Reliable Life Insurance Co. v. Rivera

570 S.W.2d 234, 1978 Tex. App. LEXIS 3610
CourtCourt of Appeals of Texas
DecidedAugust 17, 1978
DocketNo. 17133
StatusPublished

This text of 570 S.W.2d 234 (Reliable Life Insurance Co. v. Rivera) 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
Reliable Life Insurance Co. v. Rivera, 570 S.W.2d 234, 1978 Tex. App. LEXIS 3610 (Tex. Ct. App. 1978).

Opinion

EVANS, Justice.

A “grudge fight” involving four men at Sylvia’s Lounge on November 10, 1973, left Roy Rivera dead from a gunshot wound in his chest. His widow, Connie Rivera brought this action against The Reliable Life Insurance Company to recover accidental death benefits under a policy issued on her husband’s life. The insurance company defended on the basis of a policy limitation which provides that “no accidental death benefit will be payable if death results directly or indirectly from, or is caused by or contributed to by . . . committing or attempting to commit an assault or felony.”

In response to special issues, the jury found that Rivera was not illegally carrying a handgun on the occasion in question and that he had not assaulted or attempted to assault either Manuel Gonzales or Justo Hernandez, two of the participants in the fight. The trial court entered judgment on the jury’s verdict, awarding Connie Rivera the sum of $5000.00 as accidental death benefits payable under the policy, plus a 12% penalty as provided by Texas Insurance Code, Article 3.62, and attorney’s fees. The Reliable Life Insurance Company brings this appeal, contending that the evidence is legally and factually insufficient to support the jury’s findings.

In an action on an insurance policy the burden of proof is upon the insured to negative the exclusions and limitations contained in the policy which are pleaded as a defense by the insurance company. Sherman v. Provident American Insurance Co., 421 S.W.2d 652, 654 (Tex.1967). Thus, the burden of proof was upon Mrs. Rivera to establish by a preponderance of the evidence that her husband’s death was not caused by or contributed to by a criminal act on his part in committing or attempting to commit an assault or felony.

Mrs. Rivera met this burden in her case in chief by making a prima facie showing of the existence of the policy and that her husband had died as a result of a gunshot wound. A presumption exists that the insured is innocent of any criminal conduct, and in the absence of any evidence to the contrary, the jury was entitled to find that the insured was not engaged in a criminal act at the time of his death. Republic National Life Insurance Co. v. Heyward, 536 S.W.2d 549, 559 (Tex.1976).

The presumption of an insured’s innocence merely raises an issue of fact to go before the jury where no contrary evidence is produced. It does not constitute evidence [236]*236in itself nor does it shift the burden of proof. Prudential Insurance Co. of America v. Krayer, 366 S.W.2d 779 (Tex.1963). Republic National Life Insurance Co. v. Heyward, supra. The insurance company’s position in the case at bar is that it rebutted the presumption of innocence by proof that the insured was involved in a criminal act within the meaning of the policy limitation.

The insured, Roy Rivera, was sometimes employed as a carpenter by his friend, Daniel Ramirez, and occasionally the two men stopped to drink beer together after work. On the evening in question they had several beers at a place near their work, and on their way home, they stopped at Sylvia’s Lounge for another beer. According to Ramirez’ testimony, Rivera was a “nice easy going person who did not start trouble with people.” The two men were friends and Ramirez felt that each would come to the other’s assistance if one were in trouble.

When the fight started, Ramirez and Rivera were just beginning to play a game of pool. Rivera was standing across the table from Ramirez and was watching Ramirez get ready “to shoot”. Ramirez testified that just as he was about to make his “shot”, he felt somebody hit him from behind and knock him down. The person who hit him was his second cousin, Manuel Gonzales, with whom he had a previous quarrel. As Ramirez tried to get up, Gonzales shot him. Gonzales did not say anything to Ramirez, just kicked him and when he tried to get up, shot him. Ramirez said that he had a prior dispute with Gonzales which resulted from his telling Gonzales to keep away from his house. On a prior occasion at Sylvia’s Lounge, Gonzales had tried to pick a fight with him and with his stepson. Ramirez said he thought Gonzales knew Rivera but that Rivera was not aware of his dispute with Gonzales. He knew of no reason why Gonzales would have a grudge against Rivera. Ramirez said he did not have a gun with him on the evening in question, and he did not see Rivera with a gun.

