Brush v. Washington Nat. Ins. Co.

• Decision Date: 04 August 1941
• Docket Number: 45625.
• Citation: 299 N.W. 403,230 Iowa 872
• Parties: BRUSH v. WASHINGTON NAT. INS. CO.
• Court: Iowa Supreme Court

299 N.W. 403

230 Iowa 872

BRUSH v. WASHINGTON NAT. INS. CO.

No. 45625.

Supreme Court of Iowa.

August 4, 1941

Appeal from District Court, Marshall County; B. O. Tankersley Judge.

Parrish, Guthrie, Colflesh & O'Brien, of Des Moines, for appellant.

Mills Hewitt & Diltz, of Des Moines, and O. H. Allbee, of Marshalltown, for appellee.

HALE Justice.

Plaintiff's petition stated as her cause of action that the defendant insurance company issued to Austin O. Brush, on July 1, 1939 a policy of insurance, agreeing to insure the said Brush against loss of life by accidental means, in the sum of $1,000. Attached to the petition were copies of the policy and application. The petition alleged that during the night of October 1-2, 1939, the insured met his death by accidental means, by being accidentally asphyxiated by carbon monoxide gas, which he accidentally inhaled while sitting in his parked automobile near Marshalltown; and further alleged the furnishing of proper proofs and compliance with all the conditions of the policy, and that the defendant refused to pay the claim and denied liability; and the petition asked judgment. To this petition the defendant filed a demurrer, on the ground that the facts stated did not entitle the plaintiff to the relief demanded under the terms of the policy, which are referred to as pleaded in the petition. This demurrer was overruled, and defendant electing to stand on the demurrer, judgment was entered for the amount claimed, with interest. From this order of the court the defendant appeals.

The provisions of the policy, so far as pertinent to this inquiry, are as follows:

" This policy provides benefits for the loss of life, limb, sight, or time by accidental means to the extent herein provided. Peerless policy. Accident department. Washington National Insurance Company, Chicago, Illinois. A stock company. Section I. Insuring Clause. In consideration (1) of the payment of the policy fee of Five Dollars, and (2) of all the agreements and representations contained in the application therefore, * * * the Washington National Insurance Company (hereinafter called the Company), subject to all the conditions, limitations, and provisions contained herein and endorsed hereon, hereby insures Austin O. Brush * * * (1) against loss resulting solely from bodily injury effected directly and independently of all other causes through accidental means, which injury is hereinafter referred to as ‘ such injury’ ; and (2) against disability resulting from sickness (if benefits are provided in paragraphs 3 and 4 of Section II hereof), the cause of which originates after thirty days from the date of this policy * * *, which sickness is hereinafter referred to as ‘ such sickness'; provided, however, that this insurance shall not cover nor shall any benefits be paid for any disability or loss caused by or resulting from suicide, venereal disease, insanity, military or naval service, nor shall such insurance cover nor benefits be paid for any disability, or loss, resulting from Insured's participation in aeronautics, as a passenger or otherwise, * * *. The principal sum of this policy is $1,000.00." (It will be noticed here that the foregoing section I contains certain exceptions, such as disability or loss resulting from suicide, etc., but no exception from gas or other causes specified in section V is specifically mentioned.)

" Section II. Benefits for Loss of Time. #1. Monthly Accident Benefits for Total Disability." Provides for rate of pay for such injury. Paragraph 2 refers to monthly accident benefits for partial disability. " #3. Monthly Sickness Benefits for Confining Total Disability. When ‘ such sickness' totally and continuously disables and confines the Insured within the house, during all of which time Insured is regularly treated therein at least once each week by a licensed physician or surgeon other than himself, the company will pay at the rate of $ None per month for a period not exceeding twelve months, for the number of consecutive days that the Insured is so disabled, confined, and treated." Paragraph 4 of Section II provides for monthly sickness benefits for nonconfining total disability.

" Section III. Specific Benefits. If ‘ such injury’, except as otherwise provided in Section V hereof, shall totally disable the Insured and shall, within ninety days from the date of the accident, result in one of the losses specified in this Section, the Company will pay, for said loss, in lieu of all other indemnity, as follows: For Loss by Accidental Means of: #1. Life * * * The Principal Sum * * *"

Section IV does not relate to matters in issue herein.

