Vowell v. Physicians Mut. Life Ins. Co., Civ. A. No. EC 88-71-D-D
| Decision Date | 17 April 1989 |
| Docket Number | Civ. A. No. EC 88-71-D-D,EC 88-72-D-D. |
| Parties | Billie J. VOWELL, Plaintiff, v. PHYSICIANS MUTUAL LIFE INSURANCE COMPANY and Amex Life Assurance Company, Defendants. |
| Court | U.S. District Court — Northern District of Mississippi |
David T. Wilson, Jr., Louisville, Miss., for plaintiff.
Charles W. Spillers, Holcomb, Dunbar, Connell, Chaffin & Willard, Oxford, Miss., for defendants.
This cause is before the court on the defendants' motions for summary judgment regarding coverage on certain life insurance policies. Defendants also moved in the alternative for partial summary judgment on the plaintiff's claims for punitive damages and extra-contractual damages. Plaintiff has responded that this was an accidental death covered by the insurance policies and that extra-contractual damages may be recovered. After a review of the motion, briefs, authorities presented, and record as a whole, the court is of the opinion that only partial summary judgment as to the punitive and extra-contractual damage elements is warranted.
Plaintiff Billie J. Vowell ("Vowell") brought separate actions against Physicians Mutual Insurance Company and Amex Life Assurance Company ("Insurers") to recover the benefits of her deceased husband's life insurance policies. The plaintiff's husband, Paul E. Vowell ("Paul"), died of a gunshot wound on July 10, 1987.
According to the statements given by several eye witnesses, Paul Vowell initiated an altercation with his son, Paul Randall Vowell ("Randy"). During the altercation, Paul Vowell went from his front yard into his home and returned with a shotgun. Paul fired the shotgun in the air, possibly in the direction of Randy, and ran toward Randy with the shotgun. Apparently, Randy returned to his car, grabbed a pistol off of his dashboard, fired a shot into the air, and then fired the gun toward his father, killing him. Whether Paul Vowell intended to kill his son or knew his son had access to a gun is uncertain on the record before the court. The Winston County Sheriff's Department arrested Randy Vowell for manslaughter in the shooting death of Paul Vowell. On August 18, 1987, the Justice Court dismissed the manslaughter charge against Randy Vowell.
On September 23, 1987, the plaintiff made a claim for the proceeds of the insurance policies. Physicians Mutual and Amex conducted an investigation and denied the plaintiff's claim to the policy proceeds on the grounds that the insured's death was a natural and probable consequence of his actions and could not be considered accidental. At the time the insurance companies made the decision to deny the claim for benefits, the insurance companies possessed the following documents: the signed statements of Billie J. Vowell, Randy Vowell, Myra Vowell, and Linda Buchanan, the medical examiner's report, Paul Vowell's death certificate, the Winston County Sheriff's Department report concerning the death of Paul Vowell, the accidental death claim statement signed by Billie Vowell, the Justice Court judgment, and certain information from Winston County Sheriff Billy Rosamond.
Paul Vowell was insured against accidental death. Amex's life insurance policy provided that they would not be liable for any loss caused by either the insured's "(1) commission of, or attempt to commit, a felony; or (2) being engaged in an illegal activity or occupation." Physician Mutual's policy provided that benefits are not payable for a loss resulting from "injury sustained while committing a felony."
The insurance companies have moved for summary judgment on the basis that the insured's death was not the result of an accident, the insured's death was the result of his commission of a felony, or that the insured's death was the result of his engaging in illegal activity. The insurance companies further claim that they have acted in good faith in denying the plaintiff's claim. The plaintiff claims that this death was the result of an accident, that a felony was not committed, and that the deceased's actions did not constitute "illegal activity." The court will consider whether the insurance companies are liable under the life insurance policies before taking up the issue of punitive damages and extra-contractual damages.
