Brede v. Continental Casualty Co.

404 F. Supp. 132, 1975 U.S. Dist. LEXIS 16010
CourtDistrict Court, E.D. Michigan
DecidedSeptember 25, 1975
DocketCiv. A. No. 74-71479
StatusPublished

This text of 404 F. Supp. 132 (Brede v. Continental Casualty Co.) is published on Counsel Stack Legal Research, covering District Court, E.D. Michigan primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Brede v. Continental Casualty Co., 404 F. Supp. 132, 1975 U.S. Dist. LEXIS 16010 (E.D. Mich. 1975).

Opinion

OPINION AND ORDER GRANTING MOTION OF DEFENDANT METROPOLITAN LIFE INSURANCE COMPANY FOR SUMMARY JUDGMENT

KENNEDY, District Judge.

This action is one to recover benefits alleged to be due under group insurance policies by reason of the death of plaintiff’s husband. It is alleged that he died of a heart attack suffered while responding to a fire as part of his job at General Motors Corporation.

Defendant Metropolitan Life Insurance Company has moved for summary judgment on the ground that a death under the circumstances pertaining to the death of plaintiff’s husband does not come within the policy provisions for “Extra Accident” coverage.

For the purposes of this motion, counsel for plaintiff and for Metropolitan Life Insurance Company have stipulated to the policy language set out in Metropolitan Life Insurance Company’s answer (Count II, paragraph 1). They have further stipulated that the only expert witness plaintiff has or will call is a Dr. Alan Belkin, whose deposition has been filed.

As recited in the stipulation, Section 7(B) of the policy provides, in part:

Upon receipt of notice and satisfactory proof . . . that any employee, while insured hereunder, shall have sustained bodily injuries solely through violent, external and accidental means . . . the Insurance Company shall pay . . . the amount of insurance specified . . . provided, however, that in no case shall any payment be made for death or any other loss which is caused wholly or partly, directly or indirectly by:
(i) disease or bodily or mental infirmity.

This paragraph of the Metropolitan Life Insurance Company policy contains language which the Michigan Supreme [134]*134Court classified, considered and clarified in its decision in Berger v. Travelers Ins. Co., 379 Mich. 51, 149 N.W.2d 441, 1967. The Court identified two types of clauses; both of which are found in the Metropolitan Life Insurance Company policy: “Sole cause” provisions (in the instant Metropolitan policy — “shall have sustained bodily injuries solely through violent, external, and accidental means”), and “exclusionary” clauses (in the instant policy- — “in no case shall any payment be made for death which is caused wholly or partly, directly or indirectly by disease . . . ”).

In Berger, the Michigan Supreme Court said:

In Nickola v. United Commercial Travellers of America (1964), 372 Mich. 600, 127 N.W.2d 309, . . . we construed a “sole cause” clause . in accordance with our earlier decision in Rangas v. New York Life Ins. Co. (1923), 223 Mich. 238, 193 N.W. 867. In Rangas, and again in Nickola, we said that such clauses do not necessarily preclude recovery when death results from a combination of accidental injury and preexisting disease but, rather, that recovery may be had when it is proved as a matter of fact that “an accidental external injury was the efficient, dominant, proximate cause of the death of the insured.” Rangas, supra, p. 244, 193 N.W. [867] p. 869.
In this case of Berger, however, the “sole cause” clauses do not stand alone. There is in each policy, in addition, an “exclusionary” clause which expressly negates the insurer’s liability in the event death is caused directly or indirectly, wholly or partly, by disease ... On rehearing in Budzinski [a. Metropolitan Life Insurance Co. (1939), 287 Mich. 495, 283 N.W. 662] and in Bristol v. Mutual Benefit Health & Accident Association (1943), 305 Mich. 145, 9 N.W.2d 38 and Scharmer v. Occidental Life Insurance Co. (1957), 349 Mich. 421, 84 N.W.2d 866, this Court committed itself to the view that such “exclusionary” clauses necessarily do preclude recovery when death results from a preexisting disease or from a combination of accident and preexisting disease.

379 Mich, at 53-54, 149 N.W.2d at 442. [emphasis original].

Plaintiff does not really challenge the applicability of the standard as set out in the Berger case. Her argument is that the question of whether the death of her husband was in fact caused “wholly or partly, directly or indirectly, by disease” is one for the jury. Both sides rely on the deposition of Dr. Belkin to support their respective arguments.

Plaintiff primarily relies on the portion of the doctor’s deposition in which he indicates that the stressful situation created by the fire was probably a contributing cause to the death. The clearest passages with reference to this theory are the following':

Q. All right. I take it, Doctor, that you did come to that conclusion, that is that stress played some factor on the onset of Mr. Brede’s myocardial infarction, is that correct?
A. Yes.
[Belkin deposition, p. 67].
Q. All right. Based on this man’s history and your knowledge through your practice, and your education of the part that stress and strain play on the individual as a build-up to a heart attack, is there any probability in your own mind as to whether or not this was a cause, the stress and strain ?
A. Yes, I think it’s related as far as the stressful situation in relation to the death of Mr. Brede.
Q. Could it be said it is reasonably probable from a medical point of view that the stress was definitely related?

A. From my medical point of view. [P. 68-69],

[135]*135Q. Would you give us an opinion as to whether or not the stress was a dominant cause, significant cause ?
A. I feel that the stress was probably was related and was a causative factor.

[P. 69].

Q. . Could it be said, Doctor, that there is a reasonable medical probability in your mind, but for the stressful situation that he may not have had the heart attack, at least at this place and time?
A. Probably not.

[P. 70].

The defendant’s brief refers to many passages in the deposition which describe the course of the doctor’s contact with Mr. Brede. (Mr. Brede was being treated by the doctor on a regular basis for conditions including high blood pressure) and the doctor’s opinion regarding Mr. Brede’s condition. His opinion was that the decedent had marked degree of arteriosclerosis and hypertensive cardiovascular disease. [Deposition at 19-20].

Regarding the cause of death, the doctor stated that he had signed the death certificate although he had not seen the decedent after the heart attack (the patient had been to the doctor’s office the morning of his death for a routine examination).

The passages most clearly supporting the defendant’s position are the following:

Q.

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Related

Surkin v. Charteris
197 F.2d 77 (Fifth Circuit, 1952)
Scharmer v. Occidental Life Insurance
84 N.W.2d 866 (Michigan Supreme Court, 1957)
Nickola v. United Commercial Travellers of America
127 N.W.2d 309 (Michigan Supreme Court, 1964)
Berger v. Travelers Insurance Co.
149 N.W.2d 441 (Michigan Supreme Court, 1967)
Budzinski v. Metropolitan Life Insurance
283 N.W. 662 (Michigan Supreme Court, 1939)
Bristol v. Mutual Benefit Health & Accident Ass'n
9 N.W.2d 38 (Michigan Supreme Court, 1943)
Appolonio v. Baxter
217 F.2d 267 (Sixth Circuit, 1954)
Kangas v. New York Life Insurance
193 N.W. 867 (Michigan Supreme Court, 1923)

Cite This Page — Counsel Stack

Bluebook (online)
404 F. Supp. 132, 1975 U.S. Dist. LEXIS 16010, Counsel Stack Legal Research, https://law.counselstack.com/opinion/brede-v-continental-casualty-co-mied-1975.