Williams v. New England Mut. Life Ins. Co.

419 So. 2d 766
CourtDistrict Court of Appeal of Florida
DecidedSeptember 23, 1982
DocketAE-495
StatusPublished
Cited by6 cases

This text of 419 So. 2d 766 (Williams v. New England Mut. Life Ins. Co.) is published on Counsel Stack Legal Research, covering District Court of Appeal of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Williams v. New England Mut. Life Ins. Co., 419 So. 2d 766 (Fla. Ct. App. 1982).

Opinion

419 So.2d 766 (1982)

William H. WILLIAMS, Myrtle Williams, Frances Williams, and William H. Williams, As Personal Representative of the Estate of Malcolm Ronald Williams, Deceased, Appellants,
v.
NEW ENGLAND MUTUAL LIFE INSURANCE COMPANY, a Foreign Corporation, Gulf Life Insurance Company, a Florida Corporation, and Independent Life & Accident Insurance Company, a Florida Corporation, Appellees.

No. AE-495.

District Court of Appeal of Florida, First District.

September 23, 1982.

*767 William F. Daniel, Tallahassee, for appellants.

Miles Davis of Beggs & Lane, Pensacola, for appellees.

*768 ERVIN, Judge.

This is an appeal from a final judgment denying coverage under the double indemnity provisions of three life and accidental death policies. We affirm the lower court's determination holding that no coverage extended to the benefit of the insured as to the Independent Life and Accident Insurance Company on the ground that the policy had expired at the time of decedent's death. The policy clearly and unambiguously provided that the accidental death and dismemberment portion of the employee group life insurance policy would automatically cease upon the insured's termination from employment. The lower court apparently found, on conflicting evidence, that the insured was no longer an employee at the time of his death. This finding is supported by competent and substantial evidence.

We affirm also the lower court's holding as to the Gulf Life policy that the insured was not covered because his wounds were intentionally inflicted by another person. The policy has an express exclusion barring accidental death benefits under such circumstances. Again, there was substantial evidence supporting the lower court's finding.

The court's ruling denying the plaintiffs' requested relief as to their action on the New England Mutual Life Insurance Company policy on the ground that the insured's death occurred as the result of illness or disease — not accident — requires more extended discussion. New England Life's coverage excludes accidental death caused directly or indirectly due to a disease, or the insured's commission of a felony. As to the former, we reverse the lower court's determination that alcoholism is a disease, but as to the latter, we remand for factual considerations.

Malcolm Ronald Williams, the decedent, had been an alcoholic for many years, succumbing on occasion to hallucinations. At noon on the day of his death, he was driven to his apartment by his brother. He was then sober. The evidence suggests that between noon and late evening he began drinking heavily. Late that night his landlord and landlady were awakened by Williams' screams, to the effect that someone was trying to break into his apartment. One of the officers who was alerted to the scene remembers that Williams appeared to be intoxicated at the time. Williams' landlady recalls that his behavior was erratic; he was seen wildly flinging his arms. Nonetheless, he was finally calmed down, and the police departed.

Shortly thereafter, the decedent's landlady heard six shots. Her husband summoned the police the second time. Upon their arrival, they cautiously approached Williams' apartment. The landlady later recounted that she heard his door slam shut, making a loud noise; an officer, however, thought that he heard a gunshot. The decedent ran out into the yard swinging his arms about, gun in hand, shouting: "I got them! I got them!" Williams was ordered to halt, but he persisted on his fateful course. Two shots were fired, abruptly terminating Williams' unhappy life.

The appellants sought to recover from New England Life under the life and accidental death coverages of the policy. New England Life refused to pay the proceeds, arguing that its policy excluded as a risk, accidental death caused by disease or the insured's commission of a felony.[1] The case went to non-jury trial, and the insurer contended that Section 396.022(1), Florida Statutes (1971),[2] classifies alcoholism as a "disease" *769 within its policy terms. Alternatively, New England Life suggested that the decedent's death was caused by his commission of the felony of aggravated assault.

In support of these contentions, a police officer testified that if Williams had lived, he would have been charged with aggravated assault. Countering this, the state's attorney testified that Williams had been determined not to have committed any crime at the time of his death. As to his mental state, evidence was presented showing that the decedent was intoxicated and possibly hallucinating at the time of his death. Williams' brother stated that he found numerous empty beer cans in the decedent's apartment the day following his death. An autopsy, moreover, reflected that he had a .27 blood-alcohol rating.

The decedent's ex-wife, a nurse, stated that Williams in her opinion was definitely an alcoholic. She recounted that he often drank a minimum of a fifth of liquor per day and on occasion hallucinated due to his heavy and prolonged use of alcohol. She related one instance in which Williams had observed non-existent kittens in a closet. From a medical standpoint, as a nurse, she stated that alcoholism is not a disease. A pathologist who testified opined that Williams had been hallucinating. The pathologist posited that alcoholics who are hallucinating appreciate the significance of acts, but are unable to appreciate what they are doing. Further, he viewed alcoholism primarily as a disease. A psychiatrist partly concurred, explaining that one who suffers from alcoholic hallucinosis is temporarily insane. Yet, he did not view alcoholism as a disease, but rather a personality disorder.

Based upon this evidence, the court, without addressing the question of whether coverage should be denied due to the exclusion in the policy relating to persons whose deaths occur during the commission of felonies, found that the decedent's estate was not entitled to the proceeds of the New England Life policies, because the "disease" of alcoholism contributed to Williams' death. The lower court specifically noted that Section 396.022, Florida Statutes (1971), states that, as a matter of public policy, alcoholism is a disease. We reverse as to that finding.

The New England Life policy provision bars company liability for death resulting, directly or indirectly, from a disease or infirmity. Section 396.022(1) states that, as a matter of public policy, alcoholism is to be regarded as a disease. Normally, a statute applicable to the insurance policy, which was in force at the time the policy of insurance was consummated, is considered a basic ingredient of the contract, because the law in existence at the time of the making of the contract of insurance forms a part of that contract, as if it were expressly referred to in its terms. National Merchandise Co., Inc. v. United Service Automobile Association, 400 So.2d 526, 531 (Fla. 1st DCA 1981). Our inquiry is directed to the question of whether Section 396.022(1) is material for the purpose of applying the policy exclusion, thereby making it a part of the contract of insurance.

Whether alcoholism is a disease for insurance purposes is a question that cannot be readily answered, although a superficial reading of Section 396.022(1) would seem to indicate that it is. Nevertheless, we note with interest the position taken by the United States Supreme Court in a criminal proceeding:

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Nugget Oil, Inc. v. Universal SEC. Ins. Co.
584 So. 2d 1068 (District Court of Appeal of Florida, 1991)
Buck v. Gulf Life Insurance Co.
548 So. 2d 715 (District Court of Appeal of Florida, 1989)
Hester v. State
503 So. 2d 1342 (District Court of Appeal of Florida, 1987)
Hayden v. Guardian Life Ins. Co. of America
500 So. 2d 831 (Louisiana Court of Appeal, 1986)
Linehan v. State
476 So. 2d 1262 (Supreme Court of Florida, 1985)
Ago
Florida Attorney General Reports, 1984

Cite This Page — Counsel Stack

Bluebook (online)
419 So. 2d 766, Counsel Stack Legal Research, https://law.counselstack.com/opinion/williams-v-new-england-mut-life-ins-co-fladistctapp-1982.