Majority
On October 31, 1925, the defendant issued its policy of life insurance in the sum of $50,000 on the life of John H. Happoldt. On January 20, 1926, the defendant issued its additional agreement for indemnity benefit of $25,000 for death from accident, which agreement was attached, as a rider, to said policy of life insurance. The plaintiff, who is the widow of the insured, is the beneficiary named in the policy and in the additional agreement. The insured died on December 12, 1945. All premiums had been paid. The defendant paid the $50,000. The agreement, or rider, for additional .indemnity benefit for death from accident provided in part that if “death resulted directly, independently and exclusively of all other causes from bodily injuries effected solely through external, violent and accidental means, of which . . . there is as evidence a visible contusion or wound on the exterior of the body, and that such death occurred within 90 days from the date of such bodily injuries, then the sum of Twenty-five Thousand Dollars will become payable under this agreement in addition to and together with the face amount of said policy. ...” It was also provided therein that said additional indemnity should not be payable if the insured’s death resulted “directly or indirectly from bodily or mental infirmity ... or illness or disease of any kind.”
Appellant contends that the evidence was insufficient to support the judgment. Its argument is that the insured’s death did not “result directly, independently and exclusively of all other causes from bodily injuries effected solely through external, violent and accidental means”; and that his death resulted from bodily infirmity, illness and disease.
At the time of the issuance of the policy and rider, and thereafter until July, 1928, the insured was employed by a clothing company in New York. At said last mentioned time the insured, having developed asthma, discontinued his work and thereafter did not engage in any occupation. The insured and plaintiff became residents of Los Angeles in 1930. Soon thereafter, in 1930, the insured’s claim for total and permanent disability benefits under the insurance policy was approved, and from that date until the death of the insured the defendant paid him disability benefits in the sum of approximately $65,000. He continued to be afflicted with asthma from 1930 until’ his death. Every morning it was necessary for him to cough until he dislodged “an oyster of tough phlegm.” He went alone to various places in the city, and he often went, over a period of 16 years, on a bus to Gardena where he played poker, and he often attended motion picture shows. From 1937 until about three weeks before his death he was under the medical care of Dr. Euth, who saw him at irregular intervals—at times there were intervals of six months when he did not see him. On October 26, 1945, the plaintiff sent the insured to a sanitarium for rest because he was exhausted nervously. She visited him at the sanitarium every other day, and at all such visits, until November 15th, he was fully clothed and he walked without assistance. On November 15th, when she visited him, she found him sitting on the edge of his bed, and she noticed that he could not stand up. The next morning she had him
The general hospital records relative to the insured, which were received in evidence, show as follows: that he was admitted to the hospital on November 16, 1945; five days prior thereto he had fallen and injured his right hip; he had had asthma for 16 years; at the time of entering the hospital his blood pressure was 170 over 100, his heart was moderately enlarged, his liver was “palpable two fingers down to the right”; on November 19th an open reduction of the fracture of the right hip was performed, and the “patient left the table in fair condition”; on December 3, 1945, he became comatose; on December 7th, “Cond is same, prognosis poor.”; on December 10th, “prognosis poor 2 days ago, Seen by two medics resident who said patient was terminal as far as two days go, ’ ’ and “patient appears to be terminal Dr. Tompkins called relative to transfer to medical ward; This case is no longer an ortho, problem. Advise: (1) transfer to a medical ward.”; a report of December 10th stated “T 103.4 . . . improvement of lung path. Widespread bronchopneumonia on left. No evidence of pulmonary edema. Liver percusses down 3 F. but is a chronic alcoholic. No venous distension of peripheral edema. Hip is now healed. Problem is no longer ortho.”; and a report of December 12, 1945, at 11 (a.m.) states “end near,” and at 4:45 (p.m.) states, “patient died.” Those hospital records also show that following the operation the insured was given three grains of digitalis three times daily; that, four days after the operation, insured’s blood pressure was 200 over 120, and that the giving of digitalis was then discontinued. Those records also show that the medical summary, made after death, was as follows: heart failure due to broncho-pneumonia and congestive failure due to arteriosclerotic heart disease; coronary sclerosis; cronie myocardial degeneration; and the complications were: fracture of the right hip; emphysema.
An autopsy was performed on December 13, 1945, by Dr. Myers, an autopsy surgeon in the office of the coroner of Los Angeles County. His autopsy report states that the
An autopsy was performed on December 15, 1945, by Dr. Butt, who is the chief pathologist of the general hospital, but the autopsy was not made in his official capacity—it was made under private employment by the defendant. That report states that his anatomical diagnosis, based on the autopsy performed by him, was as follows: “1. Emphysema with moderate right cardiac hypertrophy and decompensation. 2. Bronchitis, chronic. 3. Bronchitis, acute. 4. Arteriosclerosis, local, coronary arteries with scars in the heart muscle. 5. Arteriosclerosis, local, aorta. 6. Pleurisy, chronic, adhesive. 7. Operation, open reduction of fracture of the right hip, healed. 8. Lipoma, subcutaneous tissue, neck.” Dr. Butt testified that the cause of death was heart failure; that he doubted that there was any connection between the insured’s death and the fracture of his leg; and that, basing his opinion upon the evidences of cardiac failure, he was of the opinion in this particular case that cardiac failure “would have produced death regardless of . . . what happened to the man in the interim.” He also testified that the insured had a nutmeg liver, and that he did not think the condition of the liver could cause death but the condition was an indication of failing heart; and the heart, liver, and spleen were about normal size.
