Wilson v. Liberty Nat. Life Ins. Co.

• Decision Date: 02 April 1976
• Parties: Iris L. WILSON v. LIBERTY NATIONAL LIFE INSURANCE COMPANY. Iris L. WILSON v. The EQUITABLE LIFE ASSURANCE SOCIETY OF the UNITED STATES. SC 1522, SC 1546.
• Court: Alabama Supreme Court

Page 617

331 So.2d 617

Iris L. WILSON v. LIBERTY NATIONAL LIFE INSURANCE COMPANY.

Iris L. WILSON v. The EQUITABLE LIFE ASSURANCE SOCIETY OF the UNITED STATES.

SC 1522, SC 1546.

Supreme Court of Alabama.

April 2, 1976.

As Corrected on Denial of Rehearing May 7, 1976.

Chason, Stone, Chason & Partin, Bay Minette, for appellant.

J. B. Blackburn, Bay Minette, for appellee, Liberty Natl. Life Ins. Co.

Johnstone, Adams, May, Howard & Hill and Richard T. Dorman, Mobile, for appellee, The Equitable Life Assurance Society of United States.

BLOODWORTH, Justice.

Iris L. Wilson, the beneficiary under three insurance policies issued on the life of her husband, Charles W. Wilson, filed three lawsuits in the Circuit Court of Baldwin County, against the three insurers. All three suits presented the same basic issue, that is, whether the insured died as a result of accidental causes, thereby entitling The beneficiary's suit against Colonial Life & Accident Insurance Company was removed to the federal district court, where the District Judge found that the insured's death did not result from accidental causes. Summary judgment was rendered in favor of defendant insurance company in that case.

Iris Wilson, the beneficiary, to accidental death benefits provided by the policies.

The Baldwin County circuit court made similar dispositions in the two cases which are on appeal here (Wilson v. The Equitable Life Assurance Society of the United States and Wilson v. Liberty National Life Insurance Company). Summary judgments were granted in both cases in favor of the insurers. These two cases were consolidated on this appeal.

The accident, upon which Mrs. Wilson bases her right to recover accidental death benefits, occurred on December 22, 1972, when Mrs. Wilson's husband, the insured, fell down some steps landing on his buttocks. This fall caused the insured considerable back pain and may have caused a lumbar strain, although later X rays revealed no damage. As a result of this fall, the insured was hospitalized from January 1, 1973, until January 19, 1973 'with strain after having fallen down the steps and having concurrent increase in his angina or chest pain.'

However, on January 26, 1973, the insured was readmitted to the hospital, this time for congestive heart failure. For at least four years, the insured had been afflicted with 'three vessel disease,' the most serious coronary disease. This disease is both permanent and progressive and is associated with a very poor life expectancy for its victims. Prior to his fall, the insured's heart condition was deemed to be inoperable. On January 27, 1973, one day after being admitted to the hospital, the insured died. The death certificate indicates that the cause of death was arteriosclerotic heart disease with acute myocardial infarction, but it also lists trauma to the back as an aggravating cause of death.

The two policies under which Mrs. Wilson sought to recover in the circuit court were similarly worded. Both contained a 'general clause' to the effect that accidental death benefits would be paid only upon proof that the insured died as a result of

'. . . bodily injuries, caused directly and exclusively by external, violent and purely accidental means, . . . directly and independently of all other causes, . . .'

In addition, both policies included an 'additional clause' to the effect that no benefit shall be payable

'. . . for any loss resulting from or caused directly or indirectly, wholly or partly, by . . . bodily or mental infirmity . . . or disease or illness of any kind, . . .'

In Alabama, policy language similar to that contained in the 'general clause' has been construed to mean that 'if the accident aggravated a disease and hastened the death of the insured, the accident is yet considered the Proximate cause of the insured's death, notwithstanding the gravity of the disease or that the accidental injury would not have been fatal but for the infirmity.' (Emphasis supplied.) Liberty Nat'l Life Ins. Co. v. Reid, 276 Ala. 25, 33, 158 So.2d 667, 674 (1963).

However, our cases also hold that where the policy contains the 'additional clause' then no recovery can be had where death results from the Combined effects of an accident and a pre-existing disease which was accelerated and aggravated by the accident. First Nat'l Bank v. Equitable Life Assurance Soc. of the United States, 225 Ala. 586, 590--91, 144 So. 451, 455 (1932); Liberty Nat'l Life Ins. Co. v. Reid, supra.

