Kingsland v. Metropolitan Life Ins. Co.

• Decision Date: 17 October 1934
• Docket Number: 7269.
• Citation: 37 P.2d 335,97 Mont. 558
• Parties: KINGSLAND v. METROPOLITAN LIFE INS. CO.
• Court: Montana Supreme Court

37 P.2d 335

97 Mont. 558

KINGSLAND v. METROPOLITAN LIFE INS. CO.

No. 7269.

Supreme Court of Montana

October 17, 1934

Appeal from District Court, Fergus County; Edgar J. Baker, Judge.

Action by Christina Kingsland against the Metropolitan Life Insurance Company. From a judgment for plaintiff, defendant appeals.

Affirmed.

Belden & DeKalb, of Lewistown, for appellant.

E. K Cheadle and C. E. Baker, both of Lewistown, for respondent.

MATTHEWS Justice.

The defendant, Metropolitan Life Insurance Company, has appealed from a judgment against it and in favor of Christina Kingsland, beneficiary under two policies of life insurance issued to her husband, Alvin Kingsland, deceased.

The policies which form the basis of the judgment were originally straight life insurance policies, but in 1929, prior to the death of the insured, the company added to all such policies a rider supplementing the benefits thereof as follows:

"Upon receipt of due proof that the insured *** has sustained *** bodily injuries, solely through external violent and accidental means, resulting, directly and independently of all other causes, in death of the insured within ninety days, *** the Company will pay in addition *** an Accidental Death Benefit equal to the face amount of insurance then payable at death." It is further declared that this payment will not be made "if death is caused or contributed to directly or indirectly, or wholly or partially, by disease, or by bodily or mental infirmity."

Among other activities, Kingsland took care of the furnace in the Judith Theater at Lewistown. On August 20, 1931, while in apparent good health, although some three months prior thereto he had consulted a physician for heart trouble, the insured mounted a chair set on the uneven, rough concrete floor of the furnace room in the theater in order to adjust two pet cocks, high overhead; to get at the second of these he had to reach around the boiler, and, while doing so, the chair rocked; he lost his balance and, catching his foot in the chair, fell in such manner that he struck headfirst on the rough cement. His only movement after striking the floor was to turn over on his back; he sustained lacerations and bruises on his head; shortly his face darkened and he died. The company paid the life insurance, but refused to pay the accident benefits and plaintiff brought action to recover this additional amount.

The complaint describes the accident and alleges that Kingsland died from injuries received by accidental means which "were within the provisions, terms and conditions" of the policy, but that the plaintiff was unable to plead the policies more explicitly, inasmuch as they had been delivered to the company and it refused to redeliver them or furnish plaintiff with copies thereof. It further alleges compliance with the policies by furnishing proof of loss which conformed to the requirements of the policies.

The defendant answered, setting up the rider to the policies and alleging that "assuming that the pleading of the plaintiff" brought her into a position to claim "that she had negatived the terms of the rider," denied that the death of Kingsland "was not caused or contributed to directly or indirectly, or wholly or partially, by disease." The answer further alleged that the proof of loss shows no liability on the part of the defendant, in that it affirmatively showed: "Cause of death, Ruptured Aneurysm of Aorta, precipitated by fall striking head on cement floor. Contributory or secondary: fall striking head on cement floor."

In her reply the plaintiff alleged that if the proof of loss contains the quoted statements, "said proof of loss does not truly state the facts pertaining to the cause of death."

On the trial, the facts were not in dispute, and the record of the evidence consists chiefly of the examination and cross-examination of doctors on hypothetical questions relative to the cause of death.

At the opening of the trial, defendant objected to the introduction of evidence, on the ground that the complaint fails to state facts sufficient to constitute a cause of action. At the close of plaintiff's case, defendant moved for a nonsuit on the grounds that the plaintiff had not shown that proofs of loss were furnished showing that death occurred under circumstances casting liability on it; that it was not shown that the proofs furnished were incorrect, but, on the contrary, they were true and disclosed nonliability; that the plaintiff showed that the primary cause of death was the ruptured aneurysm. In each instance the court ruled against the defendant.

The court submitted interrogatories to the jury; the second of these is: "Was the death of Alvin Kingsland caused or contributed to, directly or indirectly or wholly or partially, by disease, or by bodily infirmity, namely a ruptured blood vessel?" The jury answered this question in the negative, and returned a verdict for the plaintiff which was followed by the judgment from which this appeal is taken.

The specifications made are that the court erred in overruling defendant's objection to the introduction of testimony and its motion for nonsuit, and that the evidence is wholly insufficient to sustain the verdict and judgment.

Under the first specification it is argued that the complaint did not state a cause of action because the proof of loss filed showed nonliability instead of liability. If the proof so shows, that fact would not avail the defendant on its objection to the introduction of evidence, for it did not appear in the complaint challenged. The complaint does not set up the proof of loss, but alleges its sufficiency and avers that the plaintiff is illiterate and relied solely upon the company and its agent in the preparation of her proofs, which were prepared by the agent and under his direction and merely signed by her and delivered to the company, and upon the assurance made to her at the time that the proofs made were sufficient proofs under the policies. The objection went only to the sufficiency of the complaint, and, with the explanation therein as to plaintiff's failure to more definitely plead facts showing liability, coupled with the allegation of the ultimate fact of compliance with the requirements of the policies in this regard and the sufficiency of the proofs submitted, the pleading was not open to the attack made upon it.

In this connection counsel for the defendant concede that one may challenge his own proof of loss on the ground of mistake fraud, neglect, or inadvertence, but assert that an action "without pleading or proof" of such challenge is premature. Again, the complaint challenged does not show this condition. The complaint states the facts within the knowledge of the plaintiff; this was met by the answer challenging the sufficiency of the proof of loss. By reply, the plaintiff, lacking knowledge of the contents of the proofs of loss, alleged that, if they contain the matter alleged to show nonliability, they "do not truly state the facts." Argument as to whether or not she produced evidence to support this allegation does not properly come under the first specification, but will be considered in connection with the remaining specifications of error, which raise...