Penn v. Standard Life & Accidental Ins. Co

• Citation: 158 N.C. 29,73 S.E. 99
• Court: North Carolina Supreme Court
• Decision Date: 23 December 1911
• Parties: PENN. v. STANDARD LIFE & ACCIDENTAL INS. CO.

73 S.E. 99

(158 N.C. 29)

PENN.

v.STANDARD LIFE & ACCIDENTAL INS. CO.

Supreme Court of North Carolina.

Dec. 23, 1911.

Insurance (§ 466^*) — Accident Policy-Construction.

Where an accident policy provided a specified insurance for the loss of sight, caused directly and independently of all other causes, through external, accidental, and violent means, insured was not entitled to recover for loss of sight due to an injury to an eye, caused by his accidentally falling from a train, such fall having merely hastened the loss of sight in the eye, which would have been ultimately lost independent of the accident because of a cataract.

[Ed. Note.—For other cases, see Insurance, Cent. Dig. §§ 1178, 1186; Dec. Dig. § 466.*]

Appeal from Superior Court, Rockingham County; W. J. Adams, Judge.

Action by Aaron T. Penn against the Standard Life & Accidental Insurance Company. Judgment for defendant, and plaintiff appeals. Affirmed.

Morehead & Morehead and Sapp & Williams, for appellant.

G. S. Bradshaw and T. H. Calvert, for appellee.

WALKER, J. The defendant issued to the plaintiff an accident policy which insured him against "the irrecoverable and entire loss of one eye" in the sum of $2,500, with the proviso that the insurance should only be "against bodily injuries effected, directly and independently of all other causes, through external, accidental, and violent means." Plaintiff alleged that he fell from a train, and was so injured that he lost the sight of one eye. There was evidence tending to cast some suspicion on his statementthat he had accidentally fallen; but, in the view we take of the case, it is not necessary to further refer to it or make any comment upon it. There was also evidence tending to show that at the time of the fall he had a cataract on the eye that he alleges was injured which would have resulted eventually in destroying it, and the plaintiff introduced evidence to the contrary.

The case turns upon the construction of the language in the policy which we have quoted, and with reference to it and the evidence as to the cataract the court charged the jury as follows: "The court charges you that if you find that the plaintiff fell from the car and was thereby injured, and that this injury was soon thereafter followed by a loss of sight, and you further find that the condition of the plaintiff's eye at that time was such that, independent of that injury, he would ultimately have lost his sight, and that this injury, falling from the car, merely hastened the loss of his sight, in that event you will not find that the injury was caused directly and independently of all other causes through external, accidental, and violent means; but if you find from the evidence and by the greater weight of it that the plaintiff has suffered the entire loss of sight of his eye, that the loss of his sight is irrecoverable, that the loss was caused directly and independently of all other causes, through external, accidental and violent means, your answer to the second issue will be 'Yes.' If you do not so find, your answer will be 'No.' " The plaintiff excepted to this instruction. There was a verdict for the defendant, and, judgment having been entered thereon, the plaintiff appealed. If the instruction was a correct one, and we think it was, the rule for a new trial was properly discharged. When the terms of a policy are free from uncertainty or ambiguity, they "should be understood in their plain, ordinary and popular sense"; and it is only when "any provision, condition or exception" is "uncertain or ambiguous in its meaning or is capable of two constructions" that it "should receive that construction which is most favorable to the insured." 1 Cyc. pp. 243, 244; May on Insurance, § 172. As long as parties who are capable of so doing shall be permitted to make their own contracts, it is the plain duty of the court to enforce them as they are written, unless fraud or public policy shall intervene. Binder v. Accident Ass'n, 127 Iowa, 25, 35, 102 N. W. 190. While the rule is thoroughly settled that policies of this and like character are to be construed liberally, and that ambiguous provisions, or those capable of two constructions, should be construed favorably to the insured, and most strongly against the insurer, plain, explicit language cannot be disregarded, nor an interpretation given the policy at variance with the clearly dis closed intent of the parties. Taking the policy, in the case at bar, by its four corners, it will admit of but one construction. White v. S. L. & Accident Ins. Co., 95 Minn. 77, 103 N. W. 735, 884.

In Carr v. P. M. Life Ins. Co., 100 Mo. App. 602, 75 S. W. 180, the court said that the question of proximate and immediate cause is not raised under the conditions of a policy which in terms excludes disease or bodily infirmity, and which could have no more force than the general provision, "independent of all other causes." See, also, C. T. Mut. Ass'n v. Fulton, 79 Fed. 423, 24 C. C. A. 654. If the jury had found that the injury was caused by the sum of two causes— that is, that the accident and the pre-existing cataract and diseased condition of the eye were together responsible for the subsequent blindness—the plaintiff could not have recovered, as the injury must have resulted from the accident, "independent of all other causes." In White v. S. L. & Accident Ins. Co., 95 Minn. 77, 103 N. W. 734, 884, the policy, in terms, had reference to injuries or death resulting "solely from such injuries as the proximate cause thereof, " and provided that the insurance did not cover accident or death "resulting wholly or partly, directly or indirectly, from bodily or mental infirmity, or disorder, or disease in any form." In that case the court said: "Similar policies have been before both the state and federal courts, and the concensus of judicial opinion is that, subject to the exceptions contained in the policy, if the injury be the proximate cause of death, the company is liable, but, if an injury and an existing bodily disease or infirmity concur and co-operate to that end, no liability exists. If, however, the injury be the cause of the infirmity or disease—If the disease results and springs from the injury—the company is liable, though both co-operate in causing death. The distinction made in this particular is found in...