Williams v. New England Mut. Life Ins. Co.

Citation419 So.2d 766
Decision Date23 September 1982
Docket NumberNo. AE-495,AE-495
CourtCourt of Appeal of Florida (US)
PartiesWilliam H. WILLIAMS, Myrtle Williams, Frances Williams, and William H. Williams, as Personal Representative of the Estate of Malcolm Ronald Williams, Deceased, Appellants, v. NEW ENGLAND MUTUAL LIFE INSURANCE COMPANY, a foreign corporation, Gulf Life Insurance Company, a Florida corporation, and Independent Life & Accident Insurance Company, a Florida corporation, Appellees.

William F. Daniel, Tallahassee, for appellants.

Miles Davis of Beggs & Lane, Pensacola, for appellees.

ERVIN, Judge.

This is an appeal from a final judgment denying coverage under the double indemnity provisions of three life and accidental death policies. We affirm the lower court's determination holding that no coverage extended to the benefit of the insured as to the Independent Life and Accident Insurance Company on the ground that the policy had expired at the time of decedent's death. The policy clearly and unambiguously provided that the accidental death and dismemberment portion of the employee group life insurance policy would automatically cease upon the insured's termination from employment. The lower court apparently found, on conflicting evidence, that the insured was no longer an employee at the time of his death. This finding is supported by competent and substantial evidence.

We affirm also the lower court's holding as to the Gulf Life policy that the insured was not covered because his wounds were intentionally inflicted by another person. The policy has an express exclusion barring accidental death benefits under such circumstances. Again, there was substantial evidence supporting the lower court's finding.

The court's ruling denying the plaintiffs' requested relief as to their action on the New England Mutual Life Insurance Company policy on the ground that the insured's death occurred as the result of illness or disease--not accident--requires more extended discussion. New England Life's coverage excludes accidental death caused directly or indirectly due to a disease, or the insured's commission of a felony. As to the former, we reverse the lower court's determination that alcoholism is a disease, but as to the latter, we remand for factual considerations.

Malcolm Ronald Williams, the decedent, had been an alcoholic for many years, succumbing on occasion to hallucinations. At noon on the day of his death, he was driven to his apartment by his brother. He was then sober. The evidence suggests that between noon and late evening he began drinking heavily. Late that night his landlord and landlady were awakened by Williams' screams, to the effect that someone was trying to break into his apartment. One of the officers who was alerted to the scene remembers that Williams appeared to be intoxicated at the time. Williams' landlady recalls that his behavior was erratic; he was seen wildly flinging his arms. Nonetheless, he was finally calmed down, and the police departed.

Shortly thereafter, the decedent's landlady heard six shots. Her husband summoned the police the second time. Upon their arrival, they cautiously approached Williams' apartment. The landlady later recounted that she heard his door slam shut, making a loud noise; an officer, however, thought that he heard a gunshot. The decedent ran out into the yard swinging his arms about, gun in hand, shouting: "I got them! I got them!" Williams was ordered to halt, but he persisted on his fateful course. Two shots were fired, abruptly terminating Williams' unhappy life.

The appellants sought to recover from New England Life under the life and accidental death coverages of the policy. New England Life refused to pay the proceeds, arguing that its policy excluded as a risk, accidental death caused by disease or the insured's commission of a felony. 1 The case went to non-jury trial, and the insurer contended that Section 396.022(1), Florida Statutes (1971), 2 classifies alcoholism as a "disease" within its policy terms. Alternatively, New England Life suggested that the decedent's death was caused by his commission of the felony of aggravated assault.

In support of these contentions, a police officer testified that if Williams had lived, he would have been charged with aggravated assault. Countering this, the state's attorney testified that Williams had been determined not to have committed any crime at the time of his death. As to his mental state, evidence was presented showing that the decedent was intoxicated and possibly hallucinating at the time of his death. Williams' brother stated that he found numerous empty beer cans in the decedent's apartment the day following his death. An autopsy, moreover, reflected that he had a .27 blood-alcohol rating.

The decedent's ex-wife, a nurse, stated that Williams in her opinion was definitely an alcoholic. She recounted that he often drank a minimum of a fifth of liquor per day and on occasion hallucinated due to his heavy and prolonged use of alcohol. She related one instance in which Williams had observed non-existent kittens in a closet. From a medical standpoint, as a nurse, she stated that alcoholism is not a disease. A pathologist who testified opined that Williams had been hallucinating. The pathologist posited that alcoholics who are hallucinating appreciate the significance of acts, but are unable to appreciate what they are doing. Further, he viewed alcoholism primarily as a disease. A psychiatrist partly concurred, explaining that one who suffers from alcoholic hallucinosis is temporarily insane. Yet, he did not view alcoholism as a disease, but rather a personality disorder.

Based upon this evidence, the court, without addressing the question of whether coverage should be denied due to the exclusion in the policy relating to persons whose deaths occur during the commission of felonies, found that the decedent's estate was not entitled to the proceeds of the New England Life policies, because the "disease" of alcoholism contributed to Williams' death. The lower court specifically noted that Section 396.022, Florida Statutes (1971), states that, as a matter of public policy, alcoholism is a disease. We reverse as to that finding.

