LIFE INS CO OF NORTH AMERICA v E
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No. 81-257 IN THE SUPREME COURT OF THE STATE OF MONTANA 1981 LIFE INSURAXCE COMPANY OF NORTH AMERICA, Petitioner and Appellant, JUDITH ANN EVANS, individually and as Personal Representative of the Estate of LORENZO LLOYD EVANS, Deceased., Respondent and Respondent. ORIGINAL PROCEEDING: Counsel of Record: For Appellant: Anderson, Brown, Gerbase, Cebull Montana & Jones, Billings, For Respondent: Douglas & Bostock, Libby, Montana Submitted on Briefs: July 2, 1981 Decided: November 6, 1981 Filed: h'O\' 6 - 1%? Mr. J u s t i c e Gene B. D a l y d e l i v e r e d t h e O p i n i o n o f t h e C o u r t . Smith Honorable R u s s e l l E. , a s e n i o r United S t a t e s D i s t r i c t J u d g e f o r t h e D i s t r i c t o f Montana, h a s c e r t i f i e d t o u s a q u e s t i o n of law i n which it a p p e a r s t h e r e a r e s u b s t a n t i a l grounds f o r d i f f e r e n c e of opinion, t h e a d j u d i c a t i o n of which by t h i s C o u r t would m a t e r i a l l y a d v a n c e a d e c i s i o n i n federal litigation. Are t h e d e c i s i o n s of Metropolitan P.2d The f o l l o w i n g q u e s t i o n s w e r e c e r t i f i e d : Life law s e t down (1934), I n s u r a n c e Co. 3 3 5 , and S u l l i v a n v . Metropolitan i n Kingsland v. 97 Mont. 558, 37 L i f e I n s u r a n c e Co. ( 1 9 3 4 ) , 96 Mont. 254, 29 P.2d 1 0 4 6 , s t i l l l a w i n Montana? If t h e K i n g s l a n d and S u l l i v a n c a s e s s t i l l s t a t e t h e l a w i n Montana, a r e t h e d i f f e r e n c e s i n t h e l a n g u a g e o f t h e "exclusions" involved clauses sufficient here from those to distinguish considered in the policy Kinqsland and Sullivan? L o r e n z o Lloyd Evans l i v e d a t a n known a s and "Copper C r e e k , " twelve miles admitted to in location, f i f t y m i l e s from Libby, f r o m Noxon, practice isolated Montana. Montana, with Montana, He was a lawyer, offices in Libby. Evans k e p t v a r i o u s w i l d a n i m a l s and b i r d s a t h i s p l a c e o n Copper C r e e k , i n c l u d i n g a n e l e v e n - y e a r - o l d r a i s e d from a pup. wolf which h e had On t h e m o r n i n g o f J u n e 2 7 , 1 9 7 9 , L l o y d Evans was f e e d i n g h i s wolf when t h e wolf him on h i s r i g h t hand and w r i s t . a t t a c k e d and b i t Evans went b a c k t o t h e h o u s e , wrapped h i s hand w i t h a t o w e l , and s a t down. Within a period m i n u t e s a f t e r t h e wolf of approximately eight to fifteen a t t a c k , Evans i n d i c a t e d t o h i s w i f e t h a t t h e b i t e had p r e c i p i t a t e d a h e a r t a t t a c k and t h a t h e s h o u l d be d r i v e n t o a h o s p i t a l r i g h t away. Evans walked t o h i s c a r a n d l a i d down i n t h e b a c k s e a t . H i s w i f e had c a l l e d a n a m b u l a n c e , and when t h e y had t r a v e l e d a l i t t l e o v e r h a l f of the distance highway. to Evans Libby, was met they transferred the to ambulance the on ambulance the where o x y g e n was a d m i n i s t e r e d t o him, and h i s p u l s e was m o n i t o r e d . While i n t h e ambulance, forty-five Evans' to sixty minutes stopped, pulse and Oxygen and C . P . R . s i g n s of room in following he went the ambulance Libby. the wolf attack, cardiac into were a d m i n i s t e r e d , l i f e when emergency and a f t e r a l a p s e o f a p p r o x i m a t e l y arrest. and Evans showed some arrived a t the hospital Approximately fifteen minutes a f t e r a r r i v a l a t t h e h o s p