O'Neil v. New York Life Insurance Co.

• Decision Date: 25 October 1944
• Docket Number: 7174,7175,7173
• Citation: 152 P.2d 707,65 Idaho 722
• Parties: ROWENAH K. O'NEIL, Appellant, v. NEW YORK LIFE INSURANCE COMPANY, a corporation, Respondent
• Court: Idaho Supreme Court

152 P.2d 707

65 Idaho 722

ROWENAH K. O'NEIL, Appellant, v. NEW YORK LIFE INSURANCE COMPANY, a corporation, Respondent

Nos. 7173, 7174, 7175

Supreme Court of Idaho

October 25, 1944

1. Insurance

The decisions of the courts of New York, with reference to the provisions of a New York insurance company's contracts and their construction, should elsewhere afford at least persuasive reasons for following the construction and application of the various provisions of such contracts.

2. Insurance

Contracts of insurance are to be construed in view of their general objects and strict technical interpretation is to be avoided and where language may be given two meanings, the one which permits recovery is to be adopted.

3. Insurance

There is no distinction between "accidental death" and "death by accidental means," as used in accident policy provision insuring against death by accidental means and such policy must be construed to protect against loss by bodily injury, neither expected or designed, suffered while insured was doing what he intended to do.

4. Insurance

Where the result of an act was not natural and probable and should not reasonably under all the circumstances have been foreseen, and is tragically out of proportion to a trivial cause, it is an "accident" within the meaning of policy providing double indemnity for death resulting from accidental means.

5. Insurance

In action on accident policies providing double indemnity for death resulting from accidental means unless resulting from committing an assault, where insured's death resulted from injuries received during an altercation with another trial court erred in refusing to instruct that, if the result of an act was not natural and probable and should not reasonably have been foreseen and is tragically out of proportion to a trivial cause, it is an accident within meaning of policies.

6. Trial

In action on accident policies providing double indemnity for death resulting from accidental means except if resulting from committing an assault, trial court erred in refusing to instruct that burden was upon defendant to prove the affirmative defense that death resulted from committing an assault.

7. Insurance

Where insurer seeks to avoid liability on ground that accident or injury is within one of the exceptions of the policy, the burden rests upon it to prove facts bringing the case within the exception.

Appeal from the District Court of the Ninth Judicial District of the State of Idaho in and for Bonneville County. Hon. C. J Taylor, Judge.

Affirmed.

St. Clair, Peterson & St. Clair, and Oscar W. Worthwine, for appellant O'Neil.

All the terms limiting liability in an insurance policy are liberally construed in favor of the insured.

(A) "All language used to limit insurer's liability in policy accepted by insured to cover all accidents must be construed strongly against the insurer." (Rosenau v. Idaho Mut. Ben. Ass'n., 65 Ida. 408, 145 P.2d 227; Jensma v. Sun Life Assur. Co. of Canada, 9 Cir., 64 F.2d 457, reversing Jensma v. Benefit Ass'n. of Ry. Employees, D. C. 1932, 1 F.Supp. 951, certiorari denied 1933; Sun Life Assur. Co. of Canada v. Jensma, 289 U.S. 763, 53 S.Ct. 795, 77 L. ed. 1505.)

(B) "Ambiguous provisions of an insurance policy will be construed most strongly against the insurer, and in favor of the insured." (Sweaney & Smith Co. v. St. Paul Fire & Marine Ins. Co. of St. Paul, Minn., 35 Ida. 303, 206 P. 178; Sweaney & Smith Co. v. Hartford Ins. Co. of Hartford, Conn., 35 Ida. 319, 206 P. 183.)

It is not every assault that will defeat a recovery on an accident insurance policy. (Clancy v. John Hancock Life Ins. Co., 282 N. Y. S. 510; Mansbacher v. Prudential Ins. Co., 7 N.E.2d 18; Gilman v. New York Life Ins. Co., 190 Ark. 397, 79 S.W.2d 78, 97 A. L. R. 755; New York Life Ins. Co. v. Jennings, 6 S.E.2d 431 (Ga.); Empire Life Ins. Co. v. Einstein, 12 Ga.App. 387, 77 S.E. 209; Riggins v. Equitable Life Assurance, 14 S.E.2d 182 (Ga.)

The respondents had the burden of proving its affirmative defenses. (Mabee v. Cont. Cas. Co., 37 Ida. 667, 219 P. 598; New York Life Ins. Co. v. Gustafson, 55 F.2d 236, 82 A. L. R. 729; New York Life Ins. Co. v. Jennings, 6 S.E.2d 431 (Ga.); Mah See v. North American Acc. Ins. Co., (Cal.), 213 P. 42, at pp 43-44; 1 C. J.., para 288, pp. 497-498.)

Otto E. McCutcheon, for respondent and cross-appellant, New York Life Insurance Company.

