Prudential Ins. Co. of America v. Kellar

• Decision Date: 06 September 1957
• Docket Number: No. 19732,19732
• Citation: 213 Ga. 453,99 S.E.2d 823
• Parties: PRUDENTIAL INSURANCE COMPANY OF AMERICA v. Lemma B. KELLAR.
• Court: Georgia Supreme Court

Page 823

99 S.E.2d 823

213 Ga. 453

PRUDENTIAL INSURANCE COMPANY OF AMERICA v. Lemma B. KELLAR.

No. 19732.

Supreme Court of Georgia.

Sept. 6, 1957.

Syllabus by the Court.

On the trial of an action on a lifeinsurance policy, to recover an additional death benefit on account of the alleged accidental death of the insured, wherein the policy provided that 'no accidental death benefit shall be payable if such death resulted * * * directly or indirectly from bodily or mental infirmity or disease in any from,' and wherein the evidence demanded a finding that the disease or condition directly leading to the insured's death was a myocardial infarction, and that, although the injuries the insured sustained in an accident may have contributed to his death, they were not related to the bodily disease or condition causing his death, a verdict for the insurer was demanded. The Court of Appeals erred in holding that the trial court did not commit error in denying the insurer's motion for a judgment notwithstanding the verdict.

Spalding, Sibley, Troutman, Meadow & Smith, William K. Meadow, Griffin B. Bell, Richard A. Denny, Jr., Atlanta, for plaintiff in error.

Pittman & Greene, Cartersville, for defendant in error.

ALMAND, Justice.

Mrs. Lemma B. Kellar, the designated beneficiary under an insurance contract between John C. Kellar and Prudential Life Insurance Company of America, brought suit against the insurer to recover an additional sum of $3,000 alleged to be payable under the accidental death benefit provision of the policy, the principal sum having been paid to the beneficiary. After the evidence had been submitted by the parties, the motion of the insurer for a directed verdict in his favor was denied, and the jury returned a verdict for the petitioner. The insurer's motions for a judgment notwithstanding the verdict and for a new trial were denied. The insurer's exceptions to these orders were, upon appeal to the Court of Appeals, overruled and the judgments of the trial court were affirmed. Prudential Insurance Co. of America v. Kellar, 95 Ga.App. 332, 98 S.E.2d 90. The case is here on the grant of the insurer's petition for a writ of certiorari.

The insurer issued a group-insurance policy to Louisville and Nashville Railroad Company, under which John C. Kellar was issued a certificate and was covered by the terms of the policy. The certificate issued to Kellar provided for $3,000 in life insurance and an additional $3,000 accidental-death benefit. The accidental-death benefit was made payable in the following words of the certificate: '$3,000.00 payable to the Beneficiary in addition to the amount of insurance, specified above, immediately upon receipt of due proof that the death of said employee occurred while said employee was in the employ of the Employer and insured under said Policy, as a result directly and independently of all other causes, of bodily injuries, effected solely through external, violent and accidental means, of which, except in case of drowning or of internal injuries revealed by an autopsy, there is a visible contusion or wound on the exterior of the body, and that such death occurred within ninety days of the accident, provided, however, that no Accidental Death Benefit shall be payable if such resulted * * * directly or indirectly from bodily or mental infirmity or disease in any form' (Italics supplied.)

On the trial, the facts were stipulated to such an extent that the sole issue was whether the cause of the insured's death was such that, under the terms and conditions of the policy, the accidental death benefits would be due and payable. The only evidence on this issue was a certified copy of the death certificate, filed with the Georgia Department of Public Health by the insured's physician, and the testimony of this physician. The undisputed evidence shows that Kellar was injured in an accident when struck by a truck on November 7, 1955, wherein he sustained a fracture of the neck of the left femur and a fracture of the left wrist. His hip was nailed on November 8, and he was discharged from the hospital on November 18, his general condition being good at that time. On November 28, 1955, he was returned to the hospital when it was discovered that the nail had withdrawn from the hip. On November 30, the plate and nail in his hip were repositioned and he was released from the hospital. On December 6, he suffered a severe myocardial infarction and was returned to the hospital, where he remained for three weeks. He died suddenly on January 14, u956. The insured's physician, in the certificate filed with the Department of Public Health, stated: '1. Disease or condition directly leading to death: (a) Myocardial infarction. Antecedent Causes due to: (b) Hypertensive cardiovascular disease. 2. Other significant conditions. Conditions contributing to the death but not related to the disease or condition causing death: Fracture neck left femur.' The insured's physician testified: that he first treated the insured in June, 1953, for high blood pressure, and, through treatments, his blood pressure was reduced from 236/136 to 150/80; that from June, 1953, until the time of the accident, the insured had worked the entire time except for a period when he had a slight stroke in 1955. The physician further testified that he did not believe that the accident and subsequent surgery was the cause of the heart attack, but that, in his opinion, 'it was certainly an aggravating factor both in the attack and its course.' As to what relationship the injuries that the insured received in the accident had to his death, the physician stated: 'As to whether or not I would say that he didn't die directly and independently of all other causes from the injuries he received in the accident; well, we have already said that he died from the heart attack, that was the thing that killed him right then, but these injuries and things, I think contributed to it. When I say 'contributed', I mean they may have aggravated...