The Aetna Casualty & Surety Company v. Evelyn Berry and Durwood Douglas Berry

350 F.2d 49, 1965 U.S. App. LEXIS 4686
CourtCourt of Appeals for the Fifth Circuit
DecidedAugust 9, 1965
Docket21803_1
StatusPublished
Cited by3 cases

This text of 350 F.2d 49 (The Aetna Casualty & Surety Company v. Evelyn Berry and Durwood Douglas Berry) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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The Aetna Casualty & Surety Company v. Evelyn Berry and Durwood Douglas Berry, 350 F.2d 49, 1965 U.S. App. LEXIS 4686 (5th Cir. 1965).

Opinion

JOHN R. BROWN, Circuit Judge.

Aetna appeals from a judgment 1 upon a jury verdict awarding Workmen’s Compensation Insurance benefits to the widow and minor son of Lawrence E. Berry who was accidentally killed while loading a rifle into his airplane. The issues, controlled by Texas law are (a) coverage and (b) scope of employment. We affirm.

Since the scope of employment issue is at once easier of disposition and exposi-tive of the facts, we deal with it first. Berry was the President of Berry Engineering Corp. and Berry Contracting Co. 2 The firms, apparently operated together, were involved in heavy industrial contract work, and Berry as chief executive officer was the main salesman, business procurer and spokesman for the companies. In such capacity he frequently entertained prospective customers. This was done most often at his ranch, incorporated as the Circle B and designed particularly for this purpose with the large and convivial lodge supplied with — among other things — about 40 rifles and shotguns for the use of guests.

The fatal accident occurred while Berry was preparing to embark on a business trip which would carry him near to the ranch. He had decided to take a rifle along in the hope that either he or his assistant could return it to the ranch from whence it had been borrowed by a guest. While he was attempting to place the gun in the baggage compartment of the plane, it discharged inflicting wounds from which he died the next day.

In the light of the liberal construction given to the Act, this evidence, briefly summarized, is sufficient to sustain the verdict of the properly charged jury that Berry was within the scope of his employment at the time of the accident. See Employers Mut. Liab. Ins. Co. of Wisconsin v. Sanderfer, Tex.Civ.App. writ ref’d n. r. e., 1964, 382 S.W.2d 144.

Although the question of coverage is more complicated, we are equally as certain that, resolved as it was by the jury, this too must be resolved against Aetna. There were two Aetna policies issued on the Berry Companies of relevance. Both came to Aetna from the Texas Assigned Risk Pool. The first which we shall call the 1960 policy was for one year from August 24, 1960. The second, the 1961 policy, substantially identical to the one involved in this case, went into effect December 28, 1961 for one year’s coverage. Berry died on March 28, 1962. From the evidence, the jury could find that the Berry Companies intended that Berry should be covered and paid the proper premiums 3 under both policies. On the other hand, it seems equally clear that those acting for Aetna did not think they were covering him. But this is not determinative. The question for us is the legal one whether by its actions or those of its agents, Aetna did cover him.

While it is true that the Texas Workmen’s Compensation Act 4 excludes from the definition of “employee” for whom the benefits of the Act flow mandatorily, the president and other officers of *52 a corporation, insurance companies may afford voluntary coverage to a corporate officer if the contract of insurance or other contractual basis so provides. Superior Ins. Co. v. Kling, 1959, 160 Tex. 155, 327 S.W.2d 422; Houston Fire & Cas. Ins. Co. v. Parker, Tex.Civ.App. writ ref’d n. r. e., 1960, 341 S.W.2d 495; Hanover Ins. Co. v. Holleman, Tex.Civ.App. writ ref’d n. r. e., 1963, 372 S.W.2d .554.

The question for us is the one stated in the Kling case:

“* * * [Although respondent [manager of the business] does not bring himself within the terms and conditions of the * * * Act, are the facts here such that would authorize the construction of this policy as a special contract of insurance covering the respondent and awarding him the benefits and indemnity provided in the policy and measured by the provisions of the Act?” 327 S.W.2d at 424.

The conclusion in Kling, based on a clear statement in the application by the broker that the executive officer was to be covered plus retention of the premium by the insurer, was that the insurer was “estopped to deny that it intended to provide protection to [the executive] by special . contract of insurance, * 327 S.W.2d at 425. At the outset we recognize that the facts showing estoppel in our case are not as strong as in Kling. The jury, however, by answer to special-interrogatories, F.R.Civ.P. 49(a), found estoppel and we conclude that the facts are strong enough to sustain the application of the rule of that case to our own.

On its face the 1960 policy offers no indication that Berry was to be covered. 5 Texas form TX-1 was attached as an endorsement to this policy and provided as follows:

“It is agreed that such insurance as is afforded by the policy by reason of the designation of Texas in Item 3 of the Declarations does not apply to injury, including death resulting therefrom, sustained by the president * * * of the Insured, * * except such officers or directors, if any, as are named below or in Item 4 of the Declarations; # * *»

No officers were named “below” nor did any of the Declarations in Item 4 in any way suggest executive officer coverage. But Berry’s salary was reported monthly under “Outside Salesmen” set off by the manual premium code number “8742” and the appropriate premium was paid each month. These monthly reports sent to Aetna’s Dallas office were on an Aetna form entitled ' “STATEMENT OF WAGES EXPENDED For Interim Premium Adjustment.” 6

The Berry Companies made this report of estimated premiums. Sometime in January of 1962, or perhaps shortly before, the Aetna payroll auditor, James Devlin, came to the Companies’ office to make an audit to determine the correctness of the wage reports and compute the necessary adjustments to arrive at a final premium report. He performed this audit in accordance with his standing instructions which included the “Audit Requisition Card.” The particular card was not produced, but Devlin testified that generally the card would *53 list the coverages with reference to the code and endorsements. Since the “Outside Salesmen” wages reported under Code 8742 was not formally consistent with the 1960 policy and, perhaps, the requisition card, the jury may have thought the auditor must have been particularly alerted to this item. The Companies’ worksheets from which the monthly reports were prepared would, of course, have to be examined. 7 These worksheets remove all doubt that “Outside Salesmen * * * 8742” (note 6, supra) refers to the salary paid L. E. Berry. Indeed for the majority of the year, his salary was the only one refer-rable to Code 8742. For at least one month’s report, the worksheet column was headed, “L. E.

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350 F.2d 49, 1965 U.S. App. LEXIS 4686, Counsel Stack Legal Research, https://law.counselstack.com/opinion/the-aetna-casualty-surety-company-v-evelyn-berry-and-durwood-douglas-ca5-1965.