" Section V. Covered and Paid as Sickness. For the purpose of avoiding any question or misunderstanding concerning the origin or cause of any disability or any loss resulting wholly or in part, directly or indirectly, in or from carbuncles, boils, felons, abscesses, ulcers, infection (external infection of any ‘ such injury’ is construed as an accident), cancer, gas, poison, culosis, appendicitis, erysipelas, fits, vertigo, hernia, surgical operations, sunstroke, freezing, heat exhaustion, heat prostration, lame back, strains, sciatica, neuritis, lumbago, paralysis, sprained back, over-exertion, dementia, or any disability following ‘ such injury’ which is or becomes complicated with or by disease, or any disability or loss (except drowning) where there is no wound or contusion visible to the eye, it is agreed that in every such case, said disability or loss and any claim therefore shall be classified and treated under this policy as sickness and shall be subject to the provisions, conditions and limitations governing sickness insurance as set forth herein, the original cause of such disability or loss notwithstanding."

The remaining sections are immaterial so far as this case is concerned.

There is but one assignment of error and one question to be considered. The assignment is, as stated by defendant: " The trial court erred in overruling the defendant's demurrer for, under the terms of the policy, the accidental death of the insured by asphyxiation from carbon monoxide gas accidentally inhaled, was not covered."

The controversy thereforee is as to the construction of the policy, plaintiff claiming that the death of insured is covered by the terms of the policy, and defendant by demurrer denying. The general rules as to construction have often been announced. They are concisely set out in 1 C.J. p. 414, Accident Insurance, sections 37 to 44. They are liberally construed as against the insured, although strictly construed as against the insurer. Where a policy insures by clear and comprehensive language against death from bodily injuries by accidental means, liability for such death will not be destroyed by language of exception, unless such exception shall be clear and free from reasonable doubt. See, Masonic Accident Ins. Co. v. Jackson, 200 Ind. 472, 164 N.E. 628, 61 A.L.R. 840. See also, to the same effect, Kirkpatrick v. Aetna Life Ins. Co., 141 Iowa 74, 117 N.W. 1111, 22 L.R.A., N.S., 1255; Simpkins v. Hawkeye Commercial Men's Ass'n, 148 Iowa 543, 126 N.W. 192; Matthes v. Imperial Accident Ass'n, 110 Iowa 222, 228, 81 N.W. 484, 486. It is the rule that where insurance contracts are ambiguous or require interpretation, or are fairly susceptible of two different constructions, the courts will adopt that construction most favorable to the insured. In general, courts give that construction to an accident policy, if the language fairly admits, as will make it of value and carry out the intention expressed therein that liability is incurred where death occurs from accidental injury. See, Masonic Accident Ins. Co. v. Jackson, supra. The rules above mentioned are those announced by our own decisions. See, as to ambiguous contracts, Foster v. North American Acc. Ins. Co., 176 Iowa 399, 402, 158 N.W. 401, 402; Crowe v. Merchants' Life & Casualty Co., 202 Iowa 43, 209 N.W. 406; Jones v. Continental Casualty Co., 189 Iowa 678, 179 N.W. 203, 18 A.L.R. 1329; Mochel v. Iowa State Trav. Men's Ass'n, 203 Iowa 623, 626, 213 N.W. 259, 260, 51 A.L.R. 1327; Carpenter v. Iowa State Trav. Men's Ass'n, 213 Iowa 1001, 240 N.W. 639. In Kascoutas v. Federal Life Ins. Co., 189 Iowa 889, 892, 179 N.W. 133, 134, it is stated: " And here comes into action the elementary rule that in construing such exceptions the court will deal strictly with the insurer who drafted the proviso, and will resolve all doubt in favor of payment." See also, Parker v. Iowa Mutual Tornado Ass'n, 220 Iowa 262, 264, 260 N.W. 844, 846, citing a large number of cases. Breen v. Great Western Acc. Ins. Co., 190 Iowa 1172, 179 N.W. 931, also states as an established rule that ambiguity in any part of the policy must operate in favor of the policy holder.

The foregoing are general rules of construction about which there is little dispute. Defendant's contention,...