The Prudential Insurance Company of America v. Genevieve D. Schreffler

376 F.2d 397
CourtCourt of Appeals for the Fifth Circuit
DecidedJune 8, 1967
Docket23315
StatusPublished
Cited by14 cases

This text of 376 F.2d 397 (The Prudential Insurance Company of America v. Genevieve D. Schreffler) 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.

Bluebook
The Prudential Insurance Company of America v. Genevieve D. Schreffler, 376 F.2d 397 (5th Cir. 1967).

Opinion

GOLDBERG, Circuit Judge:

Prudential appeals from a judgment entered in accordance with a jury verdict in favor of Genevieve Schreffler, beneficiary under the group life insurance policy on the life of Louden G. Schreffler, her husband. Mrs. Schreffler averred that her husband had died an accidental death and she claimed under the double indemnity provisions of the policy:

“ TART II. Accidental Death and Dismemberment Benefits.
If the Insured, while this Policy is in force, sustains an accidental bodily injury which results, directly and independently of all other causes, in the loss of life, sight or limb by such person within ninety days after the date such injury is sustained * * *
Exceptions and Reductions Applicable to Part II * * * For the purposes of this Part II, no loss shall be considered a loss due to accidental bodily injury if such loss is caused or contributed to by (1) bodily or mental infirmity or disease; or (2) any infection, other than a pyrogenic infection occurring through and at the time of an accidental cut or wound.’ ” [emphasis added]

*399 Prudential argues here that the trial judge should have granted judgment notwithstanding the verdict because the jury could not have found from the evidence that the accident caused the death “directly and independently of all other causes.” We walk the last mile to pay every heed to the jury’s verdict, but we agree with Prudential and reverse.

The insured, Louden Sehreffler, had suffered from asthma and pulmonary emphysema for the ten years preceding his death. Pulmonary emphysema is a chronic and progressive disease which destroys normal lung tissue and prevents transfer of oxygen to the bloodstream in usual amounts. From 1954 until his death in 1962, Sehreffler was treated by Dr. Thomas D. White, his family physician.

On the morning of April 24, 1962, Sehreffler (taking the view of the evidence most favorable to plaintiff) tripped and fell at home, breaking his hip. He was admitted to the hospital by Dr. White and underwent surgery to set the fracture. The surgeon was Dr. George Richards, who testified at trial. The surgery was successful, but following it Schref-fler’s lung condition worsened and he died on May 3.

The question of what circumstances justify the setting aside of a jury verdict, like other questions concerning the judge-jury relationship in the federal courts, is governed by federal law. Byrd v. Blue Ridge Rural Electric Co-Operative, 1958, 356 U.S. 525, 78 S.Ct. 893, 2 L.Ed.2d 953, reh. den. 357 U.S. 933, 78 S.Ct. 1366, 2 L.Ed.2d 1375 (1958); ABC-Paramount Records, Inc. v. Topps Record Distributing Co., 5 Cir. 1967, 374 F.2d 455; Shirey v. Louisville & Nashville R. Co., 5 Cir. 1964, 327 F.2d 549; Braud v. Baker, 5 Cir. 1964, 324 F.2d 213; 5 Moore, Federal Practice ¶50.06 at p. 2350 (2d Ed. 1966).

Our role here is limited. In Westborough Country Club v. Palmer, 8 Cir. 1953, 204 F.2d 143, 147, the Court said:

“As preliminary to a consideration of the contention that the court erred in denying the Country Club’s motion for a directed verdict it would seem appropriate to call attention to the rule that where the motion has been denied and the jury has returned a verdict the evidence must be viewed in a light most favorable to the prevailing party. We must assume that the evidence proved all facts which it reasonably tended to prove and the prevailing party is also entitled to the benefit of all favorable inferences that may reasonably be drawn from’ the facts and circumstances proven. We cannot concern ourselves with any question of conflict in the evidence but must assume that all such conflicts have been resolved by the jury in favor of the prevailing party. Neither is it our province to weigh the evidence nor consider the credibility of the witnesses.”

We have expressed the standard for reviewing a jury verdict. “We must determine whether the state of the proof is such that reasonable and impartial minds could reach the conclusion the jury expressed in its verdict.” American Casualty Co. v. Myrick, 5 Cir. 1962, 304 F.2d 179, 182, 96 A.L.R.2d 1352. It is conceded that all of the medical testimony save that of Dr. White was devoid of ambivalence or equivocation in concluding that emphysema caused or contributed to the cause of death. Assuming that the jury disbelieved all of the testimony except Dr. White’s, we need only consider whether Dr. White’s testimony was sufficient to support the verdict. In the margin are the crucial excerpts from his testimony. 1

*400 Plaintiff’s counsel on appeal argues that Dr. White’s iteration and reiteration that the “cause” of death was the accident furnished sufficient evidence for a jury verdict in favor of the plaintiff. The trouble with this argument is that in making it counsel assumes that “cause” to Dr. White has the same meaning as “cause” in the insurance policy. But causation, as expressed in the policy, is a legal term of art rather than a medical or popular concept. 2

Wigmore discusses the problem:

“ * * * [T]he difficulty arises from the employment in statutory or common-law phraseology of terms having also an untechnical use.
*401 “Yet it seems unfortunate that a term existing in common use among laymen should be tabooed because the law also has been obliged to use it * * *. If a witness, in the course of his testimony, comes to mention that A ‘possessed’ or B ‘owned’ or C was ‘agent’, let him not be made dumb under the law, and be compelled by evasions and circumlocutions to attain the simple object of expressing his natural thought. If there is a real dispute as to the net effect of the facts, these may be brought out in detail on cross-examination.” 7 Wigmore, Evidence § 1960 (3d ed. 1940). [emphasis added]. See also § 1955.

Dr. White’s mere recital that the accident was the “cause” of death has, without explanation of the facts leading to that conclusion, no more significance or evidentiary weight than the bald statement by a psychiatrist that a criminal defendant is “insane”, or a businessman’s unexplained assertion that a certain sale was, for income tax purposes, a “capital transaction.” These conclusions all involve application of facts to a legal standard; unless that standard is explained, the conclusion is without weight.

On Dr. White’s cross-examination, the factual basis of his conclusion was explained.

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376 F.2d 397, Counsel Stack Legal Research, https://law.counselstack.com/opinion/the-prudential-insurance-company-of-america-v-genevieve-d-schreffler-ca5-1967.