The insured's death was obviously caused by a gunshot wound to the head during an altercation between the insured and his son. It is undisputed that the insured died through external and violent means. In such a situation, a presumption arises that such injury was sustained through accidental means. Taylor v. Insurance Company of North America, 263 So.2d 749, 751 (Miss.1972); Davis v. Continental Cas. Co., 560 F.Supp. 723, 728 (N.D. Miss.1983). Judge William C. Keady has explained the rationale underlying this presumption of accidental death as follows:
Thus, it is well settled that there is a distinction between death through accidental means and a true accidental death. Death by accidental means, the relevant standard under defendant's insurance policy, is determined from the position of the insured whereas a true accidental death is determined from an objective viewpoint. Consequently, although a third party may have intended to cause the death of the insured, the insured's death may still have been sustained through accidental means within the definition of accident under the policy.
In order to rebut this presumption, the insurance companies have attempted to show that the insured was foreseeably killed during an altercation which he initiated. The Mississippi Supreme Court has long held as follows:
Where one is insured against accidental injury or death, and the insured culpably provokes an encounter, or is the aggressor therein, in the course of which, or as a result of which, the insured is killed or injured, the death or injury is not accidental within the meaning of the policy; for in such case, the injury or death is the natural and probable consequence of the act of the insured, and cannot be said to be accidental.
Taylor, 263 So.2d at 752; Occidental Life Ins. Co. v. Barnes, 226 Miss. 396, 84 So.2d 423, 424 (1956); Davis, 560 F.Supp. at 728. In a situation involving a family quarrel, the courts have been more inclined to find that death is an accident despite aggression by the insured with a deadly weapon. Davis, 560 F.Supp. at 729; Taylor, 263 So.2d at 753. Defendants have produced convincing evidence that Paul Vowell was the aggressor and that his son was acting in self defense. However, this alone is insufficient to establish that the death was not an "accident" within the meaning of the policy.
"The insured's death must have been reasonably foreseeable by him or by a reasonably prudent man in his position." Davis, 560 F.Supp. at 729. The Mississippi Supreme Court has recognized that "where the insured did not know and had no reason to believe that his misconduct would result in his death, his injury and death may be found not to have been reasonably contemplated or foreseeable and so to be `accidental' to the insured." Taylor, 263 So.2d at 752. Defendants do not suggest that Paul Vowell knew that he would be killed during this altercation. The issue is whether it would have been reasonably foreseeable to Paul Vowell, or a reasonably prudent person in his position, that his misconduct would result in his death. This issue is primarily a question of fact. The court must determine whether the plaintiff has set forth sufficient facts to raise a material issue of fact in order to preclude summary judgment.
Summary judgment is appropriate where the record before the court shows "that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law." Fed.R. Civ.P. 56(c). The moving party must set out the basis on which it believes that summary judgment is justified and the non-moving party must then demonstrate a genuine issue of material fact to preclude summary judgment. Celotex Corp. v. Catrett, 477 U.S. 317, 323-26, 106 S.Ct. 2548, 2553-55, 91 L.Ed.2d 265, 273-75 (1986). Anderson v. Liberty Lobby, 477 U.S. 242, 255, 106 S.Ct. 2505, 2513-14, 91 L.Ed.2d 202, 216 (1986).
Although the defendants have produced strong evidence that the death of the insured would not constitute an accident, the plaintiff has produced sufficient evidence to create material issues of fact in this regard. The basic facts appear undisputed, but the parties vigorously disagree as to the atmosphere and surrounding circumstances. Given the presumption, the uncertainty regarding the exact nature of the altercation, the issue of foreseeability, and other contested issues, the court is of the opinion that the better course would be to exercise caution and proceed to trial on the issue of whether or not the insured's death qualifies as an accident within the meaning of the policies.
Defendants also argue that the plaintiff's claim is not covered under the policy because the insured's death occurred during the commission of a felony or during "illegal activity. This court has ruled on numerous occasions that insurance policies are to be construed in accordance with general principals of contractual construction. Reece v. State Farm Fire & Cas. Co., 684 F.Supp. 140, 143 (N.D.Miss.1987); Western Line Consol. Sch. Dist. v. Continental Cas. Co., 632 F.Supp. 295, 301 (N.D. Miss.1986). However, Mississippi courts recognize the general rule that provisions of an insurance contract are to be construed strongly against the drafter. Brander v. Nabors, 443 F.Supp. 764, 769 (N.D. Miss.), aff'd, 579...
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