With respect to the 'additional clause,' our cases also hold, as stated by Bouldin, J., in Equitable, supra:

'But this does not mean that mere feebleness, nor predisposition to recurrence of former disease, nor every infirmity which may aggravate the effects of an accidental injury, is to be regarded as the cause of death.

'The general rules of construing insurance policies favorably to the insured apply to these clauses touching bodily infirmity, etc.'

225 Ala. at 589, 144 So. at 454.

Thus, it is that Harwood, J., in Reid, supra, concluded:

'If an injury starts a chain reaction resulting in death, recovery may be had even if one of the links in the chain is old age, frailty and some links are dormant diseases or physical conditions without which the chain would be broken. Each case must be particularized.'

276 Ala. at 33, 158 So.2d at 674. Then, Justice Harwood adds:

'Where the evidence is conflicting as to whether an accident was the cause of an insured's death, or whether the accident and a disease cooperating therewith combined to cause death, then ordinarily a question of fact within the resolution of the trier of fact is presented.'

Id.

Mrs. Wilson, the beneficiary of the policies, contends that her husband's fall and the injuries, pain, and emotional distress that he suffered from the fall placed additional demands upon his heart, directly resulting in his death. Under this theory of recovery, it is contended that the consequences of the insured's accident triggered a dormant heart condition, and precipitated the insured's death.

In furtherance of this contention, Mrs. Wilson argues that the evidence before the trial court presented at least a scintilla of evidence in support of her theory of recovery and that therefore the grant of summary judgment was in error.

The trial court, in considering the motions for summary judgment, had before it: the pleadings; the deposition of Dr. Martin Lester (the insured's personal physician); the insurance policies in question; the death certificate recording the cause of Charles Wilson's death; the findings of fact and conclusions of law of the U.S. District Court in Wilson v. Collonial Life & Accident Insurance Company; and, the affidavits of Iris Wilson in opposition to the motions for summary judgment.

We agree with the beneficiary, Mrs. Wilson, that the sole question presented by these appeals is whether the evidence before the trial court provided a scintilla of evidence in her favor thereby presenting a genuine issue as to a material fact and preventing the summary judgments being rendered against her. Putting the issue another way, are the insurers entitled to summary judgment as a matter of law?

The committee comments following Rule 56, A.R.C.P., quote with approval the following textbook authority:

'The summary judgment procedure is not a substitute for the trial of disputed issues of fact. On a motion for summary judgment, the court cannot try issues of fact. It can only determine whether there are issues to be tried. . . .' 3 Barron & Holtzoff, Federal Practice and Procedure, § 1231 (1958).

The committee added that 'if there is a Scintilla of evidence supporting the position of the party against whom the motion is made, so that at a trial he would be entitled to go to the jury, summary judgment Our scintilla rule requires only that the evidence, or reasonable inferences therefrom, furnish a mere gleam, glimmer, spark, the least bit, the smallest trace, in support of the plaintiff's complaint. Union Central Life Ins. Co. v. Scott, 286 Ala. 10, 236 So.2d 328 (1970, per Lawson, J.).

cannot be granted.' Id. (Emphasis supplied.)

Since we have the scintilla rule in Alabama, and such is not the rule under F.R.C.P., there is a clear distinction between this case and the federal district court case.

The following extracts from the documents submitted on summary judgment indicate to us that the beneficiary has at least raised a scintilla so as to defeat summary judgment. Thus, we do not think the insurer was entitled to summary judgment as a matter of law.

'STATE OF ALABAMA

'BALDWIN COUNTY

'Before me, the undersigned authority, in and for said County in said State personally appeared Iris L. Wilson who is known to me and who, after being by me first duly and legally sworn did depose and say as follows:

'My name is Iris L. Wilson and I am one and the same person as the Plaintiff . . .. I am the widow of Charles W. Wilson and the beneficiary of the insurance policies . . .. My husband at the time of his death was an employee of Cosby-Hodges Milling Company with his office and headquarters in Mobile, Alabama, where he was the manager of that branch of his employer. For the six months prior to December 22, 1972, my husband was Regularly engaged in performing his duties for his employer which consisted of traveling about his sales territory, Fulfilling his duties in the office, and generally Performing the Normal duties associated with his employment at which he was Actively engaged from eight to ten hours per day. . . .

'On December 22, 1972, at about 7:30 p.m., my husband was leaving his office after locking the door to the office he turned, slipped and fell down about six or seven concrete steps to the ground level. . . . I drove my husband to Thomas Hospital. . . . and all the while he was complaining of pain in his head and of hurting all over, but mainly with the pain in his head. We went back home . . . but he couldn't sleep on...