Valente v. Equitable Life Assur. Soc. of U.S.

• Decision Date: 23 May 1986
• Citation: 120 A.D.2d 934,502 N.Y.S.2d 876
• Parties: Marie VALENTE, Administratrix of the Estate of Francesco Valente, and Marie Valente, Individually, Respondent, v. The EQUITABLE LIFE ASSURANCE SOCIETY OF the UNITED STATES, Appellant.
• Court: New York Supreme Court — Appellate Division

Page 876

502 N.Y.S.2d 876

120 A.D.2d 934

Marie VALENTE, Administratrix of the Estate of Francesco Valente, and Marie Valente, Individually, Respondent, v. The EQUITABLE LIFE ASSURANCE SOCIETY OF the UNITED STATES, Appellant.

Supreme Court, Appellate Division Fourth Department.

May 23, 1986.

Werner Weinstock by Margretta Bowen, New York City, for appellant.

Missal, Trotto & Barry by Christopher Trotto, Rochester, for respondent.

Before CALLAHAN, J.P., and DOERR, DENMAN, BOOMER and PINE, JJ.

MEMORANDUM:

Special Term erred in granting plaintiff summary judgment in this action to recover $25,000 under the accidental death provisions of an insurance policy on the life of plaintiff's decedent. Plaintiff's husband, a 41-year-old man with no history of heart disease, had a heart attack and died shortly after lifting and moving large cartons of coffee as part of his routine duties at the supermarket where he was an assistant manager. The cause of death was given as acute myocardial infarction. His life was insured under a group policy providing for payment of $25,000 in death benefits and an additional $25,000 for accidental death. With respect to accidental death, the policy provides:

These benefits are payable in the event you suffer a loss as a result of accidental injury caused directly and exclusively by purely accidental means and independently of all other causes, within 90 days following an accidental injury which occurs either on or off the job and while you are insured.

* * *

* * *

NOT COVERED

Losses resulting from, or caused directly or indirectly, * * * by, (a) bodily or mental infirmity * * *

Defendant paid the death benefits but denied plaintiff's additional claim for accidental death benefits.

Plaintiff relies primarily on language contained in Miller v. Continental Ins. Co., 40 N.Y.2d 675, 677, 389 N.Y.S.2d 565, 358 N.E.2d 258, which defines an accident as whether, from the point of view of the insured, "it was unexpected, unusual and unforeseen". Obviously, the sudden heart attack suffered by plaintiff's decedent was neither expected nor foreseen by him; nevertheless, the problem with that definition of accidental death is that it would include, contrary to the clear intent of the policy, any sudden death resulting from natural causes. The weight of authority in this and other jurisdictions holds that death resulting from a heart attack suffered as a consequence of ordinary physical exertion is not accidental within the meaning of an accident policy ...