Metropolitan Life Ins. Co. v. Main

• Decision Date: 08 August 1967
• Docket Number: No. 23326,23328.,23326
• Citation: 383 F.2d 952
• Parties: METROPOLITAN LIFE INSURANCE COMPANY, Appellant, v. Eleanor E. MAIN, Appellee. The TRAVELERS INSURANCE COMPANY, Appellant, v. Eleanor E. MAIN, Appellee.
• Court: U.S. Court of Appeals — Fifth Circuit

383 F.2d 952 (1967)

METROPOLITAN LIFE INSURANCE COMPANY, Appellant, v. Eleanor E. MAIN, Appellee.

The TRAVELERS INSURANCE COMPANY, Appellant, v. Eleanor E. MAIN, Appellee.

Nos. 23326, 23328.

United States Court of Appeals Fifth Circuit.

August 8, 1967.

Charles Cook Howell, Jr., Jacksonville, Fla., for appellant Metropolitan Life Ins. Co.

Francis P. Conroy, Harry T. Gray, Bruce S. Bullock, Jacksonville, Fla., Marks, Gray, Yates, Conroy & Gibbs, Jacksonville, Fla., of counsel, for appellant Travelers Ins. Co.

Robert C. Gobelman, Jacksonville, Fla., Mathews, Osborne & Ehrlich, Jacksonville, Fla., of counsel, for appellee.

Before PHILLIPS,^* COLEMAN and SIMPSON, Circuit Judges.

ORIE L. PHILLIPS, Circuit Judge:

Robert C. Main was an insured under two group insurance policies covering employees of the General Electric Company. One policy was issued by the Metropolitan Life Insurance Company and one by The Travelers Insurance Company.¹ Metropolitan and Travelers each issued a certificate of insurance to Robert C. Main. Eleanor E. Main, his wife,² was named in each certificate as the beneficiary of the death benefits.

Main died on December 10, 1963, about 6 a. m. At the time of his death both policies were in effect and provided coverage for him for "bodily injury, * * * caused solely by accidental, violent and external means and, independently of all other causes, resulting in death * * *." Each policy provided that "Benefits are payable only if the death * * * is not caused or contributed to by disease, or bodily or mental infirmity or medical * * * treatment of such disease or infirmity, or by intentionally self-inflicted injury, * * *."

Mrs. Main brought an action against each of the insurers to recover as beneficiary the death benefits under its policy, alleging in her complaint in each case that "on or about December * * * 10, 1963, while said insurance contract was in full force and effect, * * * Main, sustained a bodily injury `caused solely by accidental, violent and external means and, independently of all other causes, * * *' resulted" in his death.

The actions were consolidated for trial. Each of the insurers has appealed from a judgment on a jury verdict against it.

Main was employed by the General Electric Company at its Syracuse, New York plant from March 15, 1962, to August, 1962. From the time his employment ended at Syracuse to the date of his death, he was employed by the General Electric Company in its Apollo Support Department in Florida. His duties were to supervise all the buyers and subcontractors in the purchase of all materials and services used in such department. He had between 90 and 100 employees under his supervision, and on December 9, 1963, a new unit was added to the group of employees under his supervision, giving him a greater job responsibility. His duties were complex and rather technical. He was highly qualified to perform such duties, both by education and experience.

Main's family consisted of himself, his wife, four children, and one grandchild. They lived at Ormond Beach, Florida, during the time he was employed by General Electric in Florida. Shortly prior to December 9, 1963, he had made plans for a Christmas vacation in that year.

Prior to October 30, 1962, Main had used Medomin and Elixir of Butibel to relax him and aid him in going to sleep on retiring for the night, and he had used Equanil from time to time, when needed to relieve tension, acting under the direction of his then physician, who had given him prescriptions therefor. Medomin and Butibel are barbiturates. Equanil is a tranquilizer. On October 30, 1962, Main went to the office of Dr. C. M. Crouch at Daytona Beach, Florida. At that time, Dr. Crouch had been duly licensed to practice and had practiced medicine at Daytona Beach, Florida, for the preceding 15 years. Main showed Dr. Crouch prescriptions referred to above, explained his need for the drugs, and requested Dr. Crouch to give him prescriptions for such drugs. None of such drugs could be dispensed without a prescription. Dr. Crouch, after some discussion with Main, gave him a prescription for the Medomin and for Butibel, because he was of the opinion Main needed them to relax him and aid him in going to sleep at bedtime, and he gave Main a prescription for the Equanil, because he was of the opinion that at times Main needed Equanil "to allay his nervous system" as a tranquilizer, since on occasions he was under considerable pressure in the performance of his duties. Main's duties were such that at times they subjected him to considerable nervous strain.