The New England Life policy provision bars company liability for death resulting, directly or indirectly, from a disease or infirmity. Section 396.022(1) states that, as a matter of public policy, alcoholism is to be regarded as a disease. Normally, a statute applicable to the insurance policy, which was in force at the time the policy of insurance was consummated, is considered a basic ingredient of the contract, because the law in existence at the time of the making of the contract of insurance forms a part of that contract, as if it were expressly referred to in its terms. National Merchandise Co., Inc. v. United Service Automobile Association, 400 So.2d 526, 531 (Fla. 1st DCA 1981). Our inquiry is directed to the question of whether Section 396.022(1) is material for the purpose of applying the policy exclusion, thereby making it a part of the contract of insurance.

Whether alcoholism is a disease for insurance purposes is a question that cannot be readily answered, although a superficial reading of Section 396.022(1) would seem to indicate that it is. Nevertheless, we note with interest the position taken by the United States Supreme Court in a criminal proceeding:

[T]he inescapable fact is that there is no agreement among members of the medical profession about what it means to say that "alcoholism" is a "disease." One of the principal works in this field states that the major difficulty in articulating a "disease concept of alcoholism" is that "alcoholism has too many definitions and disease has practically none." This same author concludes that "a disease is what the medical profession recognizes as such." In other words, there is widespread agreement today that "alcoholism" is a "disease," for the simple reason that the medical profession has concluded that it should attempt to treat those who have drinking problems. There the agreement stops. Debate rages within the medical profession as to whether "alcoholism" is a separate "disease" in any meaningful biochemical, physiological or psychological sense, or whether it represents one peculiar manifestation in some individuals of underlying psychiatric disorders.

Powell v. Texas, 392 U.S. 514, 522, 88 S.Ct. 2145, 2149, 20 L.Ed.2d 1254 (1968), reh. denied, 393 U.S. 898, 89 S.Ct. 65, 21 L.Ed.2d 185 (1968) (footnotes omitted; emphasis in original). The opinion persuasively points out that it is really unclear whether alcoholism is a disease. This perception is buttressed by the disparate views attested to at trial below by the decedent's former wife, who is a nurse, the pathologist, and the psychiatrist. Powell emphasizes that the classification of alcoholism as a disease is often for the express purpose of treatment, rather than punishment.

A careful scrutiny and consideration of Section 396.022, Florida Statutes, reveals that the legislature intended for alcoholics to be treated--not punished by incarceration in the county jail, or placement in the town pillory, as had been the traditional means of public response to the condition of alcoholism. This purpose of the "Comprehensive Alcoholism Prevention, Control, and Treatment Act," Chapter 396, Florida Statutes, is manifested throughout Section 396.022. The statute includes a finding that existing laws have not successfully dealt with alcoholism prevention and treatment. See § 396.022(3), Fla.Stat. (1971). It further declares that "[t]he criminal law is not an appropriate device for preventing or controlling health problems. Dealing with public inebriates as criminals has proved expensive, unproductive, burdensome, and futile." § 396.022(4), Fla.Stat. (1971). The statute calls for handling alcoholics as sick persons. § 396.022(8), Fla.Stat. (1971).

We consider...

To continue reading

Request your trial
5 cases
  • Linehan v. State
    • United States
    • Florida Supreme Court
    • August 29, 1985
    ...aggravated battery, and aggravated assault); Link v. State, 429 So.2d 836 (Fla. 3d DCA 1983) (theft); Williams v. New England Mutual Life Insurance Co., 419 So.2d 766 (Fla. 1st DCA 1982) (aggravated assault); Harris v. State, 415 So.2d 135 (Fla. 5th DCA), review denied, 419 So.2d 1198 (Fla.......
  • Buck v. Gulf Life Ins. Co.
    • United States
    • Florida District Court of Appeals
    • August 2, 1989
    ...as a matter of law. Therefore, we need not decide whether we concur with that part of the decision in Williams v. New England Mutual Life Insurance Co., 419 So.2d 766 (Fla. 1st DCA 1982), reversing a lower court finding that alcoholism is a disease. That issue was also discussed by the Supr......
  • Hayden v. Guardian Life Ins. Co. of America
    • United States
    • Court of Appeal of Louisiana — District of US
    • December 23, 1986
    ...a disorder of behavior (accent added).' " Driver, 356 F.2d at 764 (footnote omitted).3 Contra, Williams v. New England Mutual Life Insurance Company, 419 So.2d 766, 770 (Fla.Dist.Ct.App.1982).4 In reaching this last conclusion we are cognizant of the rule of construction which dictates that......
  • Hester v. State
    • United States
    • Florida District Court of Appeals
    • March 11, 1987
    ... ... State, 458 So.2d 327 (Fla. 1st DCA 1984); Williams v. New England Mut. Life Ins. Co., 419 So.2d 766 (Fla. 1st ... ...
  • Request a trial to view additional results

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT