Jefferson Pilot Life Insurance v. Clark

414 S.E.2d 521, 202 Ga. App. 385, 1991 Ga. App. LEXIS 1760
CourtCourt of Appeals of Georgia
DecidedDecember 5, 1991
DocketA91A1254
StatusPublished
Cited by33 cases

This text of 414 S.E.2d 521 (Jefferson Pilot Life Insurance v. Clark) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jefferson Pilot Life Insurance v. Clark, 414 S.E.2d 521, 202 Ga. App. 385, 1991 Ga. App. LEXIS 1760 (Ga. Ct. App. 1991).

Opinions

Birdsong, Presiding Judge.

Jefferson Pilot Life Insurance Company appeals from a judgment based upon a jury verdict in favor of Henry Lee Clark, Jr., in an action to collect the proceeds of a Jefferson Pilot accidental death insurance policy covering Mr. Clark’s son, Donnie Lee Clark, issued through his son’s employment. While a covered person under the policy, Donnie Lee Clark was killed in a one-car collision in which he was the driver and sole occupant. A blood alcohol test taken after his death revealed that his blood alcohol content was .15 percent.

Relying on a policy provision excluding coverage if Donnie Lee Clark’s death was caused by or resulted from an injury sustained while he operated a motor vehicle if he was under the influence of alcohol with a blood alcohol level of at least .15 percent, Jefferson Pilot denied Mr. Clark’s claim for the proceeds of the policy. Subsequently, Mr. Clark filed suit, and after a jury verdict, the trial court entered judgment in favor of Mr. Clark for $80,000 plus interest. This appeal followed.

Jefferson Pilot contends the trial court erred by ruling the public policy of this state requires that the exclusion contain an implied requirement that driving with a .15 percent blood alcohol level was the proximate cause of death, by charging the jury on the proximate cause requirement, and by submitting a special interrogatory to the jury on whether the death was proximately caused by Donnie Lee Clark’s intoxication. Jefferson Pilot also contends the trial court erred by restricting the testimony of a state patrol accident investigator, and by refusing to allow Jefferson Pilot opening and closing argument. Held:

1. Initially we must address Mr. Clark’s arguments that Jefferson Pilot’s enumerated errors are harmless because of certain of the trial [386]*386court evidentiary rulings, including the denial of a motion in limine to exclude the blood test results, were erroneous. Since Mr. Clark did not file a cross-appeal contesting any of the trial court’s rulings, we cannot consider these assertions. Chester v. Ga. Mut. Ins. Co., 165 Ga. App. 783 (302 SE2d 594). Accordingly, these arguments are without merit.

2. Although Jefferson Pilot enumerates as error the trial court’s ruling that the exclusion at issue must implicitly contain the requirement that the .15 percent blood alcohol level was the proximate cause of Donnie Lee Clark’s death to satisfy the public policy of this state, we must first examine the exclusion to determine the scope of its application. The relevant part of the exclusion states: “This policy does not cover any loss, caused by or resulting from ... (6) any injury sustained while operating a motor vehicle if the covered person was under the influence of alcohol as evidenced by a blood alcohol level of at least 0.15% by weight/volume (150 milligrams per 100 milliliters).”

First, we note that not even Mr. Clark has asserted that the exclusion includes a causation requirement. Instead, he has contended that the exclusion was deficient because it did not contain such a requirement.

Secondly, without a covered injury, there is no covered loss, and without a covered loss, there can be no recovery under the policy.

It is uncontroverted that the injury, death, was sustained, as set forth in the exclusion, “while the deceased was under the influence of alcohol as evidenced by a blood alcohol level of at least .15% by weight volume (150 milligrams per 100 milliliters).” (Tests confirm deceased had an alcohol content of .15 percent.) The injury was sustained at a time the deceased had .15 percent blood alcohol content. This injury therefore came within the exclusion of the policy thus eliminating an “injury” and without an injury, covered, there can be no loss.

Nothing in the exclusion of the policy refers or requires that the intoxication cause the accident, injury or loss. Therefore, this exclusion is valid without a causation requirement.

The language of this exclusion does not require that Donnie Lee Clark’s intoxication be the proximate cause either of his injury or of the automobile accident in which his injury was sustained. This exclusion requires only that the “loss” (Donnie Lee Clark’s death) be caused by or result from an “injury” sustained while operating a motor vehicle if he was under the influence of alcohol as evidenced by a .15 percent blood alcohol level.

The term “caused by or resulting from” requires a causal relationship between the “loss” and any one or more of six different circumstances (of which an “injury” “sustained” while Donnie Lee Clark operated a motor vehicle when he was under the influence of [387]*387alcohol as evidenced by a blood alcohol level of .15 percent is but' one). Thus, if Donnie Lee Clark’s death was not caused by or did not result from any one of the six situations or circumstances listed, the exclusion would not apply.

Considering circumstance six, the plain language of the exclusion does not require that the injury causing Donnie Lee Clark’s death be caused by or result from his operation of the car while under the influence of alcohol. This exclusion requires only an “injury” which is “sustained while” Donnie Lee Clark “operated” the car. while under the influence of alcohol as evidenced by his blood alcohol level of .15 percent. The exclusion does not contain the words “caused” or “resulted,” and no reasonable definition of any words in this exclusion will allow an interpretation which permits implication of a causation requirement between the injury and driving under the influence with a .15 percent blood alcohol level.

In particular, the word “sustained” not only does not carry a connotation of causation, but the generally accepted definitions of “sustain” have the opposite meaning. As used in this sense, “sustain” can only mean “to experience or to suffer” (American Heritage College Dictionary, 2d edition); “to undergo, experience, or suffer (injury or loss, etc.)” (Webster’s Encyclopedic Unabridged Dictionary of the English Language); “to suffer, receive, undergo” (Webster’s Third New International Dictionary); “to suffer, bear, undergo” (Black’s Law Dictionary, 5th ed.). Therefore, in interpreting this policy we must give “sustain” its usual meaning (OCGA § 13-2-2 (2)), and that does not include a definition that forces a causation requirement in this exclusion.

Interpretation of this policy as the dissent proposes would require that the exclusion read as follows: This policy does not cover any loss caused by or resulting from any injury caused by or resulting from the operation of a motor vehicle while the covered person was under the influence of alcohol as evidenced by a blood alcohol level of at least .15 percent. The plain language of this exclusion does not support such an interpretation, and courts are not at liberty to revise contracts while interpreting them.

Moreover, this exclusion is not ambiguous. Ambiguity is “ ‘duplicity, indistinctness, an uncertainty of meaning or expression.’ ” Tarbutton v. Duggan, 45 Ga. App. 31 (163 SE 298). A word or phrase is ambiguous when “ ‘ “it is of uncertain meaning and may be fairly understood in more ways than one.” ’ ” Kusuma v. Metametrix, Inc., 191 Ga. App. 255, 256 (381 SE2d 322). Since the words in this exclusion are plain and obvious, however, they should be given their literal meaning. United States Fire Ins. Co. v.

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Bluebook (online)
414 S.E.2d 521, 202 Ga. App. 385, 1991 Ga. App. LEXIS 1760, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jefferson-pilot-life-insurance-v-clark-gactapp-1991.