Dr. Crouch testified unequivocally that from his conversations with and his observation and questioning of Main before he gave him the prescriptions, he was of the opinion that Main was not suffering from any bodily or mental disease or infirmity and that he did not prescribe such drugs or any other drug for any physical or mental disease or infirmity, and that Main did not suffer any permanent effect from taking the drugs he had prescribed, except from the drugs he took the night preceding his death.

Marjorie Sterling, who served as Main's secretary at the General Electric plant from October 15, 1962, through December 9, 1963, testified that during that period she saw and conversed with him daily during working hours and that his physical and mental health during the entire period was excellent; that the only time he lost from work was in December, 1962, when he was confined at his home for a short period because of a flu attack. She further testified that he had made plans for a Christmas vacation in 1963, and that when he left his work about 6 p. m. on December 9, 1963, he was in excellent spirits and was delighted because his superior had praised his work and added a new unit to the employees under his supervision, which increased his job responsibility.

During Main's employment by the General Electric Company in Florida, he received two complete physical examinations. The first one, on March 15, 1962, disclosed no significant findings. The second, on October 11, 1963, disclosed only overweight and tension. Tension is not a disease or bodily or mental infirmity. Main was six feet, two inches tall and weighed 218¼ pounds. He was advised by the company physician to reduce his weight down to 200 pounds and to have his blood pressure checked periodically. His blood pressure was within the normal range, he had no fever, and his pulse and respiration were normal when Dr. Crouch examined him in December, 1962. The company dispensary file of the General Electric Company pertaining to Main disclosed that he was not suffering from or with any disease or bodily or mental infirmity at any time from the commencement of his employment up to the time of his death.

Mrs. Main testified that the Mains enjoyed a happy family life and liked living in Florida; that Main enjoyed his work with General Electric; that she and he did things together, like playing golf, bridge, and bowling; that their relationship with their friends and neighbors was congenial; that Main's relationship with their children was harmonious and that he received much delight from his children and his association with them; that the Mains had no financial difficulties; that Main enjoyed excellent health and that his only illness while they lived in Florida was an attack of flu the night before Christmas in 1962; that on December 8, 1963, they arose early, played golf together in the forenoon, and in the afternoon they went to a tea and sang Christmas carols, and in the evening they had a small group of friends in for supper; that Main was perfectly normal when he left for work in the morning of December 9, 1963, and that when he returned that evening he was thrilled and happy about the enlargement of the group under his supervision and his increased job responsibility. Mrs. Main further testified that Main returned from work about 6:30 p. m. on December 9, 1963; that when he came in, first, as was his custom, he wound their cuckoo clock; that while she was preparing the dinner he sat on a stool and told her "what had been going on all day"; that Main had two drinks of bourbon whiskey before dinner and one or two after dinner; that when Main returned from work he would usually sit down and have a drink of whiskey and talk to her while she was finishing the preparation of dinner; and that once in a while he would take two drinks, "but that was not very often"; that he took the extra drinks on the evening of December 9, because he was elated over his "new job"; that after dinner they discussed their plans for the coming Christmas vacation; that Main and the children retired about 9:30 or 10 p. m. and she went to their Florida Room and worked on some Christmas tree ornaments for their nieces and nephews; that she prepared to retire about 11:30 p. m.; that when she endeavored to sleep in their bedroom, Main was snoring so loudly that she could not go to sleep, so she returned to the Florida Room and laid down on a couch; that she returned to their bedroom two or three times, because she was not sleeping well on the couch, but that each time Main was still snoring so loudly that she could not go to sleep in the bedroom; that she last heard Main snoring between 2:30 and 3 a. m., December 10, 1963; that from then until she arose on the morning of December 10, 1963, she slept on the couch in the Florida Room; that after she arose on the morning of December 10, 1963, and while she was engaged in preparing their children's breakfast and getting them ready for school, she realized at about 7:30 a. m. that she had not heard the shower running in the bathroom and went to the bedroom to see "why my husband wasn't awake" and found him in bed and was unable to awaken him; that she then called Dr. Crouch, their family physician, and an ambulance; that she then went to the bathroom and observed the pants to Main's pajamas on the bathroom floor;...