Frame v. Prudential Insurance Co. of America

56 A.2d 76, 358 Pa. 103, 1948 Pa. LEXIS 271
Supreme Court of Pennsylvania·Decided November 25, 1947·No. Appeal, 170·Published·Cited by 13 cases

Opinion

Opinion by

Mr. Justice Horace Stern,

The question concerns the amount of proof required of plaintiff in this action on an insurance policy to *105 recover tbe amount payable if tbe death of tbe insured resulted solely from an accident.

Tbe policy insured tbe life of David A. Erame in tbe amount of $5,000 and an additional $5,000 if bis death occurred “as a result, directly and independently of all other causes, of bodily injuries, effected solely through, external, violent and accidental means, . . . ; provided, however,. that no . Accidental Death Benefit shall be payable if such death resulted . . . directly or indirectly from bodily or mental infirmity or disease in any form.”

On November 20, 1944 the insured, 71 years of age, suffered a fall downstairs in his home; he sustained a fractured right hip, three broken ribs and a large bruise on the side of his head together with severe shock and pain; he was confined thereafter to his bed, grew progressively worse, and died January 8, 1945. The Insurance Company refused to pay the accidental death benefit of $5,000 and this suit was brought by his widow, Alice Erame, who was the beneficiary of the policy, to recover that- amount. She obtained a verdict in her favor but the court entered judgment for defendant n. o. v. on the ground that her evidence did not sufficiently meet the terms of the policy upon which the Company’s liability was conditioned. Plaintiff appeals.

The factual issues were (1) whether the insured’s fall was due to his slipping on the stairway or to a possible attack of vertigo, and (2) whether a preexisting-infirmity was a contributing cause of his death. It appeared that five years previously he had had a cerebral hemorrhage which had resulted in a partial paralysis of his right -side and an impediment in his speech, and it was upon that fact that the Company básed its defense.

The rule, as it has been generally stated, is that, where a policy has provisions such as those here contained and it appears that the death of the insured resulted from accidental injury acting in conjunction with a preexisting and substantial physical infirmity, *106 recovery must be denied; plaintiff must show that the death was caused solely by external and accidental means, and if the proof points to á preexisting infirmity or abnormality which may have been a contributing factor he must also produce evidence to exclude that possibility: Lucas v. Metropolitan Life Insurance Company, 339 Pa. 277, 280, 14 A. 2d 85, 86; Rodia v. Metropolitan Life Insurance Co., 354 Pa. 313, 315, 316, 47 A. 2d 152, 153. It should be added, however, that' the word “possibility” in that connection is not to be taken in its absolute or literal sense, but rather ás having the practical meaning which the law ordinarily ascribes to such abstract terms.

In the present case plaintiff produced testimony of eyewitnesses to the effect that the insured had ascended a few steps from the first to the second story of his house when he slipped and fell down the stairs after a vain attempt to save himself by clutching at a hanging curtain. There was testimony that the steps had been waxed, a fact which in itself would reasonably suggest the cause of the accident. Defendant propounded the theory that he might have had an attack of dizziness due to the high blood pressure or hypertension which had caused his stroke five years before but plaintiff’s uncon-tradicted evidence éstablished that during that entire' period he had been in excellent systemic health, had never been in bed due to any illness, and had not had any attacks of vertigo. His physician; Dr. Switzer, testified that he had checked his blood pressure a couple of times and found it to be normal for a man of his age — 150 systolic, 80 diastolic; that he did not have any coronary disease; that his arteries “were a little hard, maybe, but I don’t think they were out of the way for a man 71”. There was not a scintilla of evidence that at the time the fall occurred he had any circulatory disturbance which might have produced a momentary instability or that his misadventure was caused in any manner other fcimn by his slipping on a waied. step. ' ■

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Frame v. Prudential Insurance Co. of America, 56 A.2d 76, 358 Pa. 103, 1948 Pa. LEXIS 271 (Pa. 1947).

56 A.2d 76 (Frame v. Prudential Insurance Co. of America) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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