Interstate Life & Accident Insurance Co. v. Gammons

408 S.W.2d 397, 56 Tenn. App. 441, 1966 Tenn. App. LEXIS 231
CourtCourt of Appeals of Tennessee
DecidedApril 1, 1966
StatusPublished
Cited by27 cases

This text of 408 S.W.2d 397 (Interstate Life & Accident Insurance Co. v. Gammons) is published on Counsel Stack Legal Research, covering Court of Appeals of Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Interstate Life & Accident Insurance Co. v. Gammons, 408 S.W.2d 397, 56 Tenn. App. 441, 1966 Tenn. App. LEXIS 231 (Tenn. Ct. App. 1966).

Opinion

HUMPHREYS, J.

Daisy F. Gammons and Cordell H. Gammons, as beneficiaries of a health and accident insurance policy insuring J ames F. Gammons against death by accidental means, recovered a nonjury judgment in the amount of $6,000.00 against the insuror, Interstate Life & Accident Insurance Co., and the insuror has appealed.

It is admitted insured was killed in an automobile accident while the policy was in force. However, liability is denied on the ground there is a provision in the policy, “the company shall not be liable for any loss sustained or contracted in consequence of the insured being intoxicated * * *” and the company contends insured’s death was in consequence of his intoxication.

It is evident Circuit Judge Sam L. Felts, Jr., gave the case most serious consideration, as he made a written finding of facts and conclusions of law which we attach as Appendix. 1.

Here, four errors have been assigned which may be summarized: That the court erred in failing to find as a matter of fact that insured James F. Gammons was intoxicated at the time of his death; erred in holding that, because the death certificate indicated “fracture base skull neck and left femur”, this was the cause of insured’s death and there was no causal connection between in *444 sured’s intoxication and Ms death; erred in failing to find as a matter of fact that the death of the insured was in consequence of his being intoxicated and; erred in imposing liability on appellant under the terms of the policy.

The first assignment may be passed over as the trial judge, while assuming that Gammons was intoxicated when killed, was yet of opinion there was liability, so his judgment is not reversible on this account.

We find ourselves in partial agreement with the second assignment, as we do not think the exception from liability on account of intoxication is as limited as the trial judge held. In construing the policy provision to require the insurer to show the insured died from the ingestion of intoxicating beverages, we think the trial judge went too far.

However, this is not to say that we do not concur in the ultimate result reached by the trial judge, for we do.

The point now under consideration is, of course, the turning point of this appeal.

We should restate the exception to have it before us:

‘ ‘ The company shall not be liable for any loss sustained or contracted in consequence of the insured’s being intoxicated. * * *”

After a most able discussion of this second assignment, appellant concludes with this proposition:

“Appellant insists that a causal connection has been established between Gammons’ intoxication and his death — or, in different terms, that Gammons ’ death was in consequence of his intoxication.”

*445 It is with this proposition that we find disagreement.

While it is fundamental that insurance contracts are construed as other contracts, from their four corners, with the attitude on the part of the judges that there is no intention to he unfair, still, since the insurer drew the contract and of necessity has had much time within which, and legal advice from which, to ascertain its meaning, any ambiguities therein will be resolved in favor of the not so educated insured who buys it, who generally assumes the contract will do what the big black print on the first page says it will do.

In other words, as said in McKee v. Potomac Insurance Co., 208 Tenn. 152, 344 S.W.2d 366, an insurance contract is simply a contract, and must be construed as expressed, in absence of uncertainty or ambiguity. And, again, as stated in Fidelity Bond & Mortgage Co. v. American Surety Co., 14 Tenn.App. 211, insurance contracts, like other contracts, should be construed so as to give effect to the intention and express language of the parties. However, it is an unalterable rule that an ambiguous insurance contract must be construed most favorably to the insured, even though plain provisions taken as a whole must be enforced as stated. And, finally, with respect to this aspect of the case, which we think is conclusive of it, it is the controlling rule that ambiguous language in an insurance contract is to be construed most favorably to insured. Ludlow v. Life & Casualty Ins. Co. of Tenn., 31 Tenn.App. 508, 217 S.W.2d 361, 13 A.L.R.2d 980; Ansley v. Travelers Ins. Co., 27 Tenn.App. 720, 173 S.W.2d 702; Citizens’ Ins. Co. v. Ayers, 88 Tenn. 728, 13 S.W. 1090; Hoffman v. Germania Ins. Co., 88 Tenn. 735, 14 S.W. 72; Interstate Life & *446 Acc. Ins. Co. v. Gann, 196 Tenn. 422, 268 S.W.2d 336, 44 A.L.R.2d 1230.

In addition, there is the rule that where the loss is within the insuring provisions of a policy, but the insurer relies upon an exception to avoid liability, the burden is upon the insurer to show that the exception exists, and, by the preponderance of the evidence that it operates to relieve of liability. Freeze v. Continental Cas. Co., 5 Tenn. App. 261.

In other words, it is clear in this case that, since the insurer agrees the insured’s death was accidental, at a time while he was covered by its insurance policy, the burden of proof is on it to show the exception upon which it relies has the effect both in law and fact of excepting it from liability.

Reverting to our stated disagreement with the argument of appellant, it is simply that it relies on a construction of the exception most favorable to itself. Although the exception applies only to “loss sustained or contracted m consequence of the insured’s being intoxicated”, appellant argues as though the phrase read “loss sustained or contracted as a consequence of the insured’s being intoxicated”. Of course, if the exception had been so written we think it could fairly be argued under the evidence that intoxication could have been a factor in insured’s death so that the exception applied. But, the exception is not so written. It is written, “in consequence”. This can mean, and we think more nearly means, “loss sustained or contracted as the consequence of the insured’s being intoxicated.” So that the insurer is excepted from liability only if it proves insured’s intoxication was “the”, not “a”, proximate cause of death. Since the exception is susceptible of the interpretations *447 we liave indicated we must adopt that interpretation favorable to the insured.

It is evident the trial judge had in mind the construction of this exception which we have made, but we think he applied it too strictly, when he held that the exception only applied where the ingestion of intoxicating beverages was itself the cause of death.

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408 S.W.2d 397, 56 Tenn. App. 441, 1966 Tenn. App. LEXIS 231, Counsel Stack Legal Research, https://law.counselstack.com/opinion/interstate-life-accident-insurance-co-v-gammons-tennctapp-1966.