Mutual Benefit Health & Accident Ass'n v. Hickman

111 S.E.2d 380, 100 Ga. App. 348, 1959 Ga. App. LEXIS 619
CourtCourt of Appeals of Georgia
DecidedSeptember 9, 1959
Docket37715
StatusPublished
Cited by31 cases

This text of 111 S.E.2d 380 (Mutual Benefit Health & Accident Ass'n v. Hickman) 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
Mutual Benefit Health & Accident Ass'n v. Hickman, 111 S.E.2d 380, 100 Ga. App. 348, 1959 Ga. App. LEXIS 619 (Ga. Ct. App. 1959).

Opinions

Quillian, Judge.

The only general grounds of the motion for new trial insisted on in this court and the motion for judgment notwithstanding the verdict raise the single question as to whether the verdict was supported by some evidence.

The motion for new trial assigns as the reason for the insufficiency of the evidence to support the verdict, that the evidence failed to show that the insured came by his death through purely accidental cause “independently and exclusively” of all other causes. The ground points out the provision of the policy that confines its coverage to death caused solely in that manner.

The defendant’s argument in support of the motion for judgment notwithstanding the verdict raised the question as to whether a verdict in the plaintiff’s favor was authorized because the plaintiff refused, after her husband, who was the insured, had been buried for six months and about five months after notice of his death had been given the insurer, to allow his body to be exhumed that an autopsy might be performed. The defendant points to the stipulation of the policy sued upon that [357]*357“The association shall have the right and opportunity to examine the person of the insured when and so often as it may reasonably require during the pendency of claim hereunder, and also the right and opportunity to make an autopsy in case of death where it is not forbidden by law.”

If the defendant is right as to either of these contentions the verdict was not supported by evidence and should be set aside, and, if as the defendant insists, the evidence demanded a finding that the plaintiff failed, without valid cause, to comply with the terms of the policy in reference to the autopsy, the motion for judgment notwithstanding the verdict should have been granted.

If on the other hand the evidence made an issue that could be legally submitted to the jury as to the plaintiff’s right to refuse the defendant’s request to perform an autopsy on the insured, and, if there was any evidence that the insured came to his death through purely accidental means independently and exclusively of all other causes, the trial judge did not err in denying the motion for new trial or in denying the motion for judgment notwithstanding the verdict.

It is vigorously insisted that the plaintiff is not entitled to recover because she did not comply with the policy of insurance on which her cause is predicated. It is an elementary principle of law that one who> stands on a contract must abide by its terms. As a matter of course the principle is applicable to insurance contracts as well as to all other contracts. Thus the question before this court is whether the refusal of the plaintiff to have her husband exhumed and permit an autopsy, as a matter of law, constituted a violation of the policy provision to which reference has been made, or whether that issue was one of fact for solution by the jury.

Pretennitting discussion as to whether the policy provision relative to the autopsy had been waived, we further consider the question as to whether in the absence of waiver the refusal on the plaintiff’s part to permit the autopsy was an absolute bar to her right of recovery,

Where, as here, circumstances and their consequences must be considered in passing on the question as to whether the plain[358]*358tiff’s refusal to allow the disinterment and autopsy was in violation of the terms of the policy, and reasonable men might reach a different conclusion from the consideration of the same facts, the question is one for the jury.

This view is supported by ample authority, and particularly by the majority opinion of Order of United Commercial Travelers of America v. Moore, 134 F. 2d 558 (4) (5). The case considered the same question as here presented in the light of the law of this State. In the opinion it is held: “(4) Whether insurer’s request to perform autopsy permitted by accident certificate is made within a reasonable time is for the court to' decide if it is made either so promptly or so tardily after death that reasonable minds could not fairly differ on the question, otherwise it is for the jury to decide.

“ (5) Where accident certificate conferred on insurer right to perform an autopsy under penalty of forfeiture of all rights thereunder, but 65 days elapsed between date notice of death was received by insurer and date autopsy was requested and 56 days intervened between time insurer inquired into facts surrounding insured’s death and date that leave to conduct autopsy was demanded and there was no evidence to' explain the delay, evidence sustained jury’s determination that request was not made within a 'reasonable time.’ ”

The demand for the autopsy was, according to the undisputed testimony of the plaintiff made about six months after the insured’s death, which the record shows was about 47 days after the defendant had written a letter to the plaintiff denying liability of her claim for the insured’s death, and more than a month after the suit was filed.