Plaintiff contended at the trial that- the accidental fall, and the resulting broken hip suffered by the insured, set in motion a chain of events, namely, the surgery, the pneumonia, and the cardiac failure, which eventually caused death. Appellant contended at the trial that death was not the result of the injury, but was the result of diseases known as bronchial asthma and heart disease.
Four doctors of medicine, called as witnesses by plaintiff, gave testimony in support of plaintiff’s contentions, and four doctors of medicine, called as witnesses by defendant, testified in support of defendant’s contentions.
Dr. Ruth, above referred to as the personal physician of the insured from 1937 until the insured entered the general hospital, was called as a witness by plaintiff. He testified that
Dr. LaJoie, called as a witness by plaintiff, testified that in September, 1945, when Dr. Ruth was not available, he “was called to the insured’s home where he found the insured in a semicomatose condition which apparently resulted from an overdose of sleeping tablets. In answer to a hypothetical question, based upon the autopsy report of the coroner, the hospital records, and assumed facts within the evidence above mentioned, Dr. LaJoie testified that in his opinion “the precipitating cause of death was the fracture of the hip, which in itself started events . . . like the fracture of the hip, the surgery, and the pneumonia which set in after the surgery and then the cardiac failure which ensued.” He testified, on cross-examination, that the fracture alone did not cause the death, but it was the complications that arose after the fracture that caused the death—a combination of the events of pneumonia, putting him to bed, lowering and enfeebling his circulation, and finally cardiac failure; that in his opinion the preexisting cardiac condition could contribute to the death.
Dr. Brem, called as a witness by plaintiff, testified, in answer to a hypothetical question, based upon the autopsy report of the coroner, the hospital records, and assumed facts within the evidence above mentioned, as follows: “Well, I would say that—I have no doubt that the primary cause of death was certainly the injury [the fractured hip] sustained by this man. The immediate cause of death was complications arising from this, to be sure; surgery, bronchial pneumonia, and eventually death. None of these influencing things would have happened had it not—had not this person been injured in the first place, and it is my conviction; I feel sure that there was nothing in this man’s body, according to
Dr. Lasky, called as a witness by plaintiff, testified, in answer to a hypothetical question, based upon the coroner’s autopsy report, the hospital records, and assumed facts within the evidence above mentioned, that the insured died as a result of the fracture of his hip; that ‘ There is no doubt in my mind but what this man suffered an injury which introduced a series of events . . . which ended in death.” On cross-examination he testified that the cause of death was bronchiolitis and bronchial pneumonia, which were secondary to the trauma, the accident.
Dr. Butt, called as a witness on behalf of defendant, testified that the “main operating cause of death in this case was heart failure”; that in his opinion, right side hypertrophy of his heart and chronic bronchitis were the main operating causes of the death of the insured; that (contrary to the finding of the coroner’s autopsy surgeon) he found no evidence of bronchial pneumonia; and that the insured’s major condition was coronary disease.
Dr. Ruddock, called as a witness by defendant, testified, in answer to a hypothetical question, that the proximate cause of death was “chronic arteriosclerotic heart disease with failure.”
Dr. Newbarr, called as a witness by defendant, testified, in answer to a hypothetical question, that the proximate cause of death was arteriosclerotic heart disease; there is nothing in the coroner’s autopsy report which, would substantiate a
Dr. Cefalu, called as a witness by defendant, testified, in answer to a hypothetical question, that the insured’s death was caused by a myocardial degeneration due to arteriosclerotic changes; and that in his opinion bronchial pneumonia did not cause the death. The testimony of the four doctors called as witnesses by the plaintiff, if believed, was sufficient to support a finding that the accident was the proximate cause of death.
Appellant further contends that the court erred in giving certain instructions requested by plaintiff. It argues that those instructions took from the consideration of the jury the two material issues in the ease, namely, whether death resulted directly from accidental means, and whether death resulted directly from disease. It also argues that those instructions made issues of law of those issues of fact; and that by said instructions the trial court directed the jury to return a verdict for plaintiff if it found that disease was not a proximate cause of death, regardless of whether it found that injury by accidental means was the proximate cause of death. The instructions so referred to are as follows :
Instruction 26 stated, in part: “. . . that Mr. Happoldt’s death did not result directly or indirectly from bodily or mental infirmity ... or disease of any kind, so as to bar recovery under this policy, if his death was the proximate result of a fractured hip sustained through accidental means . .. which aggravated or awakened a previously existing bodily infirmity or dormant ailment. . . from which death resulted.”
