Pacific Mut. Life Ins. Co. of California v. Schlakzug

180 S.W.2d 980, 1944 Tex. App. LEXIS 749
CourtCourt of Appeals of Texas
DecidedApril 6, 1944
DocketNo. 11616.
StatusPublished
Cited by2 cases

This text of 180 S.W.2d 980 (Pacific Mut. Life Ins. Co. of California v. Schlakzug) 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
Pacific Mut. Life Ins. Co. of California v. Schlakzug, 180 S.W.2d 980, 1944 Tex. App. LEXIS 749 (Tex. Ct. App. 1944).

Opinion

CODY, Justice.

This is an action to recover accident benefits under a policy of insurance brought by the beneficiary, who alleged that the insured died as a result of an infection after pulling a hair from his nose.

As his cause of action the beneficiary alleged in his petition: “That while the insured was shaving in his home on or about January 25, 1940, he plucked a hair from his nose, bringing about immediate pyo-genic infection of said nose and his body. That said infection brought about an early death of the insured, towit: within three days, and said infection and said death was brought about by the plucking of said hair in said nose, which was accidentally caused solely through bodily, external, violent and accidental means.”

The insurer defended upon the following provision of the policy as relieving it from liability under the policy: “The accident benefits of this policy do not cover loss of life or disability, caused or contributed to, directly or indirectly, in whole or in part by disease, ptomaines or bacterial infection (except pyogenic infection which shall occur simultaneously with and through an accidental cut or wound).” And in its answer the insurer pled that the loss sued on was due to a risk or cause coming within said exception to liability under the policy.

The case was tried without a jury, and judgment was rendered for the beneficiary. In response to the insurer’s request, the court filed conclusions of fact and law. The following statement of facts is taken therefrom:

That the insured pulled out a hair from the right nostril of his nose on January 23, 1940. And that as a result there immediately arose a cut, laceration or wound, which occurred accidentally and unexpectedly. That as a result thereof, and as a part thereof, and in connection therewith, there was at once introduced into the tissues of the nose certain pyogenic organisms, commonly known as septic. This brought about a pyogenic infection of “blood poisoning” from which the insured died on January 28, 1940. That early, on the morning of January 24th, the nose of the insured was swollen and inflamed, showing the infection to be the result of the cut, laceration or wound, which was not the necessary, expected or usual result from the pulling of the hair, but was unexpected, extraordinary and very rare. Nor was the infection the necessary, expected or usual, result of pulling the hair, nor of the wound, but was unexpected, extraordinary, unusual and very rare. That the death of Aaron Slater was the result, solely and directly, from said cut, laceration or wound, and the infection resulting therefrom, and independently of all ether causes; and that said cut, laceration or wound, and the infection resulting therefrom, were bodily injuries effected solely through external, violent and accidental means. The court found $1250.-00 to be reasonable attorney’s fees.

The first point on which the insurer or appellant predicates its appeal is: “This case should be reversed and rendered because the loss alleged by plaintiff was not covered by the policy sued upon in that the infection which resulted in the insured’s death did not result from an accidental cut or wound.”

We are concerned in this case with but two of the provisions of the policy. The insuring clause, reading:

“The * * * Company * * * hereby insurers against (1) loss of life, limbs or sight, as hereinafter set forth, resulting directly and indirectly of all other causes, from bodily injuries effected solely through external, violent and accidental means.”

The other provision of the policy with which we are concerned is the exception to liability pled by appellant in its answer, and set forth above.

The foregoing insuring clause is similar in all material respects to the one considered by the Supreme Court in the case of International Travelers’ Ass’n v. Francis, 119 Tex. 1, 23 S.W.2d 282. *982 The clause was there held to insure against the loss of life resulting from .an intentional act, such as pulling a tooth, because such a result was so rare, unusual and extraordinary as to constitute the loss of life from bodily injuries effected solely through external, violent and accidental means. Assuming that the court’s finding to the effect that the insured’s death resulted from intentionally pulling a hair from his nose is supported by the evidence, then, under the authority of the Francis case, such death was covered by the insuring clause. Numerous other decisions to the same effect might be cited. We will cite additionally, however, only the case of Bryant v. Continental, etc., 107 Tex. 582, 182 S.W. 673, L.R.A.1916E, 945, Ann.Cas.1918B, 517.

Appellant does not deny that under the authority of the Francis case the loss here sued for was covered by the insuring clause of the policy. But it contends that the exception which it invoked in its answer defeats any recovery on the policy. And appellant further contends that a like exception was considered in the Francis case, and that the Supreme Court held that if the same had appeared upon the face of the policy (instead of in the by-laws) that it would have there defeated recovery. Since the Supreme Court held that the exception (because it appeared only in the by-laws and not upon the face of the policy) formed no part of the contract, the same was not before the court for construction. Nor is the same set out in the opinion of the Supreme Court. Therefore the statement to the effect that if the exception could be considered it would defeat recovery is obiter dicta. Nevertheless 'we have compared the exception here invoked by appellant with the exception in its various forms as set forth in the opinion of the Court of Civil Appeals in the Francis case (260 S.W. 938), and we do not regard it as being substantially similar to the one here considered.

When appellant admits that the loss sued for in this case is covered by the insuring clause, it yields up the case. Because the language of the exception was selected and inserted for the evident purpose of preventing a conflict between the insuring clause and said exception. That is to say, the exception provides for instances where the insurance benefits shall not be applicable, whereas the insuring clause provides for the instances where they shall. Whereas accident benefits are provided for loss of life by accidental means, it will be noted that the instances which are excepted from accident benefits are losses resulting from natural causes— diseases, ptomaines or bacterial infection. However, the exception clause does not stop there, for, if it did, it would except from the contract of insurance risks which the insurer had agreed to cover. In other words, death from bacterial infection may be death from a natural cause, or it may be under such circumstances as was present in the Francis case, death brought about by accidental means. Hence the exception to the exception in order to limit the instances where accident benefits were not to be paid to cases where death or disability resulted from natural causes.

If there can be said to be any doubt that the exception to the exception was intended merely to prevent a conflict between the insuring clause and the exception, then we have a doubtful provision, and it is well settled that an exception to a contract of insurance must be construed most strongly against the insurer and in favor of the insured.

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Related

Universal Life & Accident Insurance Co. v. Burden
294 S.W.2d 855 (Court of Appeals of Texas, 1956)
Pacific Mutual Life Insurance Co. of California v. Schlakzug
183 S.W.2d 709 (Texas Supreme Court, 1944)

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Bluebook (online)
180 S.W.2d 980, 1944 Tex. App. LEXIS 749, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pacific-mut-life-ins-co-of-california-v-schlakzug-texapp-1944.