Duvall v. Massachusetts Indemnity & Life Insurance

748 S.W.2d 650, 295 Ark. 412, 1988 Ark. LEXIS 236
CourtSupreme Court of Arkansas
DecidedMay 9, 1988
Docket87-288
StatusPublished
Cited by27 cases

This text of 748 S.W.2d 650 (Duvall v. Massachusetts Indemnity & Life Insurance) is published on Counsel Stack Legal Research, covering Supreme Court of Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Duvall v. Massachusetts Indemnity & Life Insurance, 748 S.W.2d 650, 295 Ark. 412, 1988 Ark. LEXIS 236 (Ark. 1988).

Opinions

Darrell Hickman, Justice.

The legal question in this case is whether or not Ricky Duvall’s death was accidental. He was a 26 year old pulpwood cutter. After going to work on November 5, 1983, he was found lying on the ground. He was taken to a nearby hospital where he was declared dead. It is undisputed that the cause of death was Marfan’s syndrome, a congenital disease affecting the connective tissue of the body.

The appellee insurance company had an accidental death and injury policy on Duvall. The insurance company denied coverage and Duvall’s wife filed suit against the policy. The insurance company filed a motion for summary judgment, and the appellant also moved for summary judgment. The trial court found no substantial factual dispute and granted the motion for summary judgment in favor of the insurance company. We agree that the death was not accidental and affirm the judgment.

Appellant first argues that the trial court erred in granting summary judgment because the question of accidental death is a question of fact for the jury. The argument has no merit. Appellant and appellee agreed on all of the facts surrounding the insured’s death. During oral arguments to this court, appellant’s counsel conceded that no additional material facts could be developed at a trial on the matter. The construction and legal effect of a written contract are to be determined by the court as a question of law except where the meaning of the language depends upon disputed extrinsic evidence. Arkansas Rock & Gravel Co. v. Chris-T-Emulsion Co., 259 Ark. 807, 536 S.W.2d 724 (1976); C. & A. Constr. Co. v. Benning Const. Co., 256 Ark. 621, 509 S.W.2d 302 (1974).

There were no witnesses to Duvall’s collapse; we have only the undisputed testimony of Dr. Allan Rozzell, a board certified pathologist who performed an autopsy on Duvall. In his opinion, the strenuous work of woodcutting caused Duvall’s heart rate to increase and his blood pressure to rise, which in turn caused his aorta to rupture. According to Dr. Rozzell, the cause of Duvall’s death was Marfan’s syndrome.

Once again we are faced with the difficult legal question of what is an “accidental” death or injury. Our experience has been similar to that of other courts, groping for a simple definition of accident, or accidental means, and deciding cases on the basis of facts. See Reid, Insurance Accident Policies — “Accident or Accidental Means,” 10 Ark. L. Rev. 226 (1955-56); Eckert, Sickness and Accident Insurance, 11 Ark. L. Rev. 1 (1956-57); Annotation, Insurance: “accidental means” as distinguishable from “accident,” “accidentalresult,” “accidental death,” “accidental injury,” etc., 166 A.L.R. 469 (1947). We have held that “accident” and “accidental means” are synonymous. Travelers Ins. Co. v. Johnston, 204 Ark. 307, 162 S.W.2d 480 (1942).

Appleman, a leading authority on insurance law, discusses the subject at length and recognizes the difficulty courts have had in defining accident and accidental means. 1A J. Appleman & J. Appleman, Insurance Law and Practice § 360 (1981). First, he points out that the medical and legal definition of an accident differ:

From the point of view of the physician, anything which occurs suddenly may be considered an accident. Therefore, if a particle in a blood stream floats and lodges in a lung or in a coronary artery, that is an accident; the development of a thrombosis in place is not. The bursting of a blood vessel in the brain is a cerebral accident, an occlusion resulting from atherosclerosis or its inadequacy from arteriosclerosis is not. None of these things constitute a legal accident unless trauma causes the clot to float or acts upon a predisposing medical condition so as to produce disability or death.

Appleman also discusses the reasons for extended litigation on this question:

Since the ingenuity of attorneys, and the sympathies of courts, have made great strides into attempting to bring unexpected occurrence within the coverage of accident policies, insurers have resorted to stringent language to attempt to prevent overliberal results. That is why such terms as ‘external’ and ‘violent’ have come to have a place in such contracts, and why many insurers employ a phrase such as ‘accidental means’. The difficulty is that the companies have become entranced by the language they employ, extending it to situations not originally intended to be excluded, and unnecessary for the purpose of distinguishing between medical and legal causation or, in addition, to prevent fraudulent acts designed for the purpose of collecting policy benefits. With the companies reaching too far, and the courts desiring to narrow such constructions, there is a never ending contest apparent in litigation over such policies. If we bear in mind the legitimate purpose intended to be served both by the insuring agreements and the proper exceptions, the lines of demarcation can be drawn with some degree of fairness.

The appellant argues that according to our definition of accident, Duvall’s death was accidental and that she should recover under the policy. The policy language in this case reads:

The term ‘injury’ as used in this policy shall mean accidental bodily injuries from which loss results directly and independently of all other causes, provided such injuries are sustained by an Insured Person while this policy is in force with respect to such person.

The parties agree that this language is not ambiguous. In fact, the language in this policy is fairly typical policy language. See Hartford Life Ins. Co. v. Catterson, 247 Ark. 263, 445 S.W.2d 109 (1969). There is no doubt that we should interpret the policy by construing the words in a plain and ordinary manner. 1A J. Appleman & J. Appleman, Insurance Law and Practice § 360 (1981). We have adopted the generally accepted definition of the term “accident” or “accidental,” which is “something happening by chance, unexpectedly taking place, not according to the usual course of things, or not as expected.” See Continental Casualty Co. v. Bruden, 178 Ark. 683, 11 S.W.2d 493 (1928); Aetna Life Ins. Co. v. Little, 146 Ark. 70, 225 S.W. 298 (1920). Duvall argues that her husband’s death was sudden and unexpected and the result of strenuous work and therefore accidental. Not every death that is sudden or unexpected is an accidental death, as our cases and the authorities demonstrate. According to American Jurisprudence, the words “bodily injury” are commonly and ordinarily used to designate an injury caused by external violence, and not to indicate disease. 43 Am. Jur. 2d Insurance § 563 (1982).

In some cases the decision has been easy. In Hartford Life Ins. Co. v. Catterson, supra, we held that death from exposure was an accident. We compared it to death from heat prostration, which we held to be accidental in Continental Casualty Co. v. Bruden, supra.

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Bluebook (online)
748 S.W.2d 650, 295 Ark. 412, 1988 Ark. LEXIS 236, Counsel Stack Legal Research, https://law.counselstack.com/opinion/duvall-v-massachusetts-indemnity-life-insurance-ark-1988.