{ "id": 8555044, "name": "ADA GRANSON WILLIAMS v. PILOT LIFE INSURANCE COMPANY", "name_abbreviation": "Williams v. Pilot Life Insurance", "decision_date": "1975-05-07", "docket_number": "No. 7414DC1022", "first_page": "505", "last_page": "510", "citations": [ { "type": "official", "cite": "25 N.C. App. 505" } ], "court": { "name_abbreviation": "N.C. Ct. App.", "id": 14983, "name": "North Carolina Court of Appeals" }, "jurisdiction": { "id": 5, "name_long": "North Carolina", "name": "N.C." }, "cites_to": [ { "cite": "166 A.L.R. 469", "category": "reporters:specialty", "reporter": "A.L.R.", "year": 1947, "pin_cites": [ { "page": "476" } ], "opinion_index": 0 }, { "cite": "150 S.E. 2d 40", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1966, "opinion_index": 0 }, { "cite": "268 N.C. 98", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8560233 ], "weight": 3, "year": 1966, "pin_cites": [ { "page": "99" }, { "page": "104" } ], "opinion_index": 0, "case_paths": [ "/nc/268/0098-01" ] }, { "cite": "127 S.E. 2d 789", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1962, "opinion_index": 0 }, { "cite": "258 N.C. 1", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8559261 ], "year": 1962, "opinion_index": 0, "case_paths": [ "/nc/258/0001-01" ] }, { "cite": "142 N.W. 2d 57", "category": "reporters:state_regional", "reporter": "N.W.2d", "year": 1966, "opinion_index": 0 }, { "cite": "3 Mich. App. 220", "category": "reporters:state", "reporter": "Mich. App.", "case_ids": [ 2030427 ], "year": 1966, "opinion_index": 0, "case_paths": [ "/mich-app/3/0220-01" ] }, { "cite": "297 F. 681", "category": "reporters:federal", "reporter": "F.", "case_ids": [ 3638731 ], "year": 1924, "opinion_index": 0, "case_paths": [ "/f/297/0681-01" ] }, { "cite": "22 L.R.A. 620", "category": "reporters:federal", "reporter": "L.R.A.", "year": 1905, "pin_cites": [ { "parenthetical": "opinion by Taft, Circuit Judge, later Chief Justice of the United States Supreme Court" } ], "opinion_index": 0 }, { "cite": "58 F. 945", "category": "reporters:federal", "reporter": "F.", "case_ids": [ 6738490 ], "year": 1893, "opinion_index": 0, "case_paths": [ "/f/58/0945-01" ] }, { "cite": "259 Or. 453", "category": "reporters:state", "reporter": "Or.", "case_ids": [ 2108742 ], "weight": 3, "year": 1971, "pin_cites": [ { "page": "456" } ], "opinion_index": 0, "case_paths": [ "/or/259/0453-01" ] } ], "analysis": { "cardinality": 523, "char_count": 11028, "ocr_confidence": 0.563, "pagerank": { "raw": 5.527646540942415e-08, "percentile": 0.347943837652311 }, "sha256": "0a825789f4a18890a7316af8b5321fe6514e720b91ed7b4a2edf824eb93bc873", "simhash": "1:306353085d957393", "word_count": 1874 }, "last_updated": "2023-07-14T15:30:12.075015+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [ "Judge Hedrick concurs.", "Judge Clark dissents." ], "parties": [ "ADA GRANSON WILLIAMS v. PILOT LIFE INSURANCE COMPANY" ], "opinions": [ { "text": "PARKER, . Judge.\nWhen judgment was announced, defendant made and the court denied the following motion:\n\u201cThat the Court make specific findings of facts as to whether the decedent had (a) slipped and fallen or (b) became suddenly stiff and fallen or (c) the court was concluding that the fall was accidental regardless of whether decedent slipped and fell or suddenly became stiff and fell.\u201d\nDefendant concedes that if (a) is true, plaintiff is entitled to recover, but contends that if (b) is true, plaintiff is not, and if (c) is true, the court erred and defendant is entitled to a new trial in which the court must specifically find whether (a) or (b) is true. Defendant further contends that the judgment does not make it clear on which basis the court proceeded. The trial court did expressly find, however, that the insured suffered \u201can accidental fall\u201d and that her death \u201cwas solely as a direct result thereof and independent of all other causes.\u201d In my opinion these findings are fully supported by any view of the evidence and in turn support the judgment for plaintiff entered thereon.\nThe policy provided that defendant insurance company would pay death benefits if the insured\u2019s death occurred \u201csolely as a direct result, and independent of all other causes, of accidental bodily injury\u201d sustained while the policy was in effect. All of the evidence shows that the insured\u2019s death occurred solely as a result of the blow to her head which she received when she fell, and in its brief defendant concedes that \u201c[t]here is no dispute in this case that the death of the insured was caused by a blow she' sustained as a result of a fall.\u201d Thus, there was here neither evidence nor contention that death was due to a seizure or to illness or to any bodily infirmity whatever other than the injury caused directly by the blow to the insured\u2019s head. The question presented, therefore, is whether the injury so caused was an \u201caccidental bodily injury,\u201d as those words are used in the policy, even though the fall which resulted in the blow to the head might itself have been caused by a sudden seizure. I hold that it was.