i t a l , Lloyd Evans d i e d . L l o y d Evans had p r e v i o u s l y s u f f e r e d a h e a r t a t t a c k on 4, April 1979. He was hospitalized Administration hospital in three On A p r i l 25, weeks. d i s c h a r g e and r e t u r n e d Spokane, 1979, at the Washington, Veteran's for h e was g i v e n a t o t h e c a r e of about regular h i s physician, with t h e recommendation t h a t h e be i n h o u s e r e s t f o r a n o t h e r s i x weeks and g r a d u a l l y resume h i s p r e h o s p i t a l a c t i v i t i e s . Medical evidence i n d i c a t e s t h a t o f Lloyd E v a n s ' the immediate c a u s e d e a t h was h e a r t a t t a c k , but t h a t the heart a t t a c k was " t r i g g e r e d " by t h e wolf b i t e . The wolf b i t e was n o t s e v e r e enough, by i t s e l f , t o have caused t h e d e a t h of Evans. Lloyd Company of Evans North had America voluntary accidental policy, No. OK-2598, e f f e c t i v e November and effect, applied to and issued, and the 1, 1 9 7 2 . according had death in for, Life a certain dismemberment principal Insurance sum of group insurance $50,000, The p o l i c y was i n f u l l f o r c e its terms, on t h e d a t e of Lloyd Evans' d e a t h . The p o l i c y c o n t a i n e d t h i s l a n g u a g e : . . . "[The i n s u r e d ] is i n s u r e d asainst loss r e s u l t i n g d i r e c t l y and independently of a l l o t h e r c a u s e s f r o m b o d i l y i n j u r i e s c a u s e d by a c c i d e n t o c c u r r i n g w h i l e t h e p o l i c y is i n f o r c e a s t o the I n s u r e d , h e r e i n c a l l e d s u c h injuries. "EXCLUSIONS "The p o l i c y d o e s n o t c o v e r l o s s c a u s e d by o r r e s u l t i n g f r o m a n y o n e o r more o f t h e f o l l o w ing : . . "(D) I l l n e s s , d i s e a s e . bodily infirmity o r a n y b a c t e r i a l i n f e c t i o n o t h e r t h a n bact e r i a l i n f e c t i o n o c c u r r i n g i n consequence of a n a c c i d e n t a l c u t o r wound." ( E m p h a s i s supplied.) The i s s u e h e r e i s w h e t h e r K i n g s l a n d v . L i f e I n s u r a n c e Co. ( 1 9 3 4 ) , 97 Mont. 558, Metropolitan 37 P.2d 3 3 5 , and S u l l i v a n v . M e t r o p o l i t a n L i f e I n s u r a n c e Co. ( 1 9 3 4 ) , 96 Mont. 254, 29 P.2d 1 0 4 6 , a r e s t i l l law i n t h e S t a t e o f Montana. A f t e r a review of t h e r u l e s i n t h e s e c a s e s , we a g r e e w i t h r e s p o n d e n t J u d i t h Evans and that the reasoning rules set down i n S u l l i v a n and K i n q s l a n d a r e s t r i c t and h a r s h . In Sullivan, the insured tripped s h e e t m e t a l and f e l l , h i t t i n g h i s head. d i e d of a c e r e b r a l hemorrhage. the t r i a l pressure that the and arteriosclerosis blood pressure sheet metal, a piece of F i v e d a y s l a t e r he E v i d e n c e was s u b m i t t e d a t i n s u r e d was s u f f e r i n g Evidence a l s o i n d i c a t e d high over at the from h i g h time of the blood fall. t h a t had a man n o t s u f f e r i n g f r o m and a r t e r i o s c l e r o s i s t r i p p e d o v e r in a l l probability, the no h e m o r r h a g e would h a v e resulted. The i n s u r a n c e p o l i c y i n S u l l i v a n p r o v i d e d c o v e r a g e i f the insured sustained "bodily injuries, s o l e l y through external and violent and independently accidental of all means, other resulting causes." The S u l l i v a n admitted t h a t a reasonable scope of c o n t e m p l a t e d by the policy. directly Nevertheless, Court in i n s u r a n c e was because of the c l e a r and u n e