GLENS FALLS GROUP INSURANCE COMPANY v. Simpson

439 S.W.2d 292, 246 Ark. 654, 1969 Ark. LEXIS 1292
CourtSupreme Court of Arkansas
DecidedApril 14, 1969
Docket5-4861
StatusPublished
Cited by7 cases

This text of 439 S.W.2d 292 (GLENS FALLS GROUP INSURANCE COMPANY v. Simpson) 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
GLENS FALLS GROUP INSURANCE COMPANY v. Simpson, 439 S.W.2d 292, 246 Ark. 654, 1969 Ark. LEXIS 1292 (Ark. 1969).

Opinion

J. Fred Jones, Justice.

This is an appeal by The Glens Falls Group Insurance Company from an adverse judgment of the Jefferson .County Circuit Court awarding medical payments to James M. Simpson under a medical endorsement to an insurance policy issued to Eosswood Country Club.

It was stipulated that the appellee, Simpson, and three companions had played several holes of golf at the Eosswood Country (dub when it commenced to rain. As they made their way to the shelter of the clubhouse, appellee stopped under the cover of a large tree where he was struck by lighting and sustained injuries resulting in medical expenses amounting to $186.65.

The appellee filed claim for medical expenses under the provisions of the policy. The appellant insurance company denied coverage under the policy and refused payment. The appellee filed suit in the Municipal Court of Pine Bluff where judgment was rendered for the insurance company. The circuit court, on appeal, reversed the judgment of the municipal court and rendered judgment for the appellee Simpson. On appeal to this court the appellant, Glens Falls, designates the following points for reversal:

“The injuries sustained by the appellee were not caused by accident and did not arise out of the ownership, maintenance or use of the insured premises by the Eosswood Country Club and that there is no coverage under the policy issued by the appellant.
That at the time of the incident described in the complaint, appellee was participating in a sport and such activities are clearly excluded from coverage under appellant’s policy.”

The point actually involved in this case is whether the insurance contract insured the named insured, Eosswood Country Club, against its own liability or whether it insured the members and guests of the club against medical expenses incurred because of accident arising out of ownership, maintenance or use of the club premises.

Apparently the entire insurance contract was not made a part of the record in this case and the copy of the endorsement that is before us, is on printed form obviously designed more for individuals rather than country clubs as named insureds.

Under its first point appellant argues that it properly denied coverage under the language of the insurance policy “Insuring Agreement” which states:

“The company agrees with the named insured to pay all reasonable expenses incurred within one year from the date of accident for necessary medical, surgical and dental services, including prosthetic devises, and necessary ambulance, hospital, professional nursing and funeral services, to or for each person who sustains bodily injury, sickness or disease, caused by accident and a,rising out of the oivnership, maintenance or use of premises by the named insured and the ways immediately adjoining, or operations of the named insured, subject to the following provisions.” (Emphasis supplied.)

Accident has acquired the meaning of a happening or event out of the usual order of things or not reasonably to be anticipated. Webster defines it as “an event that takes place without one’s foresight or expectation; an event which proceeds from an unknown cause, or is an unusual effect of a known cause, and, therefore, not expected”; and Bouvier defines it as “an event which, under the circumstances, is unusual and unexpected by the person to whom it happens.” Bouv. Law Dict, vol 1, p. 51. See Appleman, Insurance Law and Practice, vol. 1A, § 391, footnote 12, p. 20.

The policy endorsement does not define the term “accident” as used in the policy and injury by lightning is-not excluded. We conclude, therefore, that the trial court did not err in holding that the appellant’s injury was caused by accident.

As to the principal issue, it is noted that “the company agrees with the named insured to pay” (not the expenses the named insured is required or obligated to pay), but “all reasonable expenses incurred... to or for each person who sustains bodily injury, sickness or disease, caused by accident arising out of the ownership, maintenance or use of premises by the named insured.” (Emphasis supplied.) Did the accident here arise out of the ownership, maintenance or use of the premises by the named insured f We are of the opinion that there was some substantial evidence to support the trial court’s decision that it did.

The named insured owned, maintained and used the premises as a golf course where the appellee’s accident occurred, and there is no evidence that appellee would have been on the premises had the named insured not been using the area for a golf course. There is substantial evidence that appellee’s injury arose out of the club’s use of the premises as a golf course. There are fifteen exclusions from coverage set out in the policy endorsement and being struck by lightning is not one of them. When the endorsement is examined for coverage in the light of the specific exclusions, it is difficult to determine what is covered under the endorsement if appellee’s medical expenses are not.

As to appellant’s second point, exclusion (b) under the endorsement provides as follows: This insurance do.es not apply:

“to bodily injury, sickness, disease or death sustained by any person practicing, instructing or participating in any physical training, sport, athletic activity or contest, unless this exclusion is specifically stated to be inapplicable.”

The appellee did not sustain his injury while practicing, instructing or participating in any physical training, sport, athletic activity or contest, he sustained Ms injury while standing under a tree. He was not struck by a golf ball he was struck by lightning. He had been participating in a golf game, otherwise he would not have been under the tree on the premises owned, maintained and used by the club as a golf course. We find appellant’s second point without merit.

Liability insurance is distinguished from accident insurance in 44 C.J.S. 474 as follows:

“... [Liability insurance is a variety of accident insurance, but it is distinguishable from accident insurance in that accident policies, strictly speaking cover accidents happening to the person of insured. While liability policies cover accidents to others than insured, provided insured stands in such relation to the person accidentally injured or killed as to be legally liable for the result of the accident.” (Emphasis supplied.)

The law is well settled in Arkansas that ambiguities in, and uncertainties as to the meaning of, the terms used in insurance policies will be interpretated most favorably to the insured and against the insurer who drew the contract. Hope Spoke Co. v. Maryland Casualty Co., 102 Ark. 1, 143 S.W. 85 and the numerous other cases listed in 10A West’s Ark. Digest. 146.6.

The judgment of the trial court is affirmed and appellee’s attorney is awarded an additional fee in the amount of $300.00.

Affirmed.

Harris, C.J., not participating.

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Bluebook (online)
439 S.W.2d 292, 246 Ark. 654, 1969 Ark. LEXIS 1292, Counsel Stack Legal Research, https://law.counselstack.com/opinion/glens-falls-group-insurance-company-v-simpson-ark-1969.