Lower v. Metro. Life Ins. Co.

• Decision Date: 27 September 1933
• Docket Number: No. 8.,8.
• Parties: LOWER v. METROPOLITAN LIFE INS. CO.
• Court: New Jersey Supreme Court

168 A. 592

LOWER

v. METROPOLITAN LIFE INS. CO.

No. 8.

Court of Errors and Appeals of New Jersey.

Sept. 27, 1933.

Syllabus by the Court.

1. L., a laborer, while pursuing his usual work on an extremely hot day, suffered a sunstroke from the effect of which he died. At the time he was insured, under a policy in full force, providing that the insurance company, "* * * hereby agrees to pay to the beneficiary * * * the sum of $1000 upon receipt * * * of due proof of death of the insured, as the result, directly and independently of all other causes, of bodily injuries sustained through external, violent and accidental means, provided * * * (5) That death shall not have been * * * caused by or contributed to, directly or indirectly, or wholly or partially, by disease, or bodily or mental infirmity * * *." Held, that the sunstroke was not a disease, but that the death of the insured from such cause was the result "directly and independently of all other causes, of bodily injuries sustained through external, violent and accidental means," and not "caused by or contributed to directly or indirectly, or wholly or partially, by disease or bodily or mental infirmity, * * *" and consequently fell within the coverage and indemnity of the policy of insurance.

2. Where there is no fixed or technical meaning which the court must follow in the construction of a contract, "the best construction * * * is that which is made by viewing the subject of the contract as the mass of mankind would view it; for it may be safely assumed that such was the aspect In which the parties themselves viewed it. A result thus obtained is exactly what is obtained from the cardinal rule of intention."

3. "It is a familiar rule that the words used in a policy of insurance should be interpreted most strongly against the insurer when the policy is so framed as to leave room for two constructions."

Appeal from Supreme Court, Monmouth County Circuit.

Action by Clara H. Lower against the Metropolitan Life Insurance Company. From a judgment for defendant (163 A. 233, 10 N. J. Misc. 1236), plaintiff appeals.

Judgment reversed, and cause remanded, with directions.

Theodore D. Parsons, of Red Bank, for appellant.

Clinford I. Voorhees, of New Brunswick, for respondent.

CAMPBELL, Chancellor.

The judgment under review resulted from a trial of on action upon a policy of insurance. The cause was tried, by agreement, before the trial judge without a jury upon an agreed state of facts and resulted in the judgment in question in favor of the defendant below.

The facts are not in dispute, and we quote them as they are contained in the opinion of the trial judge:

"The circumstances involved are that Francis T. Lower, fifty years of age, a laborer in the employ of one Raub, was on August 4, 1930, the holder of a so-called double indemnity policy, theretofore issued to him by the defendant company, and in force, covering life insurance in a stated amount and a like sum in case of death, as the result, directly and independently of all other causes, of bodily injuries sustained through external, violent and accidental means.

"August 4, 1930, was evidently a torrid day, and in the morning he had been working out of doors at his usual employment, which he resumed after his midday meal. At two o'clock the temperature registered 94 degrees Fahrenheit. Sometime during the afternoon he suffered a sunstroke, from the effects of which he died."

The contract of insurance provided that the respondent company "hereby agrees to pay to the beneficiary or beneficiaries of record under said policy, in addition to the amount payable according to the terms of the said policy the sum of One Thousand Dollars, upon receipt * * * of the proof of the death of the insured, as the result, directly and independently of all other causes, of bodily injuries sustained through external, violent and accidental means; provided, * * * (5) that death shall not have been the result of self-destruction, whether sane or insane, or caused by or contributed to, directly or indirectly, or wholly or partially, by disease or bodily or mental infirmity * * *."

The learned trial judge, in reaching his conclusion that death by sunstroke is not "through external, violent and accidental means," held that it is not accidental but is in fact a disease.

We do not reach this conclusion.

This presents two outstanding matters for consideration:

1. Is sunstroke an accident, and does the infliction and injury arise from accidental means?

2. Is sunstroke a disease, or is it the result of external violence?

Point 1. Many cases are cited to us by both appellant and respondent upon this question, and they go in both directions.

Measured, however, by the rule laid down by the United States Supreme Court in United States Mutual Accident Association v. Barry, 131 U. S. 100, 9 S. Ct. 755, 33 L. Ed. 60, the great weight of authority is that injury or death by sunstroke, under the admitted facts in the case before us, is to be classed as an accident, or as resulting from or effected by accidental means.

This rule appears to be, as said in Caldwell v. Travelers' Ins. Co., 305 Mo. 619, 267 S. W. 907, 921, 39 A. L. R. 56, which carefully reviews and critically analyzes a great number of cases, that based upon the Barry Case, supra, "accidental means" is to be defined, "that, if a result is such as follows from ordinary means, voluntarily employed, in a not unusual or unexpected way, it cannot be called a result effected by accidental means; but that if, in the act which precedes the injury, something unforeseen, unexpected, unusual occurs which produces the injury, then the injury has resulted through accidental means."

