Commercial Casualty Insurance v. Mathews

195 S.E. 887, 57 Ga. App. 446, 1938 Ga. App. LEXIS 626
CourtCourt of Appeals of Georgia
DecidedMarch 10, 1938
Docket26546
StatusPublished
Cited by16 cases

This text of 195 S.E. 887 (Commercial Casualty Insurance v. Mathews) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Commercial Casualty Insurance v. Mathews, 195 S.E. 887, 57 Ga. App. 446, 1938 Ga. App. LEXIS 626 (Ga. Ct. App. 1938).

Opinion

Sutton, J.

1. Where an accident policy insures “against the effects resulting directly and exclusively of all other causes from bodily injury sustained” during the life of the policy “solely through external, violent, and accidental means,” it is necessary, in an action thereon, to show that in the act which preceded the injury alleged to have been sustained by the plaintiff something unforeseen, unexpected, or unusual occurred. “The rule which seems to reconcile the cases involving a construction of this, or a similar clause, in an accident policy of insurance, is that when the facts show that no unforeseen, unexpected, unusual, unintentional, or involuntary muscular effort or exertion occurred in the doing of the act which preceded the injury, the injury can not be regarded as resulting from accidental means; but where the circumstances under which the injury was sustained were such as to call for a severe effort or exertion, in the course of which the insured may have been placed in a position where some unforeseen, unexpected, unusual, unintentional, or involuntary movement produced a physical injury, it is a question of fact for the jury whether the injury was caused by such involuntary strain; in which case the means are accidental.” Fulton v. Metropolitan Casualty Insurance Co., 19 Ga. App. 127, 131 (91 S. E. 228). The petition in the present case alleges that the plaintiff instinctively leaped from steps, where he had been sitting, to assist in supporting a motor and pump, weighing 250 pounds, superimposed on a wooden base or platform but careening at the time, and while being held up above the ground by two others, and that the entire weight was thrown against him, and that because of the awkward position in which he was forced to place himself, with the descending weight of the pump and motor, he sustained a certain described hip injury solely by such involuntary strain. The allegations were sufficient to make an issue for determination by the jury as to whether or not, after beginning the act of assisting in the support of the motor and pump, something “unforeseen, unexpected, or unusual” occurred-which produced an involuntary strain on the part [453]*453of the plaintiff and caused his injury by such accidental means. The petition set forth a cause of action, and the court did not err in overruling the demurrer.

2. The defendant set up the defense that in the application, which was attached to and made a part-of the insurance contract, the insured made false and material representations, in that to the question, “Are your habits of life correct and temperate, and are you in sound condition mentally and physically?” the insured answered “Yes;” that to the question, “Have you ever had any infirmity, deformity, or disease?” the insured answered “No;” and that he was not entitled to recover, for the further reason that his answer to question 15 conclusively showed that the right to recover would be barred in the event he made a false statement material either to the acceptance of the risk or to the hazard assumed by the company, or in the event it was made with intent to deceive, and that the policy was to be based on the answers made in the application. On the trial the plaintiff admitted that although he had a curvature of the spine he did not so inform the agent who took the application, but he also testified that before the injury he could move freely backward, forward, and sideways in any direction, that his back did not seem to be stiff, and that he had had no trouble with it. There was opinionative evidence from several medical experts that he had a curvature in the lower or dorsal part of the spine, of long duration, and had a fixation or rigidity in such portion of the spine, and that such condition rendered him less capable of performing the act which he undertook. HeM: Conceding that the answers of the insured were not technically true, still the words “deformity” and “infirmity” in a warranty in an' application for insurance must be reasonably interpreted, and will not be so construed as to cover a defective condition which is of no practical disability, but must be construed as meaning a deformity or infirmity of a substantial nature, which apparently in some material degree impairs the physical condition and health of the insured and increases the likelihood of injury against which the: insurer issues a policy, and which condition, if known, would probably cause the insurer to refuse the risk. Eastern District Piece Dye Works v. Travelers Ins. Co., 234 N. Y. 441 (138 N. E. 401, 26 A. L. R. 1505, and annotations). “The terms ‘sound health’ or ‘good health,’ used in a policy, mean that the applicant ha's no [454]*454grave impairment or serious disease and is free from any ailment that seriously affects the general soundness and healthfulness of the system.” National Life & Accident Insurance Co. v. Smith, 34 Ga. App. 242 (129 S. E. 113). Such terms “must be considered, in an application for insurance, not in the light of technical definitions, but in the light of the insured’s understanding in connection with the terms emplojred in the examination.” Northwestern Mutual Life Ins. Co. v. Wiggins, 15 Fed. (2d) 646, 648. “The opinion’ of an expert witness is competent testimony to be weighed by the jury to aid them in coming to a correct conclusion; but such testimony is not so authoritative that the jury are bound to believe it and to be governed by it. The jury may deal with such testimony as they see fit, giving it credence or not.” Mitchell v. State, 6 Ga. App. 554 (65 S. E. 326). Notwithstanding the testimony of the expert witnesses, the jury was authorized to find, in view of the testimony of the plaintiff as to the use of his spine, that the “deformity” or “infirmity” was not so substantial as to be material to the risk, and that in a legal sense his answers in the application were not false. Furthermore, under the evidence the jury was authorized to find that after reaching and taking hold of the base or platform upon which the motor and pump were superimposed, and in attempting to assist others in supporting the weight, he sustained the injury solely by accidental means, which caused him to undergo an involuntary strain after being forced into a position which he did not intend to assume. Fulton v. Metropolitan Casualty Ins. Co., supra; United States Mutual Accident Association v. Barry, 131 U. S. 100 (9 Sup. Ct. 755, 33 L. ed. 60).

(a) Under the evidence the jury was not authorized to find that the insurance company, in electing to have the question of liability determined by the court instead of making payment to the plaintiff, acted in bad faith, and the award of penalty and attorney’s fees was not authorized.

(&) One ground of the motion for new trial is that the court erred in charging the jury: “I charge you, gentlemen, as a principle of law, in connection with the question of misrepresentation, the plaintiff contends that the company had notice of certain disabilities which the company contends the plaintiff was suffering at the time the policy was issued. The plaintiff contends that the [455]*455company knew about that, and was therefore not misled.

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Bluebook (online)
195 S.E. 887, 57 Ga. App. 446, 1938 Ga. App. LEXIS 626, Counsel Stack Legal Research, https://law.counselstack.com/opinion/commercial-casualty-insurance-v-mathews-gactapp-1938.