Weiner v. Continental Casualty Co.

70 Misc. 2d 935, 335 N.Y.S.2d 11, 1972 N.Y. Misc. LEXIS 1807
CourtCivil Court of the City of New York
DecidedJune 16, 1972
StatusPublished

This text of 70 Misc. 2d 935 (Weiner v. Continental Casualty Co.) is published on Counsel Stack Legal Research, covering Civil Court of the City of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Weiner v. Continental Casualty Co., 70 Misc. 2d 935, 335 N.Y.S.2d 11, 1972 N.Y. Misc. LEXIS 1807 (N.Y. Super. Ct. 1972).

Opinion

Seymour Boyers, J.

This is an action to recover accident disability benefits under a policy of insurance issued by the defendant. The plaintiff was paid benefits for a period of one year since defendant contends the disability was caused by sickness ” within the meaning of the policy. The plaintiff makes claim for ‘ ‘ accident ’ ’ disability benefits for a five-year period contending that his bodily injury was caused by an “ accident ” within the terms of the policy.

At the trial, plaintiff testified that on June 30, 1969 he was employed as a bagel maker at the Hempstead Bagel Bakery. As part of his job, he normally was required to lift 100-pound sacks of flour ‘ waist high ’ ’ into a flour sifter. The flour sifter machine located in the basement of the premises mechanically brings the flour up to a large mixing machine in the main area of the shop. On June 30,1969, the flour sifter was out of order, thus requiring plaintiff and a helper to lift the 100-lb. sacks of flour directly into the mixing machine which meant raising the sacks chest high ”. At about 11:00 a.m. in the morning of June 30, immediately after lifting a bag of flour into the mixing machine, the plaintiff felt a pain in his chest, a squeezing or tightening sensation, he started to perspire, and then stopped work and went home.

[936]*936The plaintiff visited his family physician, a Dr. Juffey, a general practitioner, on June 30, 1969 and informed the doctor of the pains in his chest on lifting the flour bags. The doctor who testified at the trial examined the plaintiff and did EKG-’s and repeat EKG’s, and advised the plaintiff to take bed rest and not to return to work until July 22, 1969. Dr. Juffey also gave the plainitff nitroglycerin and other medication, and since the doctor was going on vacation he advised the plaintiff that if he had any further problems to contact Dr. Martin Heilbraun, a cardiologist. At that time Dr. Juffey’s diagnosis was angina pectoris due to coronary insufficiency. The doctor further testified that in his opinion the flour bag lifting incident was the precipitating factor of the coronary insufficiency and the congestive heart failure which then developed.

The plaintiff testified that he returned to work on July 21, and that on July 22, he again suffered pains in the chest and immediately made an appointment to see Dr. Heilbraun. Dr. Heilbraun testified at the trial that he first saw the plaintiff on July 22, 1969. He received a history of the plaintiff lifting the 100-pound bags of flour chest high on June 30,1969, having chest pains, going to Dr. Juffey, staying out of work until July 21, 1969, returning to work July 21, and on July 22, 1969, sustaining new chest pains and coming to him. Dr. Heilbraun’s diagnosis was arteriosclerotic heart disease, acute coronary insufficiency, congestive heart failure and right bundle branch block. The plaintiff was hospitalized at Manhasset Medical Center under the care of Dr. Heilbraun. Date of admission, July 22, 1969 and date of discharge from the hospital was August 8, 1969. The plaintiff had a causally related recurrence causing hospitalization in December of 1969. Plaintiff had a prior history of an angina attack in 1960, followed by no interim history of pain until June 30, 1969. Dr. Heilbraun maintained that while the basic arteriosclerotic heart disease may have pre-existed the lifting episode of June 30, 1969, in his opinion, the heart pain suffered by plaintiff on June 30, 1969 was causally related to the lifting of the 100-pound flour bags. It was further the testimony of Dr. Heilbraun that electrical tests showed that the plaintiff sustained more damage than a mere episode of coronary insufficiency and heart pain and he characterized the damage as congestive heart failure. The doctor stated that the plaintiff’s condition was permanent and that the permanency was causally related to the lifting episode of June 30, 1969. On further examination, the doctor maintained that prolonged coronary insufficiency such as occurred here can lead to heart failure, and did so here and is causally related.

[937]*937The court is presented with the issues of whether plaintiff’s disability was caused by an “ accident ’ ’ under the terms of the policy of insurance, and if so, whether the injury was caused ‘ ‘ directly and independently of all other causes.”

The “Definitions” section of the subject insurance policy defines injury as follows: “ ‘ Injury ’ means bodily injury caused by an accident occurring while this policy is in force and resulting directly and independently of all other causes in loss covered by this policy.”

In Burr v. Commercial Travelers Mut. Acc. Assn. (295 N. Y. 294, 301), the following definition of “accident” was given: ‘ ‘ Legal scholars have spent much effort in attempts to evolve a sound theory of causation and to explain the nature of an ‘ accident ’. Philosophers and lexicographers have attempted definition with results which have been productive of immediate criticism. No doubt the average man would find himself at a loss if asked to formulate a written definition of the word. Certainly he would say that the term applied only to an unusual and extraordinary happening; that it must be the result of chance; that the cause must be unanticipated or, if known, the result must be unexpected.”

At the end of the plaintiff’s case, the defendant moved to dismiss on the ground that plaintiff failed to establish a prima facie case. Upon the court reserving decision on said motion, defendant rested without offering evidence or witnesses on its behalf. The defendant then renewed its motion asserting that plaintiff’s claim is not based on an “ accident ” within the terms of the policy and cited cases which defendant contends would indicate that plaintff has not crossed the threshold of proving that his injuries, if any, were caused by an accident.

In a review of several cases, the defendant seeks, to rely heavily on the case of Wilcox v. Mutual Life Ins. Co. of N. Y. (265 N. Y. 665). In Wilcox, the deceased was a foreman of a construction gang and his crew was engaged in raising a heavy electrical transformer. Certain planks which were being used to guide the transformer as it was being raised became displaced and the deceased and a fellow worker reached up and endeavored to push them into proper position. Shortly thereafter the deceased died as the result of a break in the inner coat of the aorta leading to the heart.

The claim instituted in Wilcox and the insurance policy terms are quite different from the instant case. In Wilcox, the claim was for double indemnity benefits under the terms of a policy wherein the injury or death resulted from ‘ ‘ external violent [938]*938and accidental means. ’ ’ The term 11 injury ’ ’ as defined by the insurance policy sued upon in the instant case does not include the language of external, violent and accidental means ” as that language is understood by the average man.

In Lewis v. Ocean Acc. & Guar. Corp. (224 N. Y. 18,.21), where death was due to a virulent and lethal infection introduced into the body by puncturing a pimple on the lip with an instrument. Judge Cakdozo, who wrote the decision, in discussing the rationale of the decision stated: ‘ ‘ Probably it is true to say that in the strictest sense and dealing with the region of physical nature, there is no such thing as an accident.

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Bluebook (online)
70 Misc. 2d 935, 335 N.Y.S.2d 11, 1972 N.Y. Misc. LEXIS 1807, Counsel Stack Legal Research, https://law.counselstack.com/opinion/weiner-v-continental-casualty-co-nycivct-1972.