Among the cases bearing upon the subject and examined by us are the following: Continental Casualty Co. v. Bruden, 178 Ark. 683, 11 S.W.(2d) 493; Dupre v. Atlantic Refining Co., 98 Conn. 646, 120 A. 288; Elsey v. Fidelity & Casualty Co., 187 Ind. 447, 120 N. E. 42, L. R. A. 1918F, 646; Higgins v. Midland Casualty Co., 281 Ill. 431, 118 N. E. 11; Hutchcraft's Ex'r v. Travelers' Ins. Co., 87 Ky. 300, 8 S. W. 570, 12 Am. St. Rep. 484; Mather v. London Guarantee & Accident Co., 125 Minn. 186, 145 N. W. 963; Pace v. North Dakota Workmen's Compensation Bureau, 51 N. D. 815, 201 N. W. 348; Young v. Western, etc., Co., 101 Neb. 696, 164 N. W. 712, L. R. A. 1918B, 1001; Gallagher v. Fidelity & Casualty Co., 163 App. Div. 556, 148 N. Y. S. 1016, affirmed 221 N. Y. 664, 117 N. E. 1067; Continental Casualty Co. v. Clark, 70 Okl. 187, 173 P. 453, L. R. A. 1918F, 1007; Lane v. Horn &amp Hardart Baking Co., 261 Pa. 329, 104 A. 615, 13 A. L. R. 963; Walsh v. River Spinning Co., 41 R. I. 490, 103 A. 1025, 13 A. L. R. 956; King v. Buckeye Cotton Oil Co., 155 Tenn. 491, 296 S. W. 3, 53 A. L. R. 1086; Bryant v. Continental Casualty Co., 107 Tex. 582, 182 S. W. 673, L. R. A. 1916E, 943, Ann. Cas. 1918A, 517; Richards v. Standard Acc. Ins. Co., 58 Utah, 622, 200 P. 1017, 17 A. L. R. 1183; Paul v. Travelers' Ins. Co., 112 N. T. 472, 20 N. E. 347, 3 L. R. A. 443, 8 Am. St. Rep. 758; Healey v. Mutual Accident Ass'n, 133 Ill. 556, 25 N. E. 52, 9 L. R. A. 371, 23 Am. St. Rep. 637; Hutton v. States Accident Ins. Co., 267 Ill. 267, 108 N. E. 296, L. R. A. 1915E, 127, Ann. Cas. 1916C, 577; United States Mutual Acc. Ass'n v. Barry, 131 U. S. 100, 9 S. Ct. 755, 33 L. Ed. 60; 1 C. J. 431, § 78; Caldwell v. Travelers' Ins. Co., 305 Mo. 619, 267 S. W. 907, 39 A. L. R, 56; Dozier v. Fidelity, etc. (C. C.) 46 F, 446, 13 L It A. 114, 581, 22 L. R. A. 620; Paist v. Aetna Life Ins. Co. (D. C.) 54 F.(2d) 393.

Among these are some arising under Employers' Compensation Acts, and others under contracts of insurance, and in the latter class some are where sunstroke is specifically made a bodily injury and others in which it is not. They also have variously involved the question of whether or not sunstroke is a disease and whether or not it is to be classed as an accident or inflicted through accidental means.

It would be an impossible task to classify them and no serviceable purpose could be attained. They are, according to their varying conditions and facts, applicable to both points or grounds argued.

Our attention is not directed to any case in this state other than those arising out of the Employers' Compensation Act (Comp. St. Supp. § **236—1 et seq.) and it is represented by counsel there are none.

In the compensation cases cited, Kauffeld v. Pfund & Sons (Err. & App.) 97 N. J. Law, 335, 116 A. 487, Higham v. Preakness Hills Country Club, 161 A. 651, 10 N. J. Misc. 889, and George v. Waldron, 111 N. J. Law, 4, 166 A. 102, it is held that heat prostration, or sunstroke, is an accident arising out of and in the course of employment, as contemplated by the statute, "when the employment brings a greater exposure than that to which persons generally in that locality are exposed."

These cases are helpful to the extent of showing that our courts have not adopted the idea that sunstroke is a disease but, on the contrary, recognize it as an accident, or a happening taking place by accidental means. In order, however, to bring it within an accident, "arising out of and in the course of employment," under the statute (Comp. St Supp. § **236—2), they have said there can be recovery by the employee only "when the employment brings a greater exposure than that to which persons generally in that locality are exposed."

Applying the authorities before cited which are applicable, to the facts in the present case, we have reached the conclusion that the death of the insured by sunstroke was an accident and occurred through accidental means.

Point 2. Is sunstroke a disease, or is it the result of external violence?...