Mainer v. American Hospital and Life Insurance Co.

371 S.W.2d 717, 1963 Tex. App. LEXIS 1725
CourtCourt of Appeals of Texas
DecidedOctober 23, 1963
Docket11106
StatusPublished
Cited by10 cases

This text of 371 S.W.2d 717 (Mainer v. American Hospital and Life Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mainer v. American Hospital and Life Insurance Co., 371 S.W.2d 717, 1963 Tex. App. LEXIS 1725 (Tex. Ct. App. 1963).

Opinion

ARCHER, Chief Justice.

This is a suit on two life insurance policies which had been in effect longer than the statutory two year period after which each policy became incontestable. Each appellee contested the accidental death benefits provided by its policy on the basis of exceptions contained in policy provisions concerning accidental death benefits. The District Court held that the accidental death provisions were separate contracts, unaffected by the statutory incontestability clause, and found that the exceptions contained in the policies were applicable to Mr. Mainer’s death.

The appeal is predicated on four points as follows:

“First Point. After the Great National (Western Reserve) policy became incontestable under its own express provisions, the District Court erred in permitting Great National to contest, and defeat, a part of the amount of insurance provided by said policy.
“Second Point. The District Court erred in holding that the accidental death provisions are separate and dis *718 tinct contracts from the other coverage provided by the policies.
“Third Point. The District Court erred in holding that an insurer may except accidental death insurance coverage from the applicability of the statutory incontestability clause required by Article 3.44.
“Fourth Point. The District Court erred in holding that the death of the Insured resulted from committing a felony, because that Conclusion depended upon a strained and technical construction of the policy exception concerning a ‘felony’; and the language of the policy should be given its ordinary, non-technical meaning.”

Appellees take the position that the insured met his death in an automobile collision while driving his automobile in the wrong direction of a median-divided limited access four lane highway, and at the time of the collision was intoxicated and was violating a criminal law; that the policies contained both life insurance provisions and supplementary contracts dealing with accidental death and are defending on the grounds that the circumstances under which Mr. Mainer met his death were not covered; that appellees were not prohibited by law from inserting in their accidental death benefits rider and their supplementary contracts limitations upon coverage denying coverage where the insured died while “committing an assault or felony” were valid under Articles 3.44 and 3.45 of the Insurance Code, V.A.T.S.

. By counterpoints appellee American Hospital says that the court correctly held that Article 3.44 has no material application to the accidental death provisions, because there had been no “contest” within the meaning of the statute and the court correctly held that the insured met his death while committing a felony within the exclusion from coverage. National Life by counterpoint says the court was correct in holding that Article 3.44 has no material application to the supplementary contracts because there had been no “contest” and that the supplementary contracts are not life policies but are accident policies pursuant to the provisions of Article 3.45, and by crosspoint that the court erred in concluding and finding that the casualty involved did follow naturally and was reasonably expected and foreseeable from the voluntary conduct of the insured on the occasion in question.

“1. ‘Attached to and made a part of’ the American Hospital and Life Insurance Company policy are provisions for ‘Additional Benefits In Event of Death By Accidental Means’ ($5000). This policy provided that it would be incontestable after two years ‘except that part * * * relating to additional insurance benefits in event of death of the Insured by accidental means.’ The policy further expressly provided that ‘the company may contest liability under this additional (accidental death) insurance benefit at any time.’ With respect to the accidental death benefit the policy provided an exception if the death of the Insured resulted from committing a felony.
“With respect to this American Hospital and Life policy two questions are presented:
“(1) Whether the above exceptions to incontestability are permitted by Article 3.44, Insurance Code, which Statute requires that every life insurance policy shall contain a provision that the policy shall be incontestable after two years, except as to military service in time of war and nonpayment of premiums. (Third Point)
“(2) Whether, if the Statute does permit other exceptions to incontestability, the death of John R. Mainer resulted from committing a felony. (Fourth Point)
“2. ‘Attached to and forming a part of’ the Western Reserve policy, which Great National Life Insurance Compa *719 ny assumed, were provisions for an ‘Automobile Accidental Death Benefit’ of $2,000 and also an ‘Accidental Death Benefit’ of $2,000. This policy became incontestable after one year, and the incontestability clause in the policy contained only one exception to incontestability, to wit, nonpayment of pre-miuns. With respect to the accidental death benefits the policy provided exceptions as to death sustained while under the influence of intoxicants or while violating any criminal law.
“With respect to this Great National (Western Reserve) policy only one question is presented:
“(1) Whether, even if an Insurer is permitted by Texas law to exclude from the statutory requirement of incontestability those exceptions which relate to accidental death coverage, an Insurer may contest liability after its policy becomes incontestable if the policy does not exclude from incontestability the exceptions relied upon. (First Point and Second Point)”

The trial court made findings of fact and conclusions of law and we believe such were justified by the evidence and the law.

The findings were, in substance, that the plaintiff is the beneficiary in the policies and made demand for payment of the accidental death benefits and payment was refused and specifically that:

“3. John Rheims Mainer, the insured under the policies referred to above, met his death on January 19, 1961, in an automobile collision while traveling on the public, interregional highway, Interstate 35, in New Braun-fels, Texas, at or near the point where said highway passes over Farm Road 725.
“(a) Mainer’s death resulted from bodily injuries caused in the collision.
“(b) Mainer sustained his death in a head-on collision with an automobile driven in a southerly direction by one George B. Whitworth. At the time of the collision Mainer was driving an automobile, of which he was the sole occupant, north on the southbound two lanes of a divided, four-lane highway, and in the wrong or lefthand lanes thereof.
“(c) Mainer’s death was sustained while he was intoxicated and under the influence of intoxicating liquor.

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Cite This Page — Counsel Stack

Bluebook (online)
371 S.W.2d 717, 1963 Tex. App. LEXIS 1725, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mainer-v-american-hospital-and-life-insurance-co-texapp-1963.