The defendant’s denial of the liability at the time the plaintiff’s claim of loss was presented to it was a waiver of the right to demand an autopsy. Gulf Life Ins. Co. v. Matthews, 66 Ga. App. 162, 166 (17 S. E. 2d 247); Central Manufacturers Mut. Ins. Co. v. Graham, 24 Ga. App. 199 (3) (99 S. E. 434); Gilley v. Glens Falls Ins. Co., 81 Ga. App. 71, 72 (2) (58 S. E. 2d 218).

The evidence showed the insured was apparently well when he left home on the afternoon of his demise; thereafter, out on his farm, the left wheel of his truck fell into a stump hole about [359]*359two and one-half or three feet deep, so that the left front part of the vehicle’s chassis was resting on the ground; within about 15 minutes the insured died; the mortician testified that he found a quantity of blood in the insured’s abdominal cavity. A physician testified: “All that I can say is that certainly would indicate some rupture of the vessel. If he found free blood within the peritoneal-abdominal cavity, that would certainly mean a ruptured vessel of some kind or would have, to be a ruptured liver or some other place to give blood into the abdominal cavity. It comes again to the question of the amount of force. One person’s head may be struck against something and he not have any bad effects and another person’s head may be struck against it with apparently the same amount of force and he may suffer severe concussion. I think these things you mention are possible but I still think when you are dealing with this, you would have to deal with the amount of force. I don’t think you could say that a lick on the abdomen would mean anything because if you hit your abdomen with your hand, that is still a lick, but when you start to talking about a non-penetrating wound upon the abdomen, I think it is purely hypothetical as to the amount of force will produce a given injury. Now, a penetrating wound is a different thing because you know what it penetrates. A sudden blow when his stomach hit the steering wheel, when the car fell into the stump hole, I don’t think would likely cause death, but probably it could produce death if the blow was of such a force as to rapture a vessel and cause internal bleeding.”

Another doctor testified: “If there is free blood in the stomach outside of the blood vessels, I would say that that showed that there was an injury to a blood vessel or to his stomach.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

McCorkle v. Department of Transportation
571 S.E.2d 160 (Court of Appeals of Georgia, 2002)
Department of Transportation v. Brown
460 S.E.2d 812 (Court of Appeals of Georgia, 1995)
Daniel v. Parkins
409 S.E.2d 233 (Court of Appeals of Georgia, 1991)
Pugh v. State
382 S.E.2d 143 (Court of Appeals of Georgia, 1989)
Johnson Realty, Inc. v. Hand
377 S.E.2d 176 (Court of Appeals of Georgia, 1988)
Pembrook Management, Inc. v. Cossaboon
278 S.E.2d 100 (Court of Appeals of Georgia, 1981)
Lovett v. State
250 S.E.2d 32 (Court of Appeals of Georgia, 1978)
Hogan v. City-County Hospital
227 S.E.2d 796 (Court of Appeals of Georgia, 1976)
Altamaha Convalescent Center, Inc. v. Godwin
224 S.E.2d 76 (Court of Appeals of Georgia, 1976)
National Trailer Convoy, Inc. v. Sutton
222 S.E.2d 98 (Court of Appeals of Georgia, 1975)
Gordon v. Gordon
211 S.E.2d 374 (Court of Appeals of Georgia, 1974)
Georgia Power Company v. Crutchfield
188 S.E.2d 140 (Court of Appeals of Georgia, 1972)
Public Savings Life Insurance v. Wilder
182 S.E.2d 536 (Court of Appeals of Georgia, 1971)
Painter v. State
143 S.E.2d 680 (Court of Appeals of Georgia, 1965)
MacH v. State
142 S.E.2d 87 (Court of Appeals of Georgia, 1965)
Rothberg v. Charles H. Hardin Construction Co.
140 S.E.2d 520 (Court of Appeals of Georgia, 1965)
Powell v. Commercial Travelers Mutual Accident Association of America
137 S.E.2d 759 (Court of Appeals of Georgia, 1964)
Mote v. Seitz
134 S.E.2d 516 (Court of Appeals of Georgia, 1963)
Bacon Grocery Co. v. Johnson
131 S.E.2d 140 (Court of Appeals of Georgia, 1963)
Westberry v. Radford
131 S.E.2d 246 (Court of Appeals of Georgia, 1963)

Cite This Page — Counsel Stack

Bluebook (online)
111 S.E.2d 380, 100 Ga. App. 348, 1959 Ga. App. LEXIS 619, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mutual-benefit-health-accident-assn-v-hickman-gactapp-1959.