\nWhen confronted with a case involving a policy of accident insurance, the courts should interpret the policy words \u201caccident\u201d and \u201caccidental\u201d as those words are commonly understood in ordinary popular usage, for that is the sense in which they are understood by those who purchase such policies. If those words are to have a more restricted meaning, the burden of making that clear should be upon the insurance company which drafts the policy and sells it to the public. In common usage the words \u201caccident\u201d and \u201caccidental\u201d are used to describe some sudden, untoward event, happening apparently by chance, taking place unexpectedly, and not according to the usual course of events. I submit that in common understanding one whose head is bashed against some hard object because he \u201csuddenly became stiff and fell\u201d has suffered an \u201caccident\u201d no less than one who suffers the same injury because his foot slipped and he fell. Even if the fall was caused by some sudden seizure or illness, it was completely fortuitous that the decedent would fall in such a manner as to strike her head- violently upon the floor. In the present case the policy had been in effect for more than ten years. There was no evidence that prior to her fatal injury the insured had ever fallen or had ever suffered any seizure of any nature. In my opinion she suffered an \u201caccidental bodily injury\u201d within the meaning of the policy, whether she slipped and fell or suddenly became stiff and fell. Since there is no dispute that her death ensued \u201csolely as a direct result, and independent of all other causes,\u201d of the bodily injury which she received in the fall, plaintiff is entitled to recover.\nThis holding is supported by the decision in Salisbury v. John Hancock Mut. Life, 259 Or. 453, 486 P. 2d 1279 (1971), in which the Supreme Court of Oregon expressly overruled one of its prior decisions in order to sustain recovery under an accident insurance policy which extended coverage for \u201cdeath resulting directly and solely from * * * [a]n accidental injury\u201d in a case in which the insured had a preexisting infirmity or disease which was a cause of the accident, but death was caused solely as the result of injuries suffered in the accident and not by virtue of the disease or infirmity itself. In the opinion in that case the Court said:\n\u201cIf it was the intention of the defendant that the policy not cover death caused solely as the result of injuries suffered in an accident where a cause of the accident is infirmity or disease, it should have more clearly expressed such intention. Ambiguous policies are construed against the company which draws them.\u201d 259 Or. at 456.\nAlthough decided against the background of differing factual situations and varying policy language, other cases which support the decision here are: Manufacturers\u2019 Accident Indemnity Co. v. Dorgan, 58 F. 945 (6th Cir. 1893), 22 L.R.A. 620 (1905) (opinion by Taft, Circuit Judge, later Chief Justice of the United States Supreme Court) ; Fairclough v. Fidelity & Casualty Co., 297 F. 681 (D.C. Cir. 1924) ; Wells v. Prudential Insurance Co., 3 Mich. App. 220, 142 N.W. 2d 57 (1966).\nCases cited and relied on by defendant are distinguishable. In Skillman v. Insurance Co., 258 N.C. 1, 127 S.E. 2d 789 (1962), the insured\u2019s automobile was seen to leave the highway and run down the bank and into the river. The autopsy disclosed that the insured died from a heart attack and not from drowning or traumatic injuries. The jury returned verdict finding the insured\u2019s death was not caused by accidental means, and on plaintiff\u2019s appeal from judgment on the verdict, our Supreme Court found no error. In Chesson v. Insurance Co., 268 N.C. 98, 150 S.E. 2d 40 (1966), the injured was seen suddenly to jump straight backwards, striking his head on a cement floor. The accident indemnity portion of the policy involved in that case provided for payment upon proof that the insured sustained bodily injury resulting in death \u201cthrough external, violent and accidental means, death being the direct result thereof and independent of all other causes\u201d and excluded coverage if death occurred \u201cfrom disease or from bodily or mental infirmity in any form.\u201d 268 N.C. at 99. In holding that nonsuit should have been granted as to plaintiff\u2019s claim for recovery under the accident indemnity portion of the policy, the opinion of our Supreme Court pointed out:\n\u201cIf he jumped backwards voluntarily, the fall was not through accidental means. ... If he jumped backwards involuntarily as a result of a stroke brought on by hypertension, delirium tremens, or some other disease, mental or physical infirmity, the fall was not the sole cause of his death, and insured\u2019s death is not covered by the policy.