Court Opinion

ID: 9538141
Source: CourtListenerOpinion
Date Created: 2023-08-07 07:31:10.278833+00
Date Added: 2024-06-11T14:57:33.155111
License: Public Domain

MOSK, J.
I dissent.
The majority, while in effect approving application of the process of nature rule, penalize the plaintiff, who appeared in propria persona, for having lacked the professional skill to offer adequate jury instructions on the subject. Yet the learned trial court failed to recognize it received a special verdict that should be interpreted as consistent with the process of nature rule, overlooked its duty to ignore irrelevant juiy responses or in the alternative to require the juiy to reconcile ambiguous replies to special queries, undertook to complete the fact-finding process itself, and then decided the disputed issues against the plaintiff. I would reverse the judgment so that at a new trial the basic issues can be resolved properly.
This is clearly a case for application of a rule of law which has been in effect in California for nearly four decades. In Frenzer v. Mutual Ben. H. & A. Assn. (1938) 27 Cal.App.2d 406 [81 P.2d 197], .the disability policy required ah injury “immediately and totally disabling.” The court held that “the weight of authority is toward the so-called process of nature rule; that is, that when a disability follows from an accidental injury *638within such time as the processes of nature consume in bringing the affected person to the state of total incapacity to prosecute every kind of business pertaining to his occupation such disability is immediately under the terms of the policy.” (Id. at p. 413.)
While “immediately” disabling, as in Frenzer, is arguably imprecise and thus open to varying interpretations, in Schilk v. Benefit Trust Life Ins. Co. (1969) 273 Cal.App.2d 302 [78 Cal.Rptr. 60, 39 A.L.R.3d 1019], the court considered a policy limiting recovery to total disability occurring within 20 days of the date of the accident. The disability did not totally manifest itself until five months after the occurrence of the accident. The carrier contended the plaintiff was estopped, under the time limitation of the policy, to assert his claim.
But the court “followed the process of nature rule that the disability is immediate within the meaning of a total disability provision when it follows directly from an accidental hurt within such time as the process of nature consumes in bringing the person affected to a state of total incapacity to perform any kind of work pertaining to his occupation.” (Id. at p. 307.) Continued the court: “The insurer further argues that the words ‘within twenty days from the date of the accident’ are so plain and definite that they are not subject to construction. If so, then, the clause involved must be ignored under other well established rules, namely, that when the strict enforcement of a provision of an insurance policy will result in unreasonable and unjust forfeitures or an absurd result, the courts will refuse to enforce the strict meaning of the language of the policy. As noted above, serious internal injuries often do not manifest themselves until long after the accident happened and the injured person may be completely oblivious of his condition, although the process of nature may be actively, engaged in developing the latent hurt into a severe or even fatal injury. The fact that respondent, under such circumstances, pursued his usual occupation and performed some or even all of his occupational duties ought not, in all fairness, militate against him when the more serious but hidden injury subsequently manifests itself.
“The strict interpretation of the clause here would lead to an unjust result [citation]. In addition, to give literal interpretation to the provision here in question would be to unreasonably restrict the coverage of the policy to a very small and minute number of instances of total disability resulting from accident, namely, only those that manifested themselves *639within 20 days after the occurrence of the accident. Such a very limited and highly technical construction of an insurance contract cannot be foisted onto a layman nor does it make any sense in terms of the risks insured against....” (Id. at pp. 307-308.)
This court unanimously denied a hearing in Frenzer in 1938 and in Schilk in 1969.
Schilk is clearly controlling in the instant case. Here there was a 30-day limitation, compared to the 20 days in the Schilk policy. There the plaintiff suffered a whiplash injuiy in an on-the-job accident; here plaintiff injured his leg in an automobile accident. There plaintiff was not totally disabled between the accident in September and Februaiy when the injury achieved its ultimate total effect, after expiration of the 20-day limitation; here plaintiff experienced leg tremors the day after the accident in Februaiy, numbness in April and diagnosis of multiple sclerosis in October, after expiration of the 30-day limitation. There plaintiff attempted to continue working as a carpenter after the accident until his disability became total; here plaintiff attempted to work as a real estate broker until his disability became total. There the court found that as a proximate result of the whiplash and “independently of any and all other causes” plaintiff became .totally disabled; here the jury in a special verdict found that plaintiff’s “disability resulted directly and independently of all other causes from the accident of Februaiy 11, 1966.” It would be difficult to find two cases more factually comparable.
The first special verdict rendered by the juiy is clear and unequivocal: “Do you find by a preponderance of the evidence that Mr. Willden’s disability resulted directly and independently of all other causes from the accident of Februaiy 11, 1966? Answer: Yes.” On the strength of that factual finding alone, plaintiff is entitled to recover.
The second special verdict rendered was: “Do you find by a preponderance of evidence that the injury suffered by the Plaintiff totally and continuously disabled him within thirty (30) days from the date of the accident so as to prevent him from performing each and every duty pertaining to his occupation? Answer: No.” Under the Schilk doctrine, the queiy was irrelevant in the light of the finding in the first special verdict that the disability resulted directly from the accident. The addition of the words “totally and continuously” was of no significance *640in view of the uncontradicted evidence that plaintiff suffers total, continuous and permanent disability from multiple sclerosis.
The jurors were then instructed that if the answer to the foregoing query was “No” they were “to return to the courtroom without answering further questions.” The juiy ignored the court’s instructions and purported to answer two other proposed special verdicts. The trial judge should have ignored the responses rendered contrary to instructions. Or in the alternative, if he believed the additional verdicts recited ambiguous conclusions, his duty was to reinstruct the jurors and send them out for further deliberations.
Defendant contends there was no evidence submitted upon which a jury could find that plaintiff was totally disabled from “any occupation.” The carrier refers consistently to “any occupation,” by the use of quotation marks inferring that the expression is taken from the policy. The relevant section of the policy relating to occupational disability refers to a disabling injury “so as to prevent him from performing each and every duty pertaining to his occupation” (italics added), not any occupation. It would require very little evidence to sustain a claim that a multiple sclerosis victim cannot perform each and every duty required of him in the demanding occupation of real estate broker.
I do not subscribe to the majority’s conclusion that the “harsh and arguably unconscionable application of the 30-day provision to bar plaintiff’s claim in the present case is the result of plaintiff’s failure to seek a jury instruction based upon the more liberal process of nature rule.” Application of the limitation here is not arguably unconscionable, it is unconscionable as the majority themselves seem to recognize by quoting from Justice Taylor’s Schilk opinion (fn. 6, ante). While it would have been preferable for plaintiff to have offered an instruction based upon Schilk, nevertheless the trial court had a duty to apply the prevailing law after the jury returned its first special verdict.
I would reverse the judgment.
Appellant’s petition for a rehearing was denied January 19, 1977. Mosk, J., was of the opinion that the petition should be granted.