to general life policies, the applicability of the § 410 limitations on the manner in which insurance carriers may limit coverage was not admitted but remained an open issue to be resolved at the trial.
Judge Davidson authorizes me to say that she concurs in the views herein expressed.