Manuel Gonzales acknowledged that he had “an old fight” with Ramirez and that there was an understanding between them that “the next time we see each other, that was going to be it.” He said he went over to where Ramirez was and kicked him, and they started fighting. His friend, Justo Hernandez, who knew of his dispute with Ramirez and who had agreed to assist him in a fight with Ramirez, joined in the affray. He said that while he was fighting with Ramirez, Rivera shot at him twice and that one of the shots “barely creased” his neck. He said that he had his own gun, a .32 caliber pistol, which he had carried with him since his prior argument with Ramirez, but that he did not pull his gun until after he had been shot by Rivera. He shot Rivera, saw him fall and then “came back” and saw Ramirez on top of Hernandez. He said he didn’t know Hernandez was already shot so he went ahead and shot Ramirez too. Gonzales was indicted for the murder of Rivera and for assault to murder Ramirez. The murder charge was dropped, but Gonzales was tried and found guilty of the offense of assault to murder.

Ruben Flores, the owner of Sylvia’s Lounge, testified that there were about 40 people in the lounge at the time the fight started. He said he saw Gonzales and another man fighting and he started over to them to break up the fight. He then heard a commotion to his right, on the other side of the pool table where Hernandez was fighting with a man he did not know, and he heard two shots come from that direction. Gonzales then started shooting and shot “both of them.” About eight or nine shots were fired in all. When the shooting stopped, Hernandez and Gonzales told him “I’ll see you”, and he told Gonzales not to leave. Both Gonzales and Hernandez then left the bar, leaving the other men lying on the floor. Hernandez’ wife then came to Flores and said that her husband was outside, and Flores then went outside and found Hernandez was already dead. There was a gun left in the lounge near one of the men who had been shot. Gonzales took his gun with him when he left the lounge. Hernandez did not have a gun, but Flores did not know whether he had a gun when he came into the lounge. Flores did [237]*237not know who started the fight, and he had his eyes directed on the fight between Gonzales and Ramirez when he heard the commotion to his right. Flores did not know if one of the men in the fight “took a pistol from another one, or whether a man pulled it out of his pocket, or where it came from.” The first time he ever saw the pistol it was lying on the floor, and the only man he saw with a pistol was Gonzales.

Mrs. Marie Rosa Hernandez, the widow of Justo Hernandez, testified that prior to the time she and her husband went to Sylvia’s Lounge on the evening in question, her husband had been doing some work on a truck belonging to Manuel Gonzales.

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Related

Sherman v. Provident American Insurance Company
421 S.W.2d 652 (Texas Supreme Court, 1967)
Republic National Life Insurance Co. v. Heyward
536 S.W.2d 549 (Texas Supreme Court, 1976)
Prudential Insurance Company of America v. Krayer
366 S.W.2d 779 (Texas Supreme Court, 1963)
Guy v. State
170 S.W. 803 (Court of Criminal Appeals of Texas, 1914)
Saldivar v. State
187 S.W.2d 996 (Court of Criminal Appeals of Texas, 1945)
Reeves v. State
217 S.W.2d 19 (Court of Criminal Appeals of Texas, 1949)
Lilly v. State
279 S.W. 267 (Court of Criminal Appeals of Texas, 1926)
March v. Walker
48 Tex. 372 (Texas Supreme Court, 1877)
Fambrough v. Wagley
169 S.W.2d 478 (Texas Supreme Court, 1943)
Guy v. State
170 S.W. 303 (Court of Criminal Appeals of Texas, 1914)

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Bluebook (online)
570 S.W.2d 234, 1978 Tex. App. LEXIS 3610, Counsel Stack Legal Research, https://law.counselstack.com/opinion/reliable-life-insurance-co-v-rivera-texapp-1978.