Erikson v. Nationwide Mut. Ins. Co.

• Decision Date: 20 November 1975
• Docket Number: No. 11833,11833
• Citation: 543 P.2d 841,97 Idaho 288
• Parties: Robert A. ERIKSON, Plaintiff-Respondent, v. NATIONWIDE MUTUAL INSURANCE COMPANY, an Insurance Corporation, Defendant-Appellant.
• Court: Idaho Supreme Court

Page 841

543 P.2d 841

97 Idaho 288

Robert A. ERIKSON, Plaintiff-Respondent, v. NATIONWIDE MUTUAL INSURANCE COMPANY, an Insurance Corporation, Defendant-Appellant.

No. 11833.

Supreme Court of Idaho.

Nov. 20, 1975.

R. Vern Kidwell, Holden, Holden, Kidwell, Hahn & Crapo, Idaho Falls, for appellant.

G. Rich Andrus, Rigby, Thatcher & Andrus, Rexburg, for respondent.

SHEPARD, Justice.

This is an appeal from a judgment entered on a jury verdict in favor of respondent Robert A. Erikson and against Nationwide Mutual which awarded insurance benefits for loss of sight. The contentions of appellant are that the admission of certain letters from doctors who examined the respondent insured was erroneous, as was the subsequent use of those letters as substantive proof of causation; that jury instructions were erroneous; and that the verdict is not supported by sufficient evidence. We affirm the judgment.

In 1965 Nationwide issued to Erikson an insurance policy providing coverage for stated injuries or death resulting from accident. While that policy was in force in December, 1971, Erikson was riding a snowmobile when he was struck in his right eye by a pine bough, a portion of which entered his eye causing it to bleed and become cloudy. Erikson's son, an optometrist, was present at the scene of the accident and immediately examined respondent's eye. He discovered therein a hemorrhage with an 'issue of blood' approximately the diameter of a pencil eraser. Erikson thereafter developed other symptoms of injury and was unable to make use of his right eye, and a few months later the eye progressively deteriorated to the point of total blindness.

Erikson, on his own initiative and at times at the request of the insurer Nationwide, consulted three ophthalmologists and two optometrists. All concurred that he suffered from a central retinal vein occlusion (an obstruction of the main blood vessel from the eye) which rendered him permanently blind in his right eye. All expert witnesses agreed that respondent's eye demonstrated signs of sclerosis or hardening of the veins and arteries in the eye but they differed in their opinions as to whether the accident or the sclerosis was the cause of the retinal occlusion. Erikson filed a claim for benefits with Nationwide which was supported and followed by letters from examining doctors. The claim was ultimately denied and this action results.

Appellant Nationwide asserts error in the admission of two letters from doctors to Nationwide and their later use as substantive evidence of causation. One is a letter from Dr. Anderson who was one of the examining physicians. That letter was written in response to a request by Nationwide. Therein Dr. Anderson stated that he had examined Erikson and had concluded that his loss of vision was 'in all probability due to the injury sustained when the twig entered the eye.' It is passing strange that Dr. Anderson appeared at the trial of this matter as an expert witness on behalf of defendant Nationwide. In contrast to his written opinion, Anderson testified at trial: 'I feel that the occlusion is due to his (Erikson's) age and due to arteriosclerotic changes in the veins and arteries of the eye. Usually they go together and as all odds by far, the most common cause.' When reminded of his previous written opinion and asked if he had made a false statement to the insurer Nationwide, Anderson 'explained': 'Well I think it was an emotional outburst. I think I had no idea that we were talking about a claim of this size or this magnitude or this nature.'

The second letter, admission of which is assigned as error, was written by Dr. Riekhof also an ophthalmologist. It also was written to Nationwide in response to its request. That letter briefly reviews the history of Erikson's vision, indicates the examination of the eye subsequent to the injury and states 'in light of this rather specific history I suppose it is indeed possible that the vascular accident resulted from this injury.'

Nationwide asserts that there was timely objection to the admission of the letters, that they were hearsay and should not have been admitted. We do not agree. The record is clear in this case that the original introduction of the letters was for the purpose of showing notice and proof of loss to the insurer. Such notice and proof of loss had been denied in Nationwide's answer and left in dispute as an issue at trial. The letters of the doctors to Nationwide were probative and direct evidence of Erikson's compliance with the notice conditions of the policy. It is well established that evidence inadmissible for one purpose may nevertheless be admissible for another purpose. McDowell v. Geokan, 73 Idaho 430, 252 P.2d 1056 (1953); 1 Wigmore on Evidence § 13; Bell, Handbook of Evidence for the Idaho Lawyer (2nd Ed.) 18.