\u201d 268 N.C. at 104.\nIt should be noted that, unlike the case now before us, the controlling policy language in both Chesson and Skillman, provided coverage only for death caused by \u201caccidental means,\u201d and the opinion of the Court in each case recognized the distinction between the terms \u201caccidental death\u201d and death by \u201caccidental means.\u201d Although I am reluctant to enter upon the \u201cSerbonian Bog\u201d which the maintenance of that distinction creates in this branch of the law, see Annot., 166 A.L.R. 469, 476 (1947), it is a distinction still recognized by our Supreme Court and serves as one basis for distinguishing those cases from the one now before us.\nThe judgment appealed from is\nAffirmed.\nJudge Hedrick concurs.\nJudge Clark dissents.", "type": "majority", "author": "PARKER, . Judge." }, { "text": "Judge Hedrick\nconcurring:\nIn my opinion Chesson v. Insurance Co., supra, insofar as it relates to the decision in this case, simply stands for the proposition that there was no competent evidence in the record to support the jury\u2019s finding that Chesson\u2019s \u201cfall was accidental\u201d and hence that his death was \u201ccaused by accidental means.\u201d Since all parties agreed here that the insured\u2019s death \u201cwas caused by a blow she sustained as a result of a fall,\u201d the only question before the trial judge was whether the fall was \u201caccidental.\u201d Unlike Chesson where the matter was \u201cleft to conjecture,\u201d there is competent evidence in the record before us that the insured fell as a result of her foot slipping on the kitchen floor, which had only shortly before been mopped. Thus, there is competent evidence in the record to support Judge Moore\u2019s finding that Mrs. Williams \u201csuffered an accidental fall\u201d and this finding supports the judgment.", "type": "concurrence", "author": "Judge Hedrick" } ], "attorneys": [ "Eugene C. Brooks III for plaintiff appellee.", "W. 0. King and R. Hayes Hofler III for defendant appellant." ], "corrections": "", "head_matter": "ADA GRANSON WILLIAMS v. PILOT LIFE INSURANCE COMPANY\nNo. 7414DC1022\n(Filed 7 May 1975)\nInsurance \u00a7 50 \u2014 accident policy \u2014 death resulting from accidental bodily injury \u2014 fall in Mtchen\nThe evidence supported the trial court\u2019s determination that insured suffered \u201can accidental fall\u201d and that her death \u201cwas solely as a direct result thereof and independent of all other causes\u201d within the meaning of an accident policy in this action wherein it was not disputed that the death of the insured was caused by a blow to her head sustained when she fell in the kitchen of her home, plaintiff\u2019s evidence tended to show that insured fell when her foot slipped on the \u2022 recently \u2019 mopped floor, and defendant\u2019s evidence tended to show that insured fell as a result of a seizure which caused her suddenly to become stiff.\nJudge Hedrick concurring.\n.Judge Clark-dissents.\nAppeal by defendant from Moore, Judge. Judgment entered 5 September 1974 in District Court, Durham County. Heard in the Court of Appeals 18 February 1975.\nCivil action to recover under a policy of accident insurance. The case was submitted to the court without a jury, and the parties stipulated that the sole issue to be determined was whether the insured died \u201csolely as a direct result, and independent of all other causes, of accidental bodily injury,\u201d as set forth in the policy. There is no dispute that the death of the insured was caused by a blow to her head which she sustained when she fell in the kitchen of her home. The only dispute is over what caused the fall. Plaintiff\u2019s evidence tended to show that the insured fell as a result of her foot slipping on the kitchen floor, which had only shortly before been mopped. Defendant\u2019s evidence tended to show that the insured fell as a result of a seizure which caused her to become suddenly stiff.\nThe court entered judgment making findings of fact, including the following:\n\u201cThat upon the hearing of the evidence, the Court further finds as a fact that the insured suffered an accidental fall in her home on April 3, 1973, and as a result of said fall died on April 5, 1973. That said death was solely as a direct result thereof and independent of all other . causes, which resulted in accidental bodily injury and death of the insured. ...\u201d\nFrom judgment that plaintiff recover the amount payable under the policy for the death of the insured, defendant appealed.\nEugene C. Brooks III for plaintiff appellee.\nW. 0. King and R. Hayes Hofler III for defendant appellant." }, "file_name": "0505-01", "first_page_order": 533, "last_page_order": 538 }