National Security Life & Casualty Co. v. Benham

233 S.W.2d 334, 1950 Tex. App. LEXIS 1619
CourtCourt of Appeals of Texas
DecidedSeptember 25, 1950
Docket6087
StatusPublished
Cited by17 cases

This text of 233 S.W.2d 334 (National Security Life & Casualty Co. v. Benham) 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
National Security Life & Casualty Co. v. Benham, 233 S.W.2d 334, 1950 Tex. App. LEXIS 1619 (Tex. Ct. App. 1950).

Opinion

LUMPKIN, Justice.

On October 15, 1949, the appellant, National Security Life & Casualty Company, issued a policy of insurance to the appellee, G. A. Benham, Jr. The policy provided, among other things, that the appellant would pay the appellee $1000 in the event the appellee’s infant daughter, Nandra Sue Benham, lost her life as a result of injuries “sustained through purely accidental means.”

On the night of November 19, 1949, the appellee, his wife, and Nandra Sue were visiting friends at San Angelo, Texas. Nandra Sue was two months and nineteen days old. About midnight the appellee and his family retired to their hotel room and went to bed. All three were in a double bed, the child between her parents. Nandra Sue was a breast baby. At about 4 a. m., November 20, the child was fed by the mother and showed every indication of being a normal, healthy child. At about 9:30 a. m., the appellee awoke and noticed that something was wrong with his daughter. He awakened his wife. At the ap-pellee’s request the hotel clerk called Dr. George L. Nesrsta. After examining the baby and questioning the parents the doctor pronounced the child dead. In Dr. Nes-rsta’s opinion Nandra Sue had died of suffocation.

In due time the appellee made proof of his daughter’s death and applied for the benefits described in appellant’s policy of insurance. On January 11, 1950, one T. W. Browning, an adjuster for appellant, called on the appellee. Without having any information as to the cause of the child’s death, other than a notice from the appellee that she had died from accidental suffocation, Browning disputed appellee’s claim and represented that the term “bodily injuries,” as used in the insurance policy, meant an open or gaping wound. Browning assured the appellee that he was not entitled to recover anything under the terms of the policy but that in his opinion the insurance company should assist in defraying Nandra Sue’s funeral expenses. He offered the appellee the sum of $500 to settle the claim. Further, Browning informed the appellee and his wife that if they did not accept the proffered $500, the insurance company would not pay them anything. The appellee agreed to accept Browning’s offer. In return for a draft on appellant for $500, which he cashed, the appellee executed a release of all claims arising out of his daughter’s death. Later, the appellee filed this suit to recover the additional $500 the appellee alleged is due *336 him under the terms of the policy of insurance.

In his petition the appellee alleged that his daughter had died from injuries received through purely accidental means, i.e., that his daughter had accidentally suffocated. The appellant answered with a general denial and alleged that the payment of the $500 to the appellee by the adjuster Browning was in satisfaction of any claim the appellee might have against the appellant because of Nandra Sue’s death.

In a supplemental petition the appellee pleaded that the release obtained by Browning had been procured through misrepresenting the meaning of the term “bodily injuries” and that the appellant had not acted in good faith in questioning the existence of its liability and attempting to settle the claim for less than the benefits prescribed by the policy. The appellee pleaded that the agreement or settlement alleged by the appellant was not supported ■by any consideration. The appellant denied these allegations.

In answer to special issues the jury found that Browning had acted with deceit when he represented to the appellee that the term “bodily injuries,” as used in the insurance policy, meant a gaping wound, and the jury found that it was only because of such representations that the ap-pellee agreed to sign the settlement papers. Furthermore, the jury determined that the appellant had not acted in good faith in questioning the company’s liability under the contract of insurance and that at the time of the settlement there did not exist a. bona fide dispute between the parties concerning the facts surrounding Nandra Sue’s death. The court did not submit an issue as to the cause of Nandra Sue’s death., The court ordered the release canceled and entered judgment in favor of ap-pellee in the amount of $500. The appellant excepted to this judgment and has duly perfected its appeal to this court.

The appellant attacks the sufficiency of the evidence on the question of whether Nandra Sue died from bodily injuries sustained through purely accidental means and insists that the court erred in not submitting the issue of cause of death to the jury. The insuring clause of appellant’s policy reads in part: “National Secdrity Life and Casualty Company * * * does hereby insure * * * Nandra Sue Ben-ham * * * against loss of life * * * sustained through purely accidental means.”

A portion of part B of the policy states: “If the insured or any dependent insured hereunder shall sustain bodily injuries * * * which injuries shall independently and exclusively of disease and all other causes, 'Continuously and wholly disable the insured or such dependent from the date of the accident and result in any of the following specific losses within thirty days, the Company will pay for the loss of: Life —$1,000.00.”

Dr. Nesrsta testified that in forming his opinion as to the cause of Nandra Sue’s death, he took into consideration the statements made by the parents as well as his own observations. On cross-examination he stated that if -he should disregard the statements made 'by the parents then he would say that Nandra Sue could have died from a respiratory congestion as well as from suffocation. The appellant insists that a respiratory congestion could 'be the result of a disease, such as diphtheria, and that in the absence of a jury finding the court erred in holding Nandra Sue’s death accidental within the provisions of the insurance policy.

The insurance company did not specifically allege that the child’s death was the result of a disease, such as diphtheria or colic, but instead relied upon a general denial. Since the appellant did not plead an affirmative defense, the court did not err in failing to submit an issue thereon. Prior to the adoption of the Texas Rules of Civil Procedure, the plaintiff in an action on an insurance policy had the •burden of alleging and proving that the insured’s death was by accident and that the insured’s death did not come within the exceptions named in the policy which specifically exempted the insurance company from liability. International Trave *337 lers Ass’n et al. v. Marshall, 131 Tex. 258, 114 S.W.2d 851. With the adoption of Rule 94, however, this rule was changed to relieve the plaintiff of the burden of alleging that death was not due to a result or cause coming within any of the exceptions listed in the policy and made it incumbent upon the insurer to specifically allege a particular exception, if the insurer wished to urge such a particular exception as a defense.

In our opinion the clause found in the policy which reads, “independently and exclusively of disease and all other causes,” constitutes an exception and limitation to the general liability as set forth in the insuring 'Clause. The appellant did not plead such an exception and therefore is not entitled in the trial court or in this court to the defense that the child died of a disease or other natural causes.

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Bluebook (online)
233 S.W.2d 334, 1950 Tex. App. LEXIS 1619, Counsel Stack Legal Research, https://law.counselstack.com/opinion/national-security-life-casualty-co-v-benham-texapp-1950.