q u i v o c a l n a t u r e o f t h i s l a n g u a g e i n t h e p o l i c y , ". . . t h e C o u r t h e l d t h a t t h e r e would be no r e c o v e r y i f the i n s u r e d might s u f f e r an a c c i d e n t r e s u l t i n g i n d e a t h t o which disease or bodily . . ." partially infirmity contributed S u l l i v a n , 29 P.2d indirectly a t 1052. or Because t h e i n s u r e d was s u f f e r i n g f r o m a r t e r i o s c l e r o s i s , which c o n t r i - b u t e d t o and a c t i v e l y c o o p e r a t e d w i t h t h e a c c i d e n t t o c a u s e t h e i n s u r e d ' s d e a t h , t h e r e was no r e c o v e r y . I n Kingsland, t h e i n s u r e d had stepped onto a chair s i t t i n g on a n uneven c e m e n t s u r f a c e ; he l o s t h i s b a l a n c e and fell head first on the shortly after the f a l l . rough cement. The c a u s e o f The insured died the insured's death was d e s c r i b e d a s a r u p t u r e d a n e u r y s m o f t h e a o r t a , p r e c i p i t a t e d by t h e f a l l and by s t r i k i n g h i s h e a d on t h e c e m e n t floor. The C o u r t i n K i n g s l a n d f i r s t l o o k e d t o t h e l a n g u a g e of t h e i n s u r a n c e p o l i c y which c o n t a i n e d t h e c o n d i t i o n t h a t d e a t h must be shown to result v i o l e n t and a c c i d e n t a l m e a n s . " "solely through external, 3 7 P.2d Kingsland, a t 337. The C o u r t t h e n r e a s o n e d t h a t t h e t e r m " p r o x i m a t e c a u s e " i s i n a p t i n t h i s c l a s s of only if injuries death resulted received Kingsland, 37 Kinqsland, there c o n d i t i o n was P.2d a c a s e s b e c a u s e " r e c o v e r y c a n be had 'solely' through at could proximately) accidental . means from I1 According 337. be (not no to the Court recovery if the insured's c o n t r i b u t i n g c a u s e of death. If in a pre- e x i s t i n g i n f i r m i t y w e r e shown, r e c o v e r y c o u l d o n l y b e had i f t h e a c c i d e n t a l i n j u r y was s u f f i c i e n t i n i t s e l f t o c a u s e t h e d e a t h o f a h e a l t h y man. The K i n q s l a n d C o u r t r e a s o n e d f u r t h e r t h a t i n S u l l i v a n the fall a l o n e was n o t s u f f i c i e n t t o c a u s e t h e insured's d e a t h , and h i s c o n d i t i o n was t h e r e f o r e a c o n t r i b u t i n g c a u s e . In contrast, insured b e c a u s e e v i d e n c e showed t h a t t h e f a l l o f the i n K i n g s l a n d was s u f f i c i e n t t o c a u s e t h e d e a t h o f t h e i n s u r e d , r e c o v e r y was g r a n t e d . The issue here is whether t h i s Court should still f o l l o w t h e r u l e s e t down i n K i n g s l a n d and S u l l i v a n t h a t i f a preexisting condition contributes to an insured's death, t h e r e c a n be no r e c o v e r y . Given t h e e x t r e m e h a r s h n e s s o f this interpretation placed on such jurisdictions today, we must rule insurance and the policies liberal in many o v e r r u l e t h e K i n g s l a n d and S u l l i v a n c a s e s t o t h e e x t e n t t h a t they hold disease t h a t t h e r e c a n b e no r e c o v e r y either directly or indirectly if a preexisting contributes to an insured's death. W a r e persuaded t h a t t h e b e t t e r r u l e f o r t h e i n t e r e pretation Where an of such accidental insurance is policies injury aggravates or the following: triggers a pre- e x i s t i n g dormant d i s e a s e or p h y s i c a l i n f i r m i t y , t h e a c c i d e n t may be s a i d t o h a v e b e e n t h e p r o x i m a t e c a u s e o f t h e r e s u l t i n g d i s a b i l i t y w i t h i n t h e t e r m s and meaning o f a n o r d i n a r y accident insurance policy. 