Catania v. State Farm Life Insurance

598 P.2d 631, 95 Nev. 532, 1979 Nev. LEXIS 601

• Court: Nevada Supreme Court
• Decided: August 16, 1979
• Docket: 9743
• Status: Published

Opinions

OPINION

By the Court,

Gunderson, J.:

Respondent State Farm issued a $10,000 life insurance policy, insuring the life of Marc Catania, which included an “Accidental Death Section.” With the policy in full force and effect, Marc Catania apparently regurgitated and choked to death, a result of “acute narcotism” occasioned by a self-administered heroin injection. State Farm tendered a check to Frank Catania, Marc’s father and beneficiary, for $10,361.03 in full settlement of the life portion of the policy. However, State Farm refused payment of any accidental death benefits, and thereupon Frank Catania brought this action for $10,000, allegedly due under the policy’s “Accidental Death Section.”

The “Accidental Death Section” provides for double recovery if the death of the insured “resulted directly, and independently of all other causes, from bodily injury effected solely through external, violent, and accidental means. ...” The same section excludes coverage for “death resulting directly or indirectly from (1) suicide or intentional self-inflicted injury of any kind, whether the insured be sane or insane; ... (3) bodily or mental infirmity or illness or disease of any kind ...”

In a motion for summary judgment, respondent State Farm claimed: (1) that since the insured intended to inject the heroin, his death was not the result of an accidental “means,” even if he did not intend or expect to die therefrom; (2) that the death resulted from a self-inflicted injury or a disease, and, as such, was specifically excluded from coverage; and (3) that in any event the death was not accidental. The district court granted State Farm’s motion for summary judgment.¹ Catania appeals, claiming the district court erred in granting State Farm’s motion for summary judgment. We agree.

1. A growing number of jurisdictions have refused to recognize the technical distinction between “accidental death” and death by “accidental means,” or between “accidental means” and “accidental result.” INA Life Insurance Company v. Brundin, 533 P.2d 236 (Alaska 1975); Gulf Life Insurance Company v. Nash, 97 So.2d 4 (Fla. 1957); Scott v. New Empire Insurance Company, 400 P.2d 953 (N.M. 1965); Beckham v. Travelers Insurance Company, 225 A.2d 532 (Pa. 1967); Burr v. Commercial Travelers Mut. Acc. Ass’n., 67 N.E.2d 248 (N.Y.App. 1946). The rationale of these cases is to apply the controlling policy language as the average person would understand it. INA Life Insurance Company v. Brundin, supra. As explained by the Arizona Supreme Court:

One paying the premium for a policy which insures against “death by accidental means” intends to provide benefits to his family or named beneficiary in the event he should suffer death caused by accident as opposed to death caused by other means, such as suicide, murder, disease or natural death. He intends to insure against the fortuitous, the unintentional, and the unexpected, that which happens through mishap, mischance or misjudgment. When he pays that premium month after month he does not intend that any act committed by him, no matter how daring, reckless or foolhardy, be adjudged by a court under “reasonable man tests” or “natural and probable consequence” standards to deprive his beneficiary of contractual rights arising out of his unintended and unexpected and, therefore, accidental death.

The term “accidental means” as used in this policy should not be construed in a technical sense but should be given its ordinary and popular meaning according to common speech and usage and the understanding of the average man. . . . Insurance policies upon which the public relies for security in case of accident should be free from fine distinctions which few can understand until pointed out by lawyers and judges. . . .(Emphasis in original.)

Knight v. Metropolitan Life Insurance Company, 437 P.2d 416, 420 (Ariz. 1968).

A distinction between “accidental means” and “accidental results” is certainly not understood by the average person, for whom accident policies are written. Burr v. Commercial Travelers Mut. Acc. Ass’n., supra.

The line of authority referred to above is consistent with the principles long recognized by this court, i.e. that insurance clauses should be taken and understood in their plain, ordinary and popular sense, Home Indem. Co. v. Desert Palace, Inc., 86 Nev. 234, 468 P.2d 19 (1970); Richfield Oil Corp. v. Harbor Ins. Co., 85 Nev. 185, 452 P.2d 462 (1969), and that ambiguous insurance policy provisions will be strictly construed against the insurer and in favor of the insured. Home Indem. Co. v. Desert Palace, Inc., supra; Smith v. N.A.A.I. Co., 46 Nev. 30, 205 P. 801 (1922); Gerhauser v. N.B. & M. Ins. Co., 7 Nev. 174 (1871).

We therefore hold that where an insured dies as the result of an intentional or expected act or event, but did not intend or expect death to result, the death is “accidental” within the contemplation of that term, as utilized in a policy such as the one before us. See Knight v. Metropolitan Life Insurance Company, supra; Miller v. Continental Ins. Co., 358 N.E.2d 258 (N.Y.App. 1976).

2. Applying the same principle of construction to the policy’s exclusion clause, we are constrained to reject respondent’s contention that, as a matter of law, Marc Catania’s injection of heroin constituted a “self-inflicted injury” or “disease” as those terms are commonly used. See Minton v. Stuyvesant Life Insurance Company, 373 F.Supp. 33 (D.Nev. 1974). See also Miller v. Continental Ins. Co., supra.

3. Whether Marc Catania’s death was expected or intended, and therefore not accidental, is a question to be determined by the trier of fact. Since this material issue of fact exists, the order granting summary judgment is reversed, and the cause is remanded for trial.

Mowbray, C. J., and Thompson, J., concur.

1 Appellant Catania also made a motion for summary judgment, which the court denied.