Court Opinion

ID: 9666342
Source: CourtListenerOpinion
Date Created: 2023-08-24 01:11:12.713773+00
Date Added: 2024-06-11T13:27:45.966454
License: Public Domain

Robert H. Dudley, Justice, dissenting. I dissent from that part of the majority opinion which holds that the insured’s death was not accidental under the language of the insurance policy. The majority opinion is based upon the single idea that because the death was caused in part by a pre-existing disease, it could not be “accidental” under the policy. Such an approach not only oversimplifies the issue, but also is clearly wrong in light of previous cases decided by this Court. The overwhelming majority of our cases dealing with accident insurance claims have been concerned with policy language which limited recovery to injuries brought about by “accidental means.” The term “accidental means” is not used in the policy at issue. It is important, however, to discuss the term in its historical context in order to understand the language in the policy before us. The term “accidental means” was almost universally used in accident insurance policies during the first half of the century. Eckert, Sickness and Accident Insurance, 11 Ark. L. Rev. 1 (1957). Judicial construction of the term “accidental means” resulted in a clear split of authority in various jurisdictions. Some courts refused to draw a distinction between loss due to “accidental means” and loss due to “accident,” holding that if the result was unusual, unforeseen, and unexpected, the requirement of “accidental means” was satisfied, as was that of simple “accident.” 1A J. Appleman & J. Appleman, Insurance Law and Practice § 360 (rev. ed. 1981). Other courts, however, took the approach that if the policy was written in terms of “accidental means,” then it was necessary that the acts or means themselves, rather than the result, be “accidental,” or “unexpected,” “unforeseen,” “not according to the usual course of events.” Id. The rules enunciated in our Arkansas cases appear to fall in the latter category, with attention focused on the act rather than the result. Absolute certainty in categorizing our cases is difficult because in applying the law to the facts of some cases it seems that if the result, rather than the means, was unforeseen, we still allowed recovery. See, e.g., Union Life Ins. Co. v. Epperson, 221 Ark. 522, 254 S.W.2d 311 (1953). Metropolitan Casualty Ins. Co. v. Fairchild, 215 Ark. 416, 220 S.W.2d 803 (1949). Apparently, we were not alone having difficulty in interpreting “accidental means,” and the insurance industry began to stop using the term. The insurance industry has recognized that the “accidental means” clause, once universally used, has several disadvantages, and, therefore, since the 1940’s the trend is away from its use and toward the more liberal “accidental bodily injury” wording. According to a recent insurance publication, this trend is an attempt to build better public relations since the distinction is highly technical and not readily understood by the insuring public or even by courts. The writer parenthetically states that claims relation suffered from “accidental means” specifications, and furthermore the courts ignored the distinction anyway. Eckert, supra, at 5 (footnote omitted). Regardless of how we construed the term “accidental means” in the past, however, the language of the policy now before us does not employ that term. Rather, it uses the more liberal term “accidental bodily injuries”: INJURY DEFINED AND SCOPE OF COVERAGE The term “injury” as used in this policy shall mean accidental bodily injuries from which loss results directly and independently of all other causes, provided such injuries are sustained by an Insured Person while this policy is in force with respect to such person. Thus, this Court is first presented with the question of whether the insured’s death falls within the policy language, “accidental bodily injury.” In'my opinion, it does. The language of an insurance contract must be construed according to the ordinary understanding and common usage of people generally. 10 G. Couch, Cyclopedia of Insurance Law § 41:8 (rev. ed. 1982); 43 Am. Jur. 2d Insurance § 559 (1982). “Generally, accident policies should be so interpreted that provisions of the policies effectuate the reasonable expectations of the purchaser. An average person buying a personal accident policy assumes that he is covered for any fortuitous and undesigned injury.” 1A J. Appleman & J. Appleman, supra, § 360. In applying the law to the facts now before us, the rupture of the insured’s aorta was the “bodily injury.” In addition, the terms “accident” and “accidental” have never acquired a technical meaning in the law. 10 G. Couch, supra, § 41:8; 43 Am. Jur. 2d, supra, § 559. Courts have almost universally construed the terms to mean something unforeseen, unexpected, fortuitous, unusual; something which does not occur in the usual course of things; an event such as would not reasonably be anticipated by a person situated as the one to whom the event occurred. See generally 1A J. Appleman & J. Appleman, supra, § 360; 10 G. Couch, supra, §§ 41:8-9; 43 Am. Jur. 2d, supra, § 559. Our own cases, in discussing “accidental means,” have defined “accidental” as happening by chance; unexpectedly taking place; not according to the usual course of things; or not as expected. E.g., Continental Casualty Co. v. Bruden, 178 Ark. 683, 11 S.W.2d 493 (1928). Further, “[i]n construing whether or not a certain result is accidental, it is customary to look at the casualty from the point of view of the insured, to see whether or not, from his point of view, it was unexpected, unusual, and unforeseen.” 1A J. Appleman & J. Appleman, supra, § 360. Under these circumstances, the rupture of the aorta, caused by the physical exertion of the job, and the resulting death were completely unexpected and unforeseen by the insured. Therefore, his death falls clearly within the policy language, “accidental bodily injury.” The next question confronting this Court under the language in this policy is whether the “loss result [ed] directly and independently of all other causes.” Again, I have no difficulty in finding that it did. However, the majority opinion, in reaching its result, completely ignores a long line of Arkansas precedent. It is unquestioned that an insurer has the right to limit or restrict the coverage of its policy. It is also true, however, that an insurer is charged with the knowledge of how certain language has been judicially construed within the jurisdiction where the policy is issued. See Clay County Cotton Co. v. Home Life Ins. Co., 113 F.2d 856 (1940); 1A J. Appleman & J. Appleman, supra, § 360. Arkansas has a rather long line of cases, dating back to 1912, in which we have consistently held that [w]hen an accident insurance policy limits liability to “bodily injuries sustained through accidental means resulting directly, independently and exclusively of all other causes of death,” and it appears that death resulted from an aggravation of a latent disease to which the deceased was subject, an instruction is correct to the effect that the defendant insurance company is liable, under the contract, if death resulted when it did on account of the aggravation of the disease from the accidental injury, even though death from the disease might have resulted at a later period, regardless of the injury. Union Life Ins. Co. v. Epperson, 221 Ark. at 525, 254 S.W.2d at 313 (emphasis added). “In other words, if death would not have occurred when it did but for the injury' resulting from the accident, it was the direct, independent and exclusive cause of death at that time, even though the death was hastened by the diseased condition.” Fidelity & Casualty Co. v. Meyer, 106 Ark. 91, 96, 152 S.W. 995, 997 (1912); see also Metropolitan Casualty Ins. Co. v. Fairchild, 215 Ark. 416, 220 S.W.2d 803 (1949); National Life & Accident Ins. Co. v. Shibley, 192 Ark. 53, 90 S.W.2d 766 (1936). Dr. Rozzell testified in his deposition that the strenuous activity of the insured’s job was directly related to his death because it initiated the rapid pulse and the elevated blood pressure, setting in motion the rupture of the aorta. Clearly, the insured’s death resulted when it did on account of the aggravation of a latent disease to which he was subject. In summary, our case law on the policy language before us is in favor of the insured and against the insurance company. Yet, the majority rules in favor of the insurance company and against the insured. Such a ruling is doubly unfair. Obviously, it does not follow our precedent, and more importantly, it rewrites an insurance policy in favor of the insurance company which originally wrote the policy. I dissent.