209 Kan. 413, Insurance McMackin Cal.App.3d 496 (1966), v. Great 428, P.2d 76 See, 1385; Boring v. Carlson Ill.App.2d American 99 C a l . R p t r . 187, Reserve 227; v. Ins. Nash v . Haynes New 222 Co. (1972), York N.E.2d Life 363; (1971), Prudential 22 Ins. Co. o f America ( 1 9 7 4 ) , 39 Cal.App.3d Brown v. (La.App. State Mutual Life 1 9 7 9 ) , 377 S o . 2 d 5 9 4 , 114 C a l . R p t r . Insurance 355; Zurich Company Ins. of Co. 299; America v. Ruscoe (Miss. 1 9 6 7 ) , 203 S o . 2 d 305; Couey v . N a t i o n a l B e n e f i t L i f e I n s u r a n c e Company ( 1 9 6 7 ) , 77 N . M . 5 1 2 , 424 P.2d 793. d i s c u s s i o n o f c a s e s on t h i s m a t t e r , s e e 84 A.L.R.2d For a 176. The mere p r e s e n c e o f a p r e e x i s t i n g d i s e a s e o r i n f i r m i t y w i l l no l o n g e r this state. relieve the R e c o v e r y may be had insurer from l i a b i l i t y even though in the disease a p p e a r s t o have a c t u a l l y c o n t r i b u t e d t o t h e c a u s e of d e a t h a s long a s t h e a c c i d e n t sets i n motion t h e c h a i n of e v e n t s leading t o death, or if i t is t h e p r i m e o r moving c a u s e . S e e , B r o o k s v . M e t r o p o l i t a n L i f e I n s . Co. 305, 1 6 3 P.2d 689; Kater v. America ( 1 9 6 0 ) , 22 I l l . A p p . 2 d United ( 1 9 4 5 ) , 27 C a l . 2 d Insurance 2 2 , 1 6 5 N.E.2d Company of 74. A mere f r a i l c o n d i t i o n s h o u l d n o t r e l i e v e a n i n s u r e r from l i a b i l i t y . A s Chief J u s t i c e Cardozo n o t e d i n S i l v e r - s t e i n v . M e t r o p o l i t a n L i f e Co. ( 1 9 3 0 ) , 254 N . Y . 914, an insurance p o l i c y that i t s coverage 81, 171 N.E. is not accepted with t h e thought i s t o be r e s t r i c t e d t o a n A p p o l l o o r a Hercules. W e agree with t h e following language f r o m Couey v . N a t i o n a l B e n e f i t L i f e I n s u r a n c e Company, s u p r a , 424 P.2d a t 795: " I n our view of t h e c a s e , e v e r y i n j u r y o r d i s e a s e s u f f e r e d by a p e r s o n f r o m h i s b i r t h t o t h e d a t e of a p a r t i c u l a r i n j u r y c o n t r i b u t e s t o some d e g r e e t o t h e c o n d i t i o n t h e n present. N e c e s s a r i l y , by t h e w o r d s u s e d i n t h e p o l i c y it c o u l d n o t have been i n t e n d e d t h a t payment would be d u e o n l y when t h e a c c i d e n t was l i t e r a l l y t h e s o l e c a u s e o f hospitalization. I f a p e r s o n had s u f f e r e d a b r o k e n l e g which had h e a l e d p e r f e c t l y f i v e y e a r s b e f o r e , and a s e c o n d a c c i d e n t w h e r e i n t h e l e g had b r o k e n a t t h e same p l a c e , c o u l d it be said that the condition resulting from the first break did not in any way contribute to the second break? We think the answer is obvious and, under defendants' theory, plaintiff would not be entitled to recover. In our view, this application of the language of the policy is entirely too restrictive and would be unreasonable. Other courts have agreed . . Likewise, the rulings of Sullivan and Kingsland were too restrictive, and any rules in these cases must be overruled to the extent they are inconsistent with this opinion. Since we have held that Kingsland and Sullivan no longer state the law in Montana, we need not discuss the second 4 l' question certified to us. Justice We concur: wdw ? A 4 $ Chief Justice j V
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