Williams v. First Unum Life Ins. Co.

• Decision Date: 24 June 2004
• Docket Number: No. 04-173.,04-173.
• Citation: 188 S.W.3d 908
• Parties: Melinda WILLIAMS, Guardian of the Estate of James Elam v. FIRST UNUM LIFE INSURANCE COMPANY.
• Court: Arkansas Supreme Court

Page 908

188 S.W.3d 908

Melinda WILLIAMS, Guardian of the Estate of James Elam v. FIRST UNUM LIFE INSURANCE COMPANY.

No. 04-173.

Supreme Court of Arkansas.

June 24, 2004.

Appellant, pro se.

Watts, Donovan & Tilley, P.A., by: David M. Donovan, Little Rock, for appellee.

ROBERT L. BROWN, Justice.

Appellant Melinda Williams, as guardian of the estate of James Elam (Elam), appeals the circuit court's judgment in favor of appellee First Unum Life Insurance Company (First Unum) following a three-day jury trial. This court previously reversed and remanded this matter for a trial on the merits. See Elam v. First Unum Life Ins. Co., 346 Ark. 291, 57 S.W.3d 165 (2001) (reversed award of summary judgment to First Unum and remanded for a jury trial on issue of whether the term "mental illness" as used in the insurance policy is ambiguous with respect to Elam's diagnosis of bipolar affective disorder) (Elam I). First Unum also cross appealed on the issue of the admissibility of testimony regarding Elam's alleged past drug usage. We affirm the judgment of the circuit court.

In 1983, Elam went to work for Shearson & Leaman and continued his employment selling securities for over ten years. In 1993, Elam elected coverage under an insurance policy provided by his employer, then known as Smith-Barney-Shearson, for his disability due to a bipolar affective disorder.¹ After receiving benefits for two years from First Unum for this disability, First Unum declined further benefits "because of a twenty-four-month policy limitation applicable to disability due to mental illness." Elam I, 346 Ark. at 293, 57 S.W.3d at 166. Elam then filed suit against First Unum asserting that bipolar affective disorder is not a "mental illness" within the policy's definition and, therefore, is not subject to the twenty-four-month limitation of benefits.

The circuit court granted summary judgment to First Unum and found that the plain, ordinary meaning of the term "mental illness" as used and defined in the First Unum policy encompassed bipolar affective disorder. Elam appealed and this court reversed in Elam I, stating:

We cannot say that the term "mental illness" is ambiguous looking only to the face of the policy. Rather, the only way that term may become ambiguous is by looking to the conflicting evidence submitted by the parties, which included the affidavits and depositions of three physicians, an excerpt from the DSM-IV, and articles from various sources. Both parties went beyond the four corners of the policy and relied on this extrinsic evidence to support their respective interpretations of the term "mental illness.". . . Accordingly, the trial court erred in resolving this issue as a matter of law by granting summary judgment to First Unum. We therefore reverse the trial court's judgment and remand for the jury to resolve whether, based on the disputed extrinsic evidence offered by the parties, the term "mental illness," as it is used and defined in the policy, is ambiguous as it applies to Elam's diagnosis of bipolar affective disorder. In resolving this issue, the jury shall be instructed on the relevant law regarding construction of an insurance contract.

Id. at 297-98, 57 S.W.3d at 170.

Following remand and the three-day jury trial, the jury returned a verdict in favor of First Unum and answered these interrogatories:

INTERROGATORY NO. 1: Do you find from a preponderance of the evidence based upon the evidence offered by the parties, that the term "mental illness," as it is used and defined in the policy, is ambiguous as it applies to James Elam's [d]iagnosis of bipolar affective disorder?

ANSWER: No.

INTERROGATORY NO. 2: If you answered ye[s] to interrogatory No. 1, then return to the courtroom. If you answered no, then answer this interrogatory: Do you find from a preponderance of the evidence that bipolar disorder is a mental illness?

ANSWER: Yes.

The circuit court then entered judgment in favor of First Unum.

I. General Contract Instructions

Elam first contends that the circuit court erred by failing to instruct the jury on the "relevant law regarding construction of an insurance contract," which this court required in our opinion in Elam I. Specifically, Elam maintains that the circuit court erred by instructing the jury on the law relating to general contract interpretation rather than the law relating to the interpretation of insurance contracts. He asserts that he proffered instructions to the circuit court to the effect that any ambiguity in insurance policies should be strictly construed against the insurer and that it is the jury's duty to allow the insured to recover if a reasonable construction could be given to the policy to justify recovery. He claims in this appeal that the general contract instructions, which were given, conflict with the insurance-contract instructions proffered. Elam also argues that the jury failed to consider the instructions as a whole, as instructed by the court when it gave Arkansas Model Jury Instruction 103(b). Finally, Elam cites Skinner v. R.J. Griffin & Co., 313 Ark. 430, 855 S.W.2d 913 (1993), for the proposition that a party has no burden to prove prejudice when a circuit court gives an erroneous jury instruction.

