McFadden v. American United Life Ins. Co., 2-82-078-CV
| Decision Date | 24 November 1982 |
| Docket Number | No. 2-82-078-CV,2-82-078-CV |
| Citation | 643 S.W.2d 232 |
| Parties | Gary McFADDEN, Appellant, v. AMERICAN UNITED LIFE INSURANCE COMPANY, Appellee. |
| Court | Texas Court of Appeals |
David F. Farris, Fort Worth, for appellant.
Seay, Gwinn, Crawford, Mebus & Blakeney, and Charles L. Perry, Dallas, for appellee.
Before MASSEY, C.J., and JORDAN and RICHARD L. BROWN, JJ.
This is an appeal from a take nothing summary judgment in favor of defendant, American United Life Insurance Company, hereinafter referred to as appellee, against plaintiff, Gary McFadden, hereinafter referred to as appellant.
We affirm.
Appellant was insured on a group medical insurance policy as an employee of Oil States Rubber Company. Appellee was the health and medical insurer. Appellant suffered from a condition termed "retrographic mandible", which essentially means that his lower jaw was shorter than his upper jaw. The material result of this condition was that appellant could not properly chew food because of an improper mesh of the upper and lower teeth. Dr. Carroll R. Carver, D.D.S., performed oral surgery upon appellant to correct the improper occlusion. The surgical procedure employed by Dr. Carver involved splitting the lower jaw and allowing it to heal in an advanced position, thus creating a longer lower jaw. Appellant filed a claim with appellee to recover the expenses of the oral surgery. Appellee denied the claim on the basis that it was not covered under the policy, which provides in part: "This insurance does not provide any benefits for charges ... incurred for dentures, dentistry or dental surgery, except as required for treatment of accidental injuries to natural teeth." The major medical rider supplement contains a like provision. It is undisputed that the treatment was not for accidental injuries to appellant's natural teeth.
Appellant instituted this suit for recovery under the policy which appellee had denied. Appellee filed its motion for summary judgment supported by affidavit, the applicable policy provisions, and a deposition containing the expert testimony of Neil W. Sternberg, D.D.S. Appellant responded to appellee's motion by answer and an affidavit of Dr. Carver in support thereof. Following a hearing on the motion and based upon the summary judgment proof before it, the trial court rendered summary judgment for appellee.
Appellant contends on appeal that the trial court erred in granting the summary judgment because a genuine...
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McFadden v. American United Life Ins. Co.
...to repair a "retrographic mandible." The trial court granted summary judgment in favor of American. The court of appeals affirmed. 643 S.W.2d 232 (1982). We reverse the judgment of the court of appeals, and remand the cause for a trial on the McFadden was an employee of Oil States Rubber Co......