National Life & Accident Insurance v. Edwards

119 Cal. App. 3d 326, 174 Cal. Rptr. 31, 1981 Cal. App. LEXIS 1748
CourtCalifornia Court of Appeal
DecidedMay 19, 1981
DocketCiv. 56282
StatusPublished
Cited by21 cases

This text of 119 Cal. App. 3d 326 (National Life & Accident Insurance v. Edwards) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
National Life & Accident Insurance v. Edwards, 119 Cal. App. 3d 326, 174 Cal. Rptr. 31, 1981 Cal. App. LEXIS 1748 (Cal. Ct. App. 1981).

Opinions

Opinion

WOODS, J.

The National Life and Accident Insurance Company (hereinafter referred to as National) filed a complaint in interpleader [330]*330against appellants Faylease Edwards and Johnnie M. Glass. Under the terms of the complaint, respondent paid into court the sum of $8,365.96 as the death benefit due on the life of the insured, William C. Edwards, and asked the court to determine the respective rights of the rival claimants, Edwards and Glass.

Thereafter, both Edwards and Glass filed cross-complaints claiming that an additional $8,000, over and above the sum deposited into court by respondent, was due and owing by respondent under a double-indemnity section of the policy of life insurance.

Respondent moved for summary judgment or, in the alternative, for summary adjudication by the court that no additional sums were due under the double-indemnity provision of this policy in that the death occurred more than 90 days after the injuries were sustained.

On March 27, 1978, summary judgment was granted as to the double-indemnity provisions, the court holding that the amount due under the policy was $8,000 plus interest and that no additional sums were payable by reason of the accidental death because the decedent died more than 90 days after the date on which the injuries were sustained.

Proceedings on the remaining issues of the litigation were continued to September 6, 1978, in order to allow appellants to pursue their rights through extraordinary writ procedure.

Following denial of appellants’ petition for writ of mandamus, the matter proceeded to trial on the remaining issues. Appellants Glass and Edwards stipulated that they would each receive one-half of all sums collected under this policy, including any monies that may be collected under the double-indemnity portion of the policy. The case proceeded to trial on the tort actions of each of the appellants against National for bad faith refusal to pay benefits and fraud. After opening statements, National’s motion for nonsuit on the cross-complaints of Glass and Edwards was argued and granted.

I

William Charles Edwards, now deceased, purchased a family life insurance policy insuring his life, the life of appellant Edwards, his wife, [331]*331and the lives of their minor children. At the time the policy was issued, Mr. Edwards was 24 years of age.

The policy was in the face amount of $4,000 and had additional coverage in the amount of $4,000 if the death of the insured occurred within 10 years following the issuance of the policy, and further contained a provision for payment of an additional sum of $8,000 in the event that the insured died as a result of injuries sustained in a vehicular accident, if the death occurred within 90 days from the date on which the injuries were sustained.

On March 2, 1974, Mr. Edwards was involved in a motor vehicle accident, as a result of which he was rendered a quadriplegic. He died on March 22, 1976. It was stipulated by the parties that the disabling effects of the injuries sustained in the accident were continuous until and including March 22, 1976. There was a chronological lapse of 751 days between the date of the accident in which the injuries were sustained and the date of death. The cause of death as stated on Mr. Edwards’ death certificate was bilateral bronchopneumonia as a consequence of a spinal cord injury due to blunt force trauma.

Mr. and Mrs. Edwards had separated in October of 1971, prior to the accident, and did not thereafter live together. Mrs. Edwards, the appellant herein, paid all of the premiums on the subject insurance policy from its inception through October 1974, following which, by the terms of the policy, premiums were waived by reason of the total disability of Mr. Edwards. The insured wife, appellant Edwards, was the named and designated primary beneficiary and successor owner under the policy.

In October of 1974, appellant Glass forwarded a letter to respondent National enclosing a general power of attorney form. The letter attempted to change the beneficiary of the subject policy from the insured’s wife to his aunt, appellant Glass. The letter was signed by appellant Glass as attorney in fact and also contained an X mark purportedly affixed by William C. Edwards. No action was taken by respondent to change the beneficiary.

II

The issues presented on appeal are:

1. Whether benefits are payable under a double-indemnity clause of a life insurance policy when death follows from an accidental injury with[332]*332in such time as the processes of nature consume in causing death, notwithstanding the fact that the death occurs subsequent to a time limitation specified in the policy; and

2. Whether the failure of an insurance company to effectuate a requested change of beneficiary in a life insurance policy gives rise to an action for breach of an implied covenant of good faith and fair dealing.

III

On appeal we are asked to consider whether the trial court, after observing that there were no California cases in point, erred in refusing to apply the “process of nature” rule to defeat the clause in this insurance policy which resulted in no additional benefits being paid by reason of Mr. Edward’s accidental death, because he died more than 90 days after the date on which the injuries were sustained.

The process of nature rule, created by judicial decisions in other states, was first applied in California in Frenzer v. Mutual Ben. H. & A. Assn. (1938) 27 Cal.App.2d 406 [81 P.2d 197], and has since been confirmed as the law of the State of California, but its application has thus far been limited to disability policies in California.

“The ‘process of nature’ rule holds that, within the meaning of policy provisions requiring disability within a specified time after the accident, the onset of disability relates back to the time of the accident itself whenever the disability arises directly from the accident .. . ‘within such time as the process of nature consumes in bringing the person affected to a state of total [disability].’ (Schilk v. Benefit Trust Life Ins. Co. (1969) 273 Cal.App.2d 302, 307 ....)” (Willden v. Washington Nat. Ins. Co. (1976) 18 Cal.3d 631, 635 [135 Cal.Rptr. 69, 557 P.2d 501].)

The rationale for the rule is best set forth in Rathbun v. Globe Indemnity Co. (1921) 107 Neb. 18 [184 N.W. 903], wherein the court pointed out that it was a matter of common knowledge that in a large majority of instances in which bodily injuries are received, the real nature and extent of injuries are not revealed until sometime in the future and after the first pains have passed away. The court said: “The injured part often lies dormant for an indefinite period, with but little or no consciousness of its existence by the person injured, although from the [333]*333very moment of the accident, perhaps, the processes of nature may be busily engaged in developing what may have seemed to be but a slight hurt into a most serious and perhaps fatal injury.” {Id., at p.

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National Life & Accident Insurance v. Edwards
119 Cal. App. 3d 326 (California Court of Appeal, 1981)

Cite This Page — Counsel Stack

Bluebook (online)
119 Cal. App. 3d 326, 174 Cal. Rptr. 31, 1981 Cal. App. LEXIS 1748, Counsel Stack Legal Research, https://law.counselstack.com/opinion/national-life-accident-insurance-v-edwards-calctapp-1981.