The burden is upon the beneficiary under an accident policy to prove that the death of insured was caused by accidental means. (Rock v. Travelers' Ins. Co., 156 P. 1029, 1916 E. L. R. A. (N. S.) 1197; Fidelity and Casualty Co. v. Carroll, 5 L. R. A. (N. S.) 657 at 661; Travelers' Ins. Co. v. McConkey, 127 U.S. 661, 32 L. ed. 308.)

The evidence does not show that the death of the insured was caused by accident. On the contrary the evidence shows that the death of the insured was caused by his voluntary actions. (Feder v. Iowa State Traveling Men's Assn., 197 Iowa 538, 70 Am. St. Rep. 212, at 214; Smith v. Travelers' Ins. Co., 219 Mass. 147, 1915 B. L. R. A. (N. S.) 872.)

Where an insured person is injured during the course of an original altercation, or assault and battery, in which the insured was the aggressor, wherein there was no interruption in the series of events from the beginning of the assault, or attack, to its ending, in the injury of the insured, from which injury of the insured his death resulted, the insured's death was not accidental. (Mabee v. Continental Casualty Co., 37 Ida. 667, at 675; Taliaferro v. Travelers' Protective Assn., 80 F. 368, 25 C. C. A. 494.)

The insurance policies expressly provided: "Double Indemnity shall not be payable if the Insured's death resulted from committing an assault or felony," and there is no dispute between the parties on the facts which led up to insured's injury and death. He was injured while making an assault, and the beneficiary cannot recover. (Bloom v. Franklin L. Ins. Co., 49 Am. Rep. 469; Equitable Acc. Ins. Co. v. Osborn, 13 L. R. A. 267; Crandall v. Accident Ins. Co., 27 F. 40-42.)

Holden, C. J. Ailshie, Budge, Givens and Dunlap, JJ., concur.

OPINION

Holden, C. J.

December 12, 1928, the New York Life Insurance Company, hereinafter called the "Company," issued to James Edward O'Neil double indemnity accident insurance contract, policy No. 10,463,864, in the amount of $ 1,000.00. January 14, 1930, the Company also issued to O'Neil double indemnity accident insurance contract, policy No. 11,352,618, in the amount of $ 1,000.00. These policies, among other things, provided: "That such double indemnity shall not be payable if the insured's death resulted from -- committing an assault or felony."

February 6, 1934, the Company issued to O'Neil double indemnity accident policy No. 12,234,926, in the amount of $ 2,000.00. March 27, 1934, the Company issued to O'Neil double indemnity accident policy No. 12,272,042, in the amount of $ 1,000.00. The last two policies carried the provision, pertinent here: "That such Double Indemnity shall not be payable if the Insured's death resulted, directly or indirectly, from -- committing an assault or felony." Plaintiff was the beneficiary in all of the policies.

August 9, 1942, the said O'Neil and one Dewey Foreman engaged in an altercation. A few hours later O'Neil died as a result of injuries received during the course of the altercation. Thereafter Rowenah K. O'Neil, widow of the said James Edward O'Neil, named as beneficiary in the said policies, brought this action to recover the double indemnities provided for in the said insurance contracts. The jury found in favor of the plaintiff and against the Company on the first two policies, above mentioned, and in favor of the Company and against the plaintiff on the last two. From a judgment entered on the verdict in favor of the plaintiff, the Company appeals, and from the judgment entered on the verdict in favor of the Company and against the plaintiff, the beneficiary appeals.

The beneficiary insists that "Where a result is tragically out of proportion to its trivial cause it is something unforeseen, unexpected, extraordinary and unlooked for and it is an accident," and further that "if the result of an act was not natural and probable and should not reasonably have been foreseen, it was brought about by accidental means" and requested instructions so instructing the jury, which the trial court refused to give. On the other hand, the Company contends, as we understand it, that any kind of an assault, trivial, simple or aggravated, defeats a recovery under either of the above quoted provisions of the contracts of insurance, and furthermore, and to illustrate the theory and position of the Company, "it is urged that the insured must be wholly free from culpability. There can be no valid argument made herein that O'Neil was free from culpability."

In Clancy v. John Hancock Mut. Life Ins. Co., 282 N.Y.S. 510, it appears that:

"In the early hours of the morning of July 19, 1934, in a night club in Long Island City, Clancy became involved in an argument with a stranger, a man about his own age. Both had been drinking rather heavily. (In the case at bar the evidence shows that Foreman and O'Neil were strangers and presumably both had been drinking.) During the course of the discussion Clancy invited the stranger 'outside,' when Clancy made a pass at the stranger, evidently intending to strike him, whereupon the latter pushed Clancy, who fell and struck his head. Clancy was removed to a hospital, where he died a few hours later from a fractured skull."

In the course of the opinion it is said:

"The court's point of view, in fixing the meaning of the word 'accident' in the contract at bar, must be that of...