New Amsterdam Casualty Co. v. Mays

43 App. D.C. 84, 1915 U.S. App. LEXIS 2574
CourtCourt of Appeals for the D.C. Circuit
DecidedJanuary 4, 1915
DocketNo. 2710
StatusPublished
Cited by1 cases

This text of 43 App. D.C. 84 (New Amsterdam Casualty Co. v. Mays) is published on Counsel Stack Legal Research, covering Court of Appeals for the D.C. Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
New Amsterdam Casualty Co. v. Mays, 43 App. D.C. 84, 1915 U.S. App. LEXIS 2574 (D.C. Cir. 1915).

Opinion

Mr. Justice Robb

delivered the opinion of- the Court:

This is an appeal from a judgment upon verdict for Imcy D. W. hi avs, the plaintiff, in the supreme court of the District, in an action on an accident and disability , insurance policy. The plaintiff is the widow and beneficiary of the insured..

At a former trial the court, at the close of all the evidence, directed a verdict for the defendant on the ground that the failure of the insured, in answering a schedule of questions in his application for insurance, to mention the rejection of an application for life insurance, constituted a breach of warranty, and avoided the policy. Dpon appeal to this court we ruled that the questions ashed in the above-mentioned schedule were not intended to elicit information concerning a rejection for life insurance, and reversed and remanded the case. Mays v. New Amsterdam Casualty Co. 40 App. D. C. 249, 46 L.R.A. (N.S.) 1108. In the present appeal counsel again attempt to raise this question, and in justification refer to Ætna L. Ins. Co. v. Moore, 281 U. S. 543, 58 L. ed. 356, 34 Sup. Ct. Rep. 186; Prudential Ins. Co. v. Moore, 231 U. S. 560, 58 L. ed. 367, 34 Sup. Ct. Rep. 191, since decided. In those cases the insured had been ashed whether any proposal or application to insure his life had been made to any company, association, or agent, for which insurance had not been granted, and also whether any physician had expressed an unfavorable opinion upon his life, with reference to life insurance. Those questions the insured answered in the negative, notwithstanding that an application for life insurance had been made, and that the medical examiner of the company had refused to pass him, telling him that he had heart disease. The difference between those cases and the present is too apparent to require further comment. We therefore adhere to our prior ruling.

Mr. Mays further stated, when he applied for insurance, that he had not received medical or surgical attention during the five years preceding, except in 1890, for hand cut lasting four weeks. At the former hearing it was insisted, as now, that the evidence warranted the coiirt in ruling, as matter of [88]*88law, that this representation was not true, and hence constituted a breach of warranty. After reviewing the evidence upon this point, which did not differ materially from the evidence in the present record, we ruled that the question was for the jury, under proper instructions from the court. The present record shows that the court, at the request of the defendant, charged the jury that if they should find from the evidence “that the assured made a false statement, or concealed the true situation in -respect of any matter stated in the schedule, that was material to the risk, their verdict must be for the defendant. * * * That if they find from the evidence that when the policy in suit was last renewed, on or about September 27, 1909, Mr. Mays was not in sound condition physically, or that any of his warranties or statements material to the risk and contained in the original policy were untrue at the time of the said last renewal thereof,” their verdict must be for the defendant; “that if they find from the evidence that Mr. Mays had received medical or surgical attention during the five years immediately preceding the date of the policy, namely September 27, 1906/ except for some slight indisposition or injury such as a hand cut about 1890, lasting four weeks, then the verdict must be for the defendantThis instruction was as favorable to the defendant as the evidence warranted.

The policy contains the following “Special Indemnities” clause: “This policy does not exclude indemnity for loss by accident as herein provided, caused or contributed to, wholly or partly, directly or indirectly, by sunstroke, freezing, .anesthetics, gas, lockjaw, septicemia, narcotics, poison, somnambulism, racing, shooting, intoxicants, asphyxiation, riot, polo playing, wrestling, strikes, steeple chasing, football playing, hydrophobia, riding to hounds, or. by bite of animal; but in any such event the liability of the company shall be one half of the amount of the ordinary accident indemnity specified for such loss;” and under the head of “Definitions,” loss of life by accident is “deemed to mean death from bodily injuries not intentionally inflicted by the assured, which independently of all other causes are effected solely and exclusively by external, vio[89]*89lent, and accidental means, and which shell result in the death of the assured within ninety days of the event causing the injury.” It is the contention of appellant that (he death of 21 r. 2fays was caused or contributed to by septicemia, and hence that the recovery should have been limited to one half of the principal amount specified in the policy.

In Western Commercial Asso. v. Smith, 40 L.R.A. 653, 29 C. C. A. 223, 56 U. S. App. 393, 85 Fed. 401, (he friction of a new shoe against one of the insured’s feet produced an abrasion of the skin of one of his toes, which caused blood poisoning resulting in death. It was the contention of the insurance company that death was not produced “by bodily injuries effected by external, violent, and accidental means;” but the court, speaking through Judge Sanborn, ruled otherwise, saying: “If the deceased suffered an accident, but at the time he sustained it he was already suffering from a disease or bodily infirmity, and if the accident would not have caused his death if he had not been affected by the disease or infirmity, but he died because the accident aggravated the disease, or the disease aggravated the effects of the accident, * * * the association was exempt from liability, because' the death was caused partly by disease and partly by accident. If the death was caused by bodily injuries effected by external, violent, and accidental means alone, the association was liable to pay the promised indemnity. If the death was caused by a disease which was not the result of any bodily infirmity or disease in existence at the time of the accident, but which was itself caused by the external, violent, and accidental means which produced the bodily injury, the association was equally liable to pay the indemnity. In such a case the disease is an effect, of the accident, the incidental means produced and used by the original moving cause to bring about its fatal effect, a mere link in the chain of causation between the accident and the death; and the death is attributable not to the disease, but to the cam* causans, to the accident alone.”

In Garvey v. Phoenix Preferred Acci. Ins. Co. 123 App. Div. 106, 108 N. Y. Supp. 186, it was ruled that a clause in [90]*90an accident insurance policy, that liability for injiudes or disability resulting, directly or indirectly, from poison or infecten, is limited to one tenth of the amount otherwise recoverable, does not apply to a disability occasioned primarily by a bruised or lacerated leg caused by a fall, though prolonged by the infection or poisoning of the wound; that the injury did not “result” from poison or infection, but the infection resulted from the injury, and was a consequence reasonably to be expected.

In Cary v. Preferred Acci. Ins. Co. 127 Wis. 67, 5 L.R.A. (N.S.) 926, 115 Am. St. Rep. 997, 106 N. W. 1055, 7 Ann. Cas.

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Bluebook (online)
43 App. D.C. 84, 1915 U.S. App. LEXIS 2574, Counsel Stack Legal Research, https://law.counselstack.com/opinion/new-amsterdam-casualty-co-v-mays-cadc-1915.