Southern Farm Bureau Life Insurance v. Moore

793 F. Supp. 702, 1992 U.S. Dist. LEXIS 9425, 1992 WL 145179
CourtDistrict Court, S.D. Mississippi
DecidedApril 28, 1992
DocketCiv. A. No. J90-0114(L)
StatusPublished
Cited by2 cases

This text of 793 F. Supp. 702 (Southern Farm Bureau Life Insurance v. Moore) is published on Counsel Stack Legal Research, covering District Court, S.D. Mississippi primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Southern Farm Bureau Life Insurance v. Moore, 793 F. Supp. 702, 1992 U.S. Dist. LEXIS 9425, 1992 WL 145179 (S.D. Miss. 1992).

Opinion

MEMORANDUM OPINION AND ORDER

TOM S. LEE, District Judge.

Cary Moore died when the automobile he was driving crashed into a building and burst into flames. At the time of the crash, Mr. Moore was insured under an accidental death policy issued by Southern Farm Bureau Life Insurance Company (Southern Farm). Following his death, his wife and beneficiary, Lou Ann Moore, sought to recover benefits under the Southern Farm policy. Southern Farm, however, denied coverage asserting that Mr. Moore’s death was not due solely to an accidental injury,- as defined in the policy, but was caused by or contributed to by a pre-exist-ing disease or bodily infirmity, a brain tumor, and thus was excluded from coverage. Under the coverage portion of Southern Farm’s policy, covered injury was defined as “bodily injury caused by an accident resulting directly and independently of all other causes of loss covered by this policy.” [704]*704The following exclusion also appeared in the policy:

A loss that is a result of or contributed to by one of the following is not a covered loss even though it was caused by an accidental bodily injury:
(1) A disease or infirmity of the mind or body.

Southern Farm brought this action seeking by way of declaratory judgment an adjudication that it has no liability under its policy. Lou Ann Moore filed a counterclaim against Southern Farm in which she contended that she was entitled to the accidental death benefit provided in the policy. The evidence introduced at trial demonstrated that Mr. Moore was likely alive at the time his car crashed into the building, and though he had an existing brain tumor, he would not have died when he did but for the injuries received in the accident. That is, the impact and/or fire was the immediate cause of death. However, the accident would not have occurred but for the brain tumor, which caused Mr. Moore to black out while driving. Thus, a pre-existing infirmity or disease was a cause of the accident, but death was caused solely as a result of injuries suffered in the accident and not by virtue of the disease or infirmity itself. The jury returned a verdict for Lou Ann Moore, and the case is now before the court on the motion of plaintiff/coun-terdefendant Southern Farm Bureau Insurance Company for judgment as a matter of law or in the alternative for a, new trial. Defendant/counterplaintiff Lou Ann Moore has responded and the court has considered the memoranda of authorities submitted by the parties. Mrs. Moore has also filed a motion for an award of attorney’s fees and expenses, to which Southern Farm has responded.

There are numerous Mississippi cases construing the reach of accidental death coverage and exclusion provisions. Most of those eases, however, address situations in which injuries sustained by an insured in an accident aggravate or make active a preexisting disease or infirmity, and the two combine to cause death, see, e.g., Peerless Ins. Co. v. Myers, 192 So.2d 437 (1966) (under accidental death policies, “recovery may be had where the accidental injury aggravates, renders active, or sets in motion a latent or dormant preexisting condition or disease, which in turn contributes to the disability or death for which recovery is sought and where the accidental injury is a proximate cause of the resulting loss.”); Mutual of Omaha Ins. Co. v. Deposit Guaranty Bank and Trust Co., 246 Miss. 640, 151 So.2d 816 (1963); United States Fidelity and Guaranty Co. v. Hood, 124 Miss. 548, 87 So. 115 (1921), and they thus provide little or no guidance for the court.

No Mississippi cases have been found which address a scenario similar to that now before the court. In its post-trial motion, Southern Farm relies on Sekel v. Aetna Life Insurance Company, 704 F.2d 1335 (5th Cir.1983), a Fifth Circuit case applying Texas law, as determinative of the question here presented. While Mrs. Moore is correct in her assertion that Sekel is not controlling authority, the court considers it, while not binding, at least instructive in the absence of Mississippi authority on the issue.1 In Sekel, a death was sustained much in the same sequence as here. The only relevant evidence as to death was that Mr. Sekel, the insured, died from a severe head trauma within an hour after falling and sustaining a severe blow to his [705]*705head. The immediate cause of death was the blow to the head, but the fall was attributed to a pre-existing bodily infirmity or disease, “severe atherosclerotic and hypertensive cardiovascular disease,” which had probably caused Mr. Sekel to pass out. The question with which the court was presented was whether the exclusion in Aetna’s policy barred recovery of accidental death benefits respecting a death as to which a bodily infirmity or disease was “a functionally closely related significant contributing factor or cause,” but as to which the “more immediately precipitating and proximate cause [was] accidental injury.” Id. at 1336.

The Sekel court observed that under Texas law, two types of exclusion clauses in accidental death policies have been recognized: “those which excluded coverage only when disease was a proximate cause, and those which excluded it when the disease was a more remote cause, of the loss.” Id. 1337 (citing Stroberg v. Insurance Company of North America, 464 S.W.2d 827, 829-31 (Tex.1971). The court’s task was thus to determine whether the Aetna exclusion fell into the latter category, “effectively excluding coverage where disease, though a functionally closely related significant contributing factor or cause is nevertheless neither a concurrent proximate nor the most immediately precipitating cause of loss,” or whether it fell into the former category, which excluded coverage “only where disease is at least a concurrent proximate cause.” Id. The court concluded that the exclusion fell into the latter category, observing,

This language contemplates a situation where “the proximate or precipitating cause of loss” is accidental bodily injury, and makes clear that, “even though ” the accidental injury is the proximate or precipitating cause, if disease or bodily injury is also a contributing factor or cause, there is no coverage. Since the exclusion clause by its terms is applicable when the proximate or precipitating cause of loss is an accidental injury, necessarily implicit in its meaning is that other contributing factors or causes which the policy excludes (e.g., “bodily or mental infirmity” or “disease”) need not be concurrent proximate or as immediately precipitating causes for the exclusion to have effect. Thus, a loss, a functionally closely related significant cause or contributing factor of which is a noncovered risk, is excluded from the policy’s accidental, death benefits even though a covered risk is the proximate and more immediately precipitating cause of the loss.

Id. at 1338 (emphasis in original); see also Huff v. Aetna Life Ins. Co., 120 Ariz. 548, 587 P.2d 267 (Ariz.App.1978) (reaching same result under identical exclusionary clause).

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Related

Southern Farm Bureau Life Ins. Co. v. Moore
993 F.2d 98 (Fifth Circuit, 1993)
Southern Farm Bureau Life Insurance v. Moore
993 F.2d 98 (Fifth Circuit, 1993)

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Bluebook (online)
793 F. Supp. 702, 1992 U.S. Dist. LEXIS 9425, 1992 WL 145179, Counsel Stack Legal Research, https://law.counselstack.com/opinion/southern-farm-bureau-life-insurance-v-moore-mssd-1992.