Armijo v. World Insurance Company

429 P.2d 904, 78 N.M. 204
CourtNew Mexico Supreme Court
DecidedJuly 10, 1967
Docket8259
StatusPublished
Cited by5 cases

This text of 429 P.2d 904 (Armijo v. World Insurance Company) is published on Counsel Stack Legal Research, covering New Mexico Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Armijo v. World Insurance Company, 429 P.2d 904, 78 N.M. 204 (N.M. 1967).

Opinion

OPINION

OMAN, Judge, Court of Appeals.

The plaintiff brought suit to recover death benefits in the amount of $5,000.00 under a policy of insurance issued by defendant to plaintiff’s deceased husband. The policy provides for the payment of certain benefits for certain designated losses which occur by accidental means.

In its brief in chief defendant has correctly summarized the conditions or events which must occur, in order to meet the policy requirements, before defendant is obligated under the policy to pay for loss of life. These requirements are (1) that the insured sustain bodily injuries through purely accidental means, (2) that the injuries wholly and continuously disable the insured from the date of the accident to the time of death, (3) that death result within 90 days from the date of the accident, and (4) that death result from the accidental bodily injuries independently and exclusively of disease and all other causes. This last condition, and particularly the underlined portion thereof, presents the basic issue on this appeal.

The material facts are that decedent sustained an accidental fall on June 1, 1964. As a result, he suffered physical injuries and disabilities. One such resulting injury and disability from which he did not readily recover was a minor head injury, which apparently produced a subdural hematoma on both sides of his head, resulting in slight mental confusion and euphoria.

On July 24, 1964, the blood and fluid under the dura, which were compressing the brain, were removed by an operative procedure. Thereafter, his mental confusion began clearing rapidly and disappeared; the slight neurological signs, which were observed by the doctor prior to the operation, also disappeared; he was making a very dramatic, steady, and excellent recovery; and, in the opinion of the doctor, there was every reason to believe he would have recovered from his injury and the surgery, but for a subsequent accident on July 28, 1964.

On July 28, and while still hospitalized from the surgery of July 24, he fell from his hospital bed. As a result of this fall, a surgical wound on the left side of his head was disrupted, and spinal fluid began draining out of his wound.

He was later taken to the operating room and, upon the wound being opened to a greater depth, “there was a gush of fluid, bloody fluid, with fresh bleeding.” Thereafter, the operating doctor, who was called as a witness by plaintiff, stated that decedent’s condition deteriorated, and it was more or less a steady downhill course until his death on October 9, 1964.

The doctor called by defendant as a witness also stated he was very pleased as to the results of the first surgery on July 24, that decedent certainly seemed better, “and that after the second fall there was always a chronic battle.”

Decedent was 67 years of age at the time of his death. He had a long history of diabetes, but such was controlled, and he had worked actively for many years. He had shown some little evidence of aging during the latter part of his life. He also suffered from arteriosclerosis, either as a part of the aging process or as a result of his diabetic condition. The terminal events, or conditions existing at the time of his death, were arteriosclerosis, basilar artery thrombosis, bronchopneumonia, and diabetes aggravated by cerebral injury, with subdural hematoma. The trial court found:

“4. That on July 28, 1964, Alfonso A. Armijo sustained an accident causing bodily injury which resulted in his death on October 9, 1964. That from the date of said accident, Alfonso A. Armijo was continuously disabled until his death. That the death of Alfonso A. Armij o was directly caused by said accident independent and exclusive of disease and all other causes.”

It is this finding which defendant contends is not supported by the evidence, and particularly that portion thereof which states that death was caused by the accident of July 28 independently and exclusively of disease and all other causes. Attacks are made on other findings and conclusions of the trial court, but it is conceded that these other findings and conclusions must stand or fall with the finding just quoted.

In determining whether or not the finding is supported, we should first decide what effect must be given to the policy language, “independently and exclusively of disease and all other causes.”

In the recent case of Couey v. National Benefit Life Ins. Co., 77 N.M. 512, 424 P.2d 793 (1967), we had to construe the meaning of “solely as a consequence” thereof “independently of all other causes.” That language and the language here involved are so nearly the same in meaning, that we consider our holding in that case controlling here. In that case we stated that liability for the loss arises if the accident is the proximate efficient cause of the loss, and that it could not have been intended that liability should arise only when the accident was literally the sole cause.

Although we do not suggest that other terms may not be used to correctly describe or define the causal relationship between the accident and the loss, within the contemplation of the language, “independently and exclusively of disease and all other causes,” in the Couey case, as above stated, we used “proximate efficient cause.” Proximate is defined in Webster’s Third New International Dictionary Unabridged (1966) as “very near, next immediately preceding.” In Black’s Law Dictionary (4th ed. 1951), it is defined as “nearest and closest in causal connection.” In 2 Bouv. Law Diet., Rawle’s 3d rev. 1914, p. 2762 it is defined as “closeness of causal connection.”

Proximate cause is defined in 2 Bouv. Law Diet. (3d rev. 1914) as:

"That which, in a natural and continuous sequence, unbroken by any new cause, produces an event, and without which the event would not have occurred. The proximate cause is that which is nearest in the order of responsible causation; That which stands next in causation to the effect, not necessarily in time or space but in causal relation.”

Efficient cause is defined in Webster’s Third New International Dictionary as “the immediate agent in the production of an effect.”

With these definitions in mind, we must then ascertain if there is any substantial evidence to support the court’s finding, “That the death of Alfonso A. Armijo was directly caused by said accident independent and exclusive of disease and all other causes.” When a question of fact is presented, and the trial court makes a finding involving this question, this finding will not be disturbed if supported by substantial evidence. Couey v. National Benefit Life Ins. Co., supra; Tsosie v. Foundation Reserve Ins. Co., 77 N.M. 671, 427 P.2d 29; Varney v. Taylor, 77 N.M. 28, 419 P.2d 234 (1966); Board of County Comm’rs v. Vargas, 76 N.M. 369, 415 P.2d 57 (1966).

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Bluebook (online)
429 P.2d 904, 78 N.M. 204, Counsel Stack Legal Research, https://law.counselstack.com/opinion/armijo-v-world-insurance-company-nm-1967.