Landress v. Phoenix Mutual Life Insurance

Mr. Justice Cardozo,

dissenting.

I am unable to concur in the decision of the Court.

1. A cause does not cease to be violent and external because the insured has an idiosyncratic condition of mind or body predisposing him to injury. Silverstein v. Metropolitan Life Ins. Co., 254 N.Y. 81; 171 N.E. 914; Leland v. Order of U. C. Travelers, 233 Mass. 558, 564; 124 N.E. 517; Collins v. Casualty Co., 224 Mass. 327; 112 N.E. 634; Taylor v. N.Y. Life Ins. Co., 176 Minn. 171; 222 N.W. 912. Under a policy phrased as this one, the insurer may be relieved of liability if the predisposing condition is so acute as to constitute a disease. See cases supra. Here the complaint alleges that the idiosyncrasy was not a physical or mental disease, and that it appeared from an autopsy that there was no bodily infirmity or disease which could have been a contributing cause of death. Since the case is here on demurrer, those allegations must be accepted as true. The plaintiff may be unable to prove them at the trial. /She should have the opportunity. There has been no failure to “ plead facts establishing the. liability defined by the policy.”

2. Sunstroke, though it may be a disease according to the classification of physicians, is none the less an accident in the common speech of men. Ismay, Imrie & Co. v. Williamson, [1908] A.C. 437, 439. Lane v. Horn & H. Baking Co., 261 Pa. 329; 104 Atl. 615. The suddenness of its approach and its catastrophic nature (Connolly v. Hunt Furniture Co., 240 N.Y. 83, 87; 147 N.E. 366) have •rnadejhat quality stand out when thought is uninstructed ip the mysteries, of science. Lower v. Metropolitan Life *499Ins. Co., 111 N.J.L. 426; 168 Atl. 593, collating the decisions. Violent it is for the same reason, and external because the train of consequences is set in motion by the rays of the sun beating down upon the body, a canse operating from without.

“ In my view this man died from an accident. What killed him was a heat-stroke coming suddenly and unexpectedly upon him while at work. Such a stroke is an unusual effect of a known cause, often, no doubt, threatened, but generally averted.by precautions which experience, in this instance, had not taught. It was an unlooked for mishap in the course of his employment. In common language, it was a case of accidental death.” Per Loreburn, L. C., in Ismay, Imrie & Co. v. Williamson, supra.

3. The attempted distinction between accidental results and accidental means will plunge this branch of the law into a Serbonian Bog. “ Probably it is true to say that in the strictest sense and dealing with the region of physical nature there is no such thing as an accident.” Halsbury, L. C. in Brintons v. Turvey, L.R. [1905] A.C. 230, 233. Cf. Lewis v. Ocean Accident & Guaranty Corp., 224 N.Y. 18, 21; 120 N.E. 56; Innes v. Kynoch, [1919] A.C. 765, 775. On the other hand, the average man is convinced that there is, and so certainly, is the man who takes out a policy of accident insurance. It is his reading of the policy that is to be accepted as our guide, with the help of the established rule that ambiguities and uncertainties are to be resolved against the company. Mutual Life Ins. Co. v. Hurni Packing Co., 263 U.S. 167, 174; Stipcich v. Metropolitan Life Ins. Co., 277 U.S. 311, 322. The proposed distinction will not survive the application of that test.

When a man has died in such a way that his death is spoken of as an accident, he has died because of an accident, and hence by accidental means. So courts of. high authority have held. Lower v. Metropolitan Life Ins. Co., *500supra (a case of sunstroke); Gallagher v. Fidelity & Casualty Co., 163 App. Div. 556; 148 N.Y.S. 1016; 221 N.Y. 664; 117 N.E. 1067 (sunstroke); Jensma v. Sun Life Assurance Co., 64 F. (2d) 457; Western Commercial Travelers’ Assn. v. Smith, 85 Fed. 401; Mutual Life Ins. Co. v. Dodge, 11 F. (2d) 486; Lewis v. Iowa State Traveling Men’s Assn., 248 Fed. 602.1 So the holder of this policy might reasonably assume.

If he had thought about the subject, he might have had his impressions fortified by the ruling of the House of Lords that a workman who suffers a heat-stroke has a claim for relief under the Workmen’s Compensation Act. Ismay, Imrie & Co. v. Williamson, supra. The British Act (6 Edw. 7, c. 58, § 1) gives compensation for personal injury “ by accident ” arising out of and in the course of the employment. Injury by heat-stroke was. held to be injury “by accident.” The result would hardly have been different, certainly one insured would not have looked for any difference, if for the phrase “ injury by accident ” the lawmakers had substituted the words injury “ by means of accident,” or injury by accidental means.

The principle that should govern the interpretation of the policy in suit was stated with clarity and precision by Sánbom, J., in a case-quoted in the. margin.2

The insured did not do anything which in its ordinary consequences was fraught with danger. The allegations *501of the complaint show that he was playing golf in the same conditions in which he had often played before. The heat was not extraordinary; the exertion not unusual. By misadventure or accident, an external force which had .hitherto been beneficent, was transformed into a force of violence, as much so as a stroke of lightning. The opinion of the court concedes that death from sunstroke, when resulting from voluntary exposure to the sun’s rays,” is “ an accident.” Why? To be sure the death is not intentional, but that does not make it an “ accident ” as the word is commonly understood, any more than death from indigestion or pneumonia. If there was no- accident in the means, there was none in the result, for the two were inseparable. No cause that reasonably can be styled an accident intervened between them. • The process of causation was unbroken from exposure up to death. There was an accident throughout, or there was no accident at all.

The judgment should be reversed.

The decisions are collated in 17 A.L.R. 1197, with the comment that by the weight of-authority sunstroke suffered unexpectedly is within the coverage of a policy insuring against injury by external, violent and accidental means. Compare Continental Casualty Co. v. Bruden, 178 Ark. 683; 11 S.W. (2d) 493; Higgins v. Midland Casualty Co., 281 Ill. 431; 118 N.E. 11; Elsey v. Fidelity & Casualty Co., 187 Ind. 447; 120 N.E. 42; Continental Casualty Co. v. Clark, 70 Okla. 187; 173 Pac. 453; Bryant v. Continental Casualty Co., 107 Tex. 582; 182 S.W. 673; Richards v. Standard-Accident Ins. Co., 58 Utah 622; 200 Pac. 1017.

Western Commercial Travelers’ Assn. v. Smith, supra, p. 405: “An effect which is the natural and probable consequence of an act or course of action is not an accident, nor is it produced by accidental means. It is either the result of actual design, or it falls under the maxim that every man must be held to intend the natural and probable consequence of his deeds. On the other hand, an effect which, is not the natural or probable consequence of the means which produced it, an effect which does not ordinarily follow and cannot be reasonably anticipated from the use of those means, an effect which the actor did not intend to produce and which he cannot be charged with the design of producing under the maxim to which we have adverted, is produed by accidental means. It is produced by means which were neither designed nor calculated to cause it.'' Such an effect is not the result of design, cannot be reasonably anticipated, is unexpected, and is produced by an unusual combination of fortuitous circumstances; in other words, it is produced by accidental means.”

The principle thus formulated has been accepted in many of the decisions cited in footnote 1, supra.