Court Opinion

ID: 9570215
Source: CourtListenerOpinion
Date Created: 2023-08-21 20:21:06.817094+00
Date Added: 2024-06-11T12:04:35.163543
License: Public Domain

Deen, Presiding Judge,
dissenting.
I respectfully dissent from the majority opinion. I agree with the majority that under the rationale of the cases cited, appellee was clearly “in the course of’ his employment when he was injured. As appellee points out, however, the cases cited by appellant were all Workers’ Compensation cases, and the remedial purpose underlying Workers’ Compensation would necessarily color the court’s construction of the “in the course of’ language in which those particular statutes are couched. However, appellee cites other cases that involve language closely similar to that in Barth’s insurance policy and that nevertheless hold the insurer liable unless the injured person was also covered by Workers’ Compensation. See United Benefit Life Ins. Co. v. Glisson, 105 Ga. App. 122 (123 SE2d 350) (1961). In the instant case appellee indisputably was not covered by Workers’ Compensation, as evidenced by the stipulation entered into by the Barths and IHOP’s carrier, even though the reasons for lack of coverage were not spelled out in the record. Moreover, it cannot reasonably be contended that the risk of being shot — particularly by *609one’s employer — is an occupational hazard ordinarily to be expected to “arise out of’ or occur “in the course of’ the occupation in which appellee was engaged.
Cantrell v. Home Security Life Ins. Co., 165 Ga. App. 670 (302 SE2d 415) (1983), is illuminating on this issue. In Cantrell the appellant had received an injury consisting of a gradual worsening of a pre-existing back condition — clearly an injury of the type contemplated by Workers’ Compensation statutes, whether or not the specific circumstances surrounding this particular injury would affect the coverage in this instance. Appellant entered into a “no liability” stipulation and received a $20,000 award. Additionally, the workers’ compensation carrier paid more than $9,000 in medical expenses.
Cantrell can be distinguished from the case sub judice in two significant respects. The first is the nature of the injury. Ms. Cantrell’s injury occurred over a period of time spent on the job and resulted from no blow, trauma, or external violence, in striking contrast to the injury received by appellee Barth. The second distinction is that, despite the “no liability” stipulation, the workers’ compensation carrier not only awarded $20,000 but paid medical expenses. Thus there was no dispute in Cantrell as to the facts that the injuries were of the sort ordinarily covered by workers’ compensation statutes, or that they fell squarely within the terms of Cantrell’s policy, which provided compensation for any injury “which does not arise out of or in the course of any employment by the employer, and ... for which he is not entitled to benefits under any workers’ compensation law.” We affirmed summary judgment for appellee.
In a recent case cited in Cantrell, King v. Public Savings &c. Ins. Co., 162 Ga. App. 49 (290 SE2d 134) (1982), the appellant received an injury that was clearly compensable under workers’ compensation, which paid all expenses incident to his two-month hospitalization. His insurer denied his claim on the basis of an exclusion which stated that the policy “does not provide any benefits... for which no charge is made that the insured is required to pay.” This court, noting the ambiguity of the language “required to pay,” held for appellant King. We reasoned that, although the payment for medical expenses was actually made by the workers’ compensation carrier, nevertheless, had the carrier refused to make it, the appellant would have been held responsible by the creditor hospital and physicians. In the instant case, in which workers’ compensation made no payment for medical expenses, the same reasoning, adjusted to the facts, should a fortiori compel the same result. Appellee Barth received an injury of a sort not ordinarily associated with activity “arising out of’ or “in the *610course of’ employment; he was specifically denied workers’ compensation coverage; he (or his father, the primary insured under appellant’s policy) was responsible for payment of his medical expenses. Recovery from a collateral source or sources would not affect the result.
Moreover, I cannot agree with the majority’s assertion that the presence of a semicolon between two disjunctive clauses in appellee’s insurance policy suffices to distinguish the fact situation in the instant case from that in United Benefit Life Ins. Co. v. Glisson, supra. In Glisson the clauses at issue — clauses containing language functionally identical with, and literally all but identical with, that in our case — had no semicolon or other punctuation mark separating the two disjunctive clauses. In and of itself, the semicolon carries no substantive significance, whether disjunctive or conjunctive or otherwise; it is the disjunctive conjunction “or” which carries the meaning. The function of the semicolon in appellee’s otherwise almost verbatim clauses is merely to facilitate the reading of the sentence, rather than to carry any substantive disjunctive significance over and above that imparted by the disjunctive conjunction “or” itself. To advert to the presence or absence of the semicolon is to make a distinction without a difference.
Furthermore, it is well settled that, when an insurance policy is capable of two constructions, it must be construed so as to favor the insured rather than the insurer. Davis v. United American Life Ins. Co., 215 Ga. 521, 527 (111 SE2d 488) (1959). Marsh v. Zurich Ins. Co., 118 Ga. App. 409 (163 SE2d 867) (1968); United Benefit Life Ins. Co. v. Glisson, supra. In view of the above considerations, it is apparent that the evidence in the case mandated neither a directed verdict for appellant nor judgment n.o.v. OCGA § 9-11-50 (Code Ann. § 81 A-150). The trial court therefore properly denied appellant’s motions with regard to Count I.
As to Count II, appellant’s contentions also appear to be without merit. Although there was evidence that would have authorized the jury to find for appellant on these issues, it was not of such nature as to preclude a finding of the converse. The issue of bad faith should be taken from the jury only when no evidence of bad faith is introduced. Interstate Life & Accident Ins. Co. v. Brown, 146 Ga. App. 622 (247 SE2d 205) (1978). The trial court therefore did not err in denying appellant’s motions regarding Count II.
For these reasons I respectfully dissent.
I am authorized to state that Presiding Judge Quillian and Presiding Judge McMurray join in this dissent.