Guest v. Horace Mann Ins. Co.

• Decision Date: 11 October 1983
• Docket Number: No. 66959,66959
• Citation: 168 Ga.App. 714,310 S.E.2d 241
• Parties: GUEST v. HORACE MANN INSURANCE COMPANY.
• Court: Georgia Court of Appeals

Page 241

310 S.E.2d 241

168 Ga.App. 714

GUEST v. HORACE MANN INSURANCE COMPANY.

No. 66959.

Court of Appeals of Georgia.

Oct. 11, 1983.

Rehearing Denied Nov. 2, 1983.

Certiorari Denied Jan. 6, 1984.

Barnard M. Portman, Michael D. Marburger, Savannah, for appellant.

Albert E. Clark, Edward T. Brennan, John D. Schminky, Savannah, for appellee.

BIRDSONG, Judge.

The basic facts of this case are undisputed. This is an action for recovery of the additional $100,000 in life insurance benefits pursuant to the policy rider for "death resulting from an accident." The rider was part of a policy of life insurance with a face amount of $100,000 issued by appellee to appellant's benefactor. The decedent died as a result of circulatory collapse from cardiac arrhythmia caused by the ingestion of three separate cold medications, all containing the medication phenylpropanolamine. The policy rider provided for an additional $100,000 in benefits in the event of the "insured's death subject to [the following] conditions ...: 1. that death resulted from an accident...." The policy further provided: "The Accidental Death Benefit will not be paid if death results from ... 2. drugs, unless prescribed by a Physician, voluntarily taken...." On the basis of these policy provisions and after paying the basic coverage provided by the policy, appellee denied liability for the additional benefits pursuant to the accidental death rider. The trial court agreed with appellee's position and granted its motion for summary judgment.

Appellant enumerates four separate errors on appeal, three of which deal with the trial court's interpretation of the relevant policy provisions and one of which deals with the grant of summary judgment on the issue of bad faith penalties and attorney fees. Held:

1. "Insurance is a matter of contract, and the language used is to be accorded its general and ordinary meaning, bearing in mind that the contract is to be construed in accordance with the intention and understanding of the parties, and, in construing it, the court can go no further than a fair construction of the language used will permit." Ballinger v. C & S Bank of Tucker, 139 Ga.App. 686, 688, 229 S.E.2d 498. " '[I]t is the understanding of the average policyholder which is to be accepted as a court's guide to the meaning of words, with the help of the established rule that ambiguities and uncertainties are to be resolved against the insurance company.' [Cit.]" Jackson v. Nat. Life etc., Ins. Co., 130 Ga.App. 208, 202 S.E.2d 711. Interpretation of the provisions of a plain and definite policy of insurance is a matter of law for the courts, and a policy "is not ambiguous even though presenting a question of construction, unless and until an application of the pertinent rules of construction leaves it uncertain as to which of two or more possible meanings represents the true intention of the parties." Anderson v. Southeastern Fidelity Ins. Co., 166 Ga.App. 750, 305 S.E.2d 383.

2. Pretermitting the issue of whether the subject policy rider requires that death result from "accidental means" (see Jackson, supra), it is...