The record further demonstrates that Nationwide waived any objection it may have had to the use of the contents of the letters as evidence of causation by its later actions. During the course of Dr. Anderson's direct testimony, ¹ he was examined on statements made by him in that letter and counsel for Erikson was permitted to cross-examine on that same letter without objection thereto. The introduction of the letter having been proper for one purpose and that purpose having been exceeded, its evidentiary use may not now be limited. Hartley v. Bohrer, 52 Idaho 72, 11 P.2d 616 (1932).

The letter from Dr. Riekhof presents another problem. Dr. Riekhof was not available for examination at trial. However, the record indicates that counsel for Nationwide affirmatively consented to the substantive use of the contents of that letter on the condition that counsel for Nationwide be allowed to admit three additional letters from the same doctor which were allegedly more favorable to Nationwide. Those additional three letters were admitted in evidence. Thereafter other medical witnesses were examined and cross-examined on the statements made by Dr. Riekhof in all four letters. The letters were properly admitted for the original purpose of showing notice and in view of later proceedings were properly before the jury as substantive evidence as the cause of Erikson's blindness.

Appellant Nationwide next assigns error to certain of the court's jury instructions and also the failure of the court to instruct the jury in accordance with appellant's requested instructions. In essence, Nationwide contends that it was entitled to an instruction stating that the accident must have been the 'sole cause or the cause independent of the other causes' in order to find liability within the requirements of the insurance policy. Defendant's instruction was refused and in lieu thereof the court instructed that in order to be the proximate cause of the injury it must be shown that the accident is the 'dominant cause' although other factors may have existed which also tended to help produce a loss of sight. Appellant asserts error in the use of the term 'dominant cause' in contrast with the provisions of the policy that satisfactory proof of injury must have been sustained 'as a direct result of an accident . . . directly and independently of all other causes' and the policy provisions excluding from coverage 'any loss resulting directly or independently, wholly or partly from: (1) disease or bodily infirmity. . . .'

It is a long established precedent of this Court to view insurance contracts in favor of their general objectives rather than on a basis of strict technical interpretation of the language found therein. Where language may be given two meanings, one of which permits recovery and the other does not, it is to be given the construction most favorable to the insured. Stated somewhat differently, an insurance contract is to be construed most favorably to the insured and in such a manner as to provide full coverage for the indicated risks rather than to narrow protection. This Court will not sanction a construction of the insurer's language that will defeat the very purpose or object of the insurance. Corgatelli v. Globe Life and Acci. Ins. Co., 96 Idaho 616, 533 P.2d 737 (1975); Rollefson v. Lutheran Brotherhood, 64 Idaho 331, 132 P.2d 758 (1942); Mayflower Ins. Exchange v. Kosteriva, 84 Idaho 25, 367 P.2d 572 (1961); Shields v. Hiram C. Gardner, Inc., 92 Idaho 423, 444 P.2d 38 (1968); Lewis v. Continental Life and Acci. Co., 93 Idaho 348, 461 P.2d 243 (1969); Toevs v. Western Farm Bureau Life Ins. Co., 94 Idaho 151, 483 P.2d 682 (1971). Consistent with this view, we believe that the mere fact that a latent disease or bodily infirmity exists prior to accident, upon which the accident acts to precipitate the loss, will not defeat coverage so long as the disease or infirmity appears as a passive ally and the accidental cause predominates. Judge Cardozo put it well in Silverstein v. Metropolitan Life Ins. Co., 254 N.Y. 81, 171 N.E. 914 (1930) when he stated that:

'. . . In a strict or literal sense, any departure from an ideal or perfect norm of health is a disease or an infirmity. Something more, however, must be shown to exclude the effects of accident from the coverage of a policy. The disease or the infirmity must be so considerable or significant that it would be characterized as disease or infirmity in the common speech of men. (Citations omitted.) 'Our guide is the reasonable expectation and purpose of the ordinary business man, when making an ordinary business contract.' (Citations omitted.) A policy of insurance is not accepted with the thought that its coverage is to be restricted to an Apollo or a Hercules.'

Seldom does a loss involve a sole cause independent of all other causes as asserted by the appellant. Furthermore, we recognize that there is a plethora of authority in other jurisdictions holding that language in insurance contracts restricting coverage as does the policy here, nevertheless has no greater meaning than the requirement that an accident must be the...