Insurance Co. of North America v. Aufenkamp

435 A.2d 774, 291 Md. 495, 1981 Md. LEXIS 283
CourtCourt of Appeals of Maryland
DecidedOctober 14, 1981
Docket[No. 154, September Term, 1980.]
StatusPublished
Cited by16 cases

This text of 435 A.2d 774 (Insurance Co. of North America v. Aufenkamp) is published on Counsel Stack Legal Research, covering Court of Appeals of Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Insurance Co. of North America v. Aufenkamp, 435 A.2d 774, 291 Md. 495, 1981 Md. LEXIS 283 (Md. 1981).

Opinions

Digges, J.,

delivered the opinion of the Court. Eldridge and Davidson, JJ., concur in the result. Eldridge, J., filed a concurring opinion at page 516 infra, in which Davidson, J., concurs.

On April 10, 1977, Easter Sunday, Melva J. Aufenkamp died from injuries sustained in a fall from the second story bedroom window of the apartment in Silver Spring, Maryland, where she resided with her spouse and son. The husband, appellee Darrel D. Aufenkamp, submitted proof of loss and made a claim for proceeds under an insurance policy issued by the Insurance Company of North America, the appellant here, and upon the refusal of INA to discharge the benefits provided by the policy, this action in assumpsit was instituted by the named beneficiary husband in the Circuit Court for Montgomery County to enforce that contract.

The "personal accident and special hazards insurance,” as it is titled, was issued by INA in the summer of 1970, and provides for the payment of specified benefits upon a loss suffered as a result of a "covered occurrence” which, as pertinent to this case, is defined in the policy as "bodily injury [suffered by the appellee, Mrs. Aufenkamp or their children] resulting directly and independently of all other causes from an accident...” (here referred to as the coverage clause). The benefits payable to the husband as the primary beneficiary in the event of a covered occurrence are keyed to the nature of the loss, which include loss of life, dismemberment and disability. In its declination to pay any moneys under the policy, INA, relying upon investigations [498]*498conducted by both the medical examiner and the police as well as medical history of the insured, asserted that the appellee was "ineligible for accidental death benefits” because the demise of his wife resulted from an intentional, self-inflicted injury which was not a risk assumed under the insurance contract. The company’s position was founded upon the following provision of the policy which in this opinion we refer to as the suicide exclusion clause:

Except as specifically provided for, the policy does not cover loss caused by or resulting, directly or indirectly, wholly or partially, from any one or more of the following:
A. Intentionally self-inflicted injuries, suicide or any attempt thereat, while sane or insane....

After the case was put at issue by the insurer’s plea, the parties engaged in pre-trial discovery procedures by appellee’s request for admissions from, and his submission of interrogatories to, INA. When appellee demanded an admission that "on or about July 27, 1970, Darrel D. Aufenkamp submitted an application for life insurance to Insurance Company of North America which would cover himself and his wife Melva J. Aufenkamp,” the insurer answered, "admitted.” Likewise, in response to interrogatories as to whether application had been made "for a policy of life insurance,” whether the appellant "issuefd] a policy of life insurance to Melva J. Aufenkamp ...,” and whether, if issued, "the said life insurance policy was in full force and effect at the time [the wife] died,” the insurance company answered each query in the affirmative. Armed with these acknowledgements, the beneficiary moved for summary judgment, urging at the outset that "the sole issue raised by the [appellant] is whether or not an exclusion from the policy, which bars payment in the event of suicide, bars the [appellee] from recovering.” Mr. Aufenkamp then reasoned the suicide exclusion provision of the policy was rendered unenforceable (and thus that coverage existed) by [499]*499section 410(a)(5) of Article 48A, which he contended was made applicable to this policy by virtue of INA’s concessions that this was a life insurance contract. This enactment provides:

(a) No policy of life insurance shall be delivered or issued for delivery in this State if it contains a provision which excludes or restricts liability for death caused in a certain specified manner or occurring while the insured has a specified status, except that such a policy may contain provisions excluding or restricting coverage as specified therein in the event of death under any one or more of the following circumstances:
(5) Death within two (2) years from the date of issue of the policy as a result of suicide, while sane or insane. [Code (1957, 1979 Repl. Vol.), Art. 48A, § 410(a)(5).1]

INA countered in its opposition to the motion for summary judgment that the policy issued by it was "a personal accident and special hazards insurance,” and therefore not governed by § 410 which, by its terms, is limited in application to life insurance. An order granting summary judgment in favor of the beneficiary was signed by the trial judge, who reasoned, as he later verbalized in denying INA’s motion for reconsideration, that the suicide exclusion clause was void by virtue of section 410 on either of two grounds: (i) that the insurance company had admitted these policies constituted life insurance, and (ii) that, "Article 48A ... demonstrates as a matter of law that a life insurance policy is here involved....” A timely appeal was noted to the Court of Special Appeals from the entry of the summary judgment, which ruling INA claims was based on answers to discovery requests that were nothing less than "a beartrap under the [500]*500leaves.” This Court issued its writ of certiorari prior to the intermediate appellate court’s consideration of the matter.

In our view, the summary judgment entered by the circuit court can be supported neither by the theory that INA made a binding concession that the insurance policy here involved is one of life insurance, nor by the finding that the policy is made so as a matter of law by statutory definition. As for the former, we are not the first to recognize that the term "life insurance,” in general usage, does not enjoy a well delineated and unambiguous signification. See National Life & Accident Ins. Co. v. Lokey, 166 Ala. 174, 52 So. 45, 46-7 (1910); Julius v. Metropolitan Life Ins. Co., 299 Ill. 343, 132 N.E. 435, 437 (1921); Jones v. Prudential Ins. Co., 208 Mo. App. 679, 236 S.W. 429, 432 (1922); Culbreth v. Prudence Life Insurance Company, 241 S.C. 46, 127 S.E.2d 132, 135-36 (1962); American Trust & Bkg. Co. v. Lessly, 171 Tenn. 561, 106 S.W.2d 551, 552, 111 A.L.R. 59 (1937). The main issue presented by this appeal, to which we shall turn shortly, is in fact a product of this ambiguity. Here, respondent in effect attempts to hold his adversary, by way of general references at discovery that this policy was one of life insurance, to a conclusion that the discovery concessions can only refer to life insurance as defined in Article 48A, section 63 (defining life insurance) and used in section 410 (a) (5) (limitation of liability in case of suicide), when in fact neither the technical usage nor the statutory definition was specified by the discovery requests. To be sure, a party need not understand the full legal ramifications of a factual concession before he is bound by the admission, but, as a prerequisite to being so constrained, the party certainly must be put on notice by sufficiently specific discovery requests of the factual nature of that which he is required to answer before he can be held to have yielded on the point.

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Insurance Co. of North America v. Aufenkamp
435 A.2d 774 (Court of Appeals of Maryland, 1981)

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Bluebook (online)
435 A.2d 774, 291 Md. 495, 1981 Md. LEXIS 283, Counsel Stack Legal Research, https://law.counselstack.com/opinion/insurance-co-of-north-america-v-aufenkamp-md-1981.