We first address our standard of review. This court has consistently held that a party is entitled to a jury instruction when it is a correct statement of the law and when there is some basis in the evidence to support giving the instruction. See, e.g., Southern Farm Bureau Cas. Ins. Co. v. Daggett, 354 Ark. 112, 118 S.W.3d 525 (2003). Moreover, this court will not reverse a trial court's refusal to give a proffered instruction unless there was an abuse of discretion. Id. Finally, we have said that it is not error for the trial court to refuse a proffered jury instruction, when the stated matter is correctly covered by other instructions. Id.

In Elam I, this court instructed the circuit court to determine whether the term "mental illness," as used in Elam's insurance policy, was ambiguous as it applied to bipolar affective disorder in light of the disputed extrinsic evidence offered by the parties. At the ensuing trial on remand, Elam proffered the following jury instructions, which he maintained were consistent with insurance contract law but which the circuit court refused to give:

Insurance policies must be construed liberally so as to resolve all doubts in favor of the insured, both as to coverage and exclusions[, citing First Heritage Life Assur. Co. v. Butler, 248 Ark. 1164, 455 S.W.2d 135 (1970), and CNA Ins. Co. v. McGinnis, 10 Ark.App. 234, 663 S.W.2d 182 (1984)].

If you find the policy susceptible to two interpretations, one favorable to James Elam and one favorable to the First Unum Life Insurance Company, the interpretation favorable to Jim Elam must be adopted[, citing Drummond Citizens Ins. v. Sergeant, 266 Ark. 611, 588 S.W.2d 419 (1979)].

Any ambiguity in the insurance policy is to be strictly construed against First Unum Life Insurance Company who prepared the policy[, citing Travelers Indemnity Co. v. Hyde, 232 Ark. 1020, 342 S.W.2d 295 (1961), and Geurin Contr. v. Bituminous Cas. Corp., 5 Ark. App. 229, 636 S.W.2d 638 (1982)].

If a reasonable construction can be given be given [sic] to the policy which would justify recovery to the insured, James Elam, it is your duty to do so[, citing Travelers Indemnity Co. v. Hyde, supra, Home Indem. Co. v. City of Marianna, 297 Ark. 268, 761 S.W.2d 171 (1988), and Drummond Citizens Ins. v. Sergeant, supra].

The circuit court, however, gave the following instructions to the jury:

In determining the meaning of the language, you may take into consideration the language of the contract, the circumstances surrounding the making of the contract, the subject of the contract, the purpose of the contract, the situation in relation of the parties at the time the contract was made, and the parties' subsequent course of performance.

You should give the words of the contract their plain, ordinary and usual meaning unless it is clear that certain words were intended to be used in a technical sense.

You should give weight to the meaning placed on the language by the parties themselves as shown by their statements, acts, or conduct after the contract was made.

If you cannot decide the intention of the parties after considering the instructions that I have already given you concerning the interpretation of the ambiguous language in the contract, then you should interpret the ambiguous language against the party who prepared the contract.

This court in Southern Farm Bureau Cas. Ins. Co. v. Daggett, supra, stated that a circuit court does not err in refusing to admit proffered jury instructions if the proffered matter is correctly covered by other instructions. In this case, the court instructed the jury to construe the contract in favor of Elam if the jury found the term "mental illness" to be ambiguous. This was the gist of Elam's proffered instructions. We hold that the court did not abuse its discretion in refusing to give Elam's instructions.

II. Expert Witnesses

Elam next claims that the circuit court erroneously excluded the proffered expert testimony of attorney Gail Matthews, via deposition, because the jury was charged with determining whether the term "mental illness" was ambiguous as a question of fact, and the expert testimony of Mr. Matthews regarding ambiguity was relevant. Elam argues that courts from other jurisdictions have found it proper to allow expert testimony for the jury to understand and apply the terms of a contract, but that Arkansas has no case law on the admissibility of expert testimony for interpreting ambiguous contractual language. Elam further argues that this case is distinguishable from cases that exclude expert testimony on the question of contractual ambiguity, because in those cases, the identification and resolution of ambiguity in an insurance policy are matters...