Instruction 29 was as follows: “If you find that the accident, if any, operating upon an unhealthy body causes injury putting in motion a chain of events which can be traced to the accidental injury, the accident may be the proximate cause of death. In other words, a recovery may be had even though a diseased or infirm condition appears to actually contribute to the cause of death, if the accident sets in progress the chain of events leading directly to death, or if it is the prime or moving cause. ’ ’
Instruction 31 stated in part: “You have been elsewhere instructed that if the death of Mr. Happoldt was proximately caused by a diseased condition of the heart or lungs which pre-existed and continued after the fracture of his hip, your verdict must be for the defendant. However,
Instruction 32 stated in part: “If an injury to a person effected through accidental means proximately causes to be set in progress disease, infection or other conditions which in natural and continuous sequence operate directly to cause death, the death is considered to have resulted from bodily injury effected through accidental means. This is true, although at the time of the injury the person is so weakened and debilitated by some pre-existing infirmity or disease that he is less able to withstand the effect of the injury and the other conditions which are the proximate result of the injury. Under such circumstances if the pre-existing infirmity does not operate directly to cause the death, but merely renders the person less able to combat the disease or conditions which are the natural and proximate result of the injury itself, the pre-existing infirmity is merely a condition, and the accidental injury is the proximate cause of death. ’ ’
Instruction 33 stated in part “. . . under the language of the policy in this case, a recovery may be had by the plaintiff if you are satisfied from a preponderance of the evidence that even though the decedent was afflicted with a pre-existing disease prior to the accident but that the accident set in motion the events that resulted in his death, such accident would be the proximate cause of his death resulting directly and independently and exclusively from all other causes from bodily injuries effected solely through . . . accidental means, but excluding death resulting directly or indirectly from bodily or mental infirmities or illness or disease of any kind. ’ ’
Those instructions did not take from the consideration of the jury any issue of fact. In each of the instructions the jury was directed, in substance, to find as a fact whether the accident was the proximate cause of death. It is to be noted
Appellant also contends that the instructions above referred to (Nos. 26, 29, 31, 32 and 33) were in conflict with instructions Nos. 25, 27, and 30, which were given at his request. Instruction 25 stated in substance that plaintiff was
Appellant’s further contention that the court erred in refusing to give instructions F, G, and H, which appellant requested, is not sustained. Those proposed instructions stated in substance that plaintiff had the burden of proving by a preponderance of the evidence that death did not result directly or indirectly from illness or disease of any kind. The court correctly instructed the jury as to the meaning of the expressions “burden of proof” and “preponderance of the evidence.” It also gave an instruction to the effect that one who asserts the affirmative of an issue has the burden of
Appellant also contends that the trial court impaired the obligation of the insurance contract, and deprived defendant of its property without due process of law, in violation of the federal Constitution. Its argument is that the trial court, in giving an instruction based upon the ease of Brooks v. Metropolitan Life Ins. Co., supra, did in effect rewrite appellant’s insurance contract. He asserts that if the Brooks case (decided in 1945) overruled previous decisions in this state “with respect to insurance policy exclusion clauses covering contribution of disease or bodily infirmity,” then it was error to apply the Brooks case herein to the insurance contract and the indemnity rider which were made in 1925 and 1926. Appellant asserts that the case law, at the time the insurance contract and rider were made, was that where a contract of insurance limits the liability for accidental death benefits, by expressly excluding death which is caused directly or indirectly by disease, there can be no recovery if the plaintiff fails to sustain the burden of proving that disease did not contribute to death. In support of that assertion appellant cites the following cases: Rock v. Travelers’ Insurance Co., 172 Cal. 462 [ 156 P. 1029 , L.R.A. 1916E 1196]; Clarke v. New Amsterdam Casualty Co., 180 Cal. 76 [ 179 P. 195 ]; Kellner v. Travelers’ Ins. Co., 180 Cal. 326 [ 181 P. 61 ]; and Ogilvie v. Aetna Life Insurance Co., 189 Cal. 406 [ 209 P. 26 , 26 A.L.R. 116 ]. The Brooks case holds, as above shown,
Appellant contends further that one of the attorneys for plaintiff, who tried the case, was guilty of prejudicial misconduct. During a recess on the first morning after the jury had been selected, several jurors were standing in a group in the corridor adjoining the courtroom, and the trial attorney for plaintiff, and others, were also in the corridor. The jurors were near the only window in the corridor. The attorney went to a place near the window, and one of the jurors spoke to him and said that the attorney resembled a certain motion picture actor, and then the attorney and the jurors laughed, and “a few bantering remarks were exchanged.” Defendant’s attorney, who had gone into the corridor and observed that incident, then walked toward the courtroom and requested plaintiff’s attorney to go with him. The attorneys went into the chambers of the trial judge, and reported the incident to the judge. The attorney for defendant did not at that time make a motion for a mistrial, but stated that he desired to call the matter to the attention of the court. The trial judge commented upon the inadequacy of facilities for the jurors, the fact that it was impossible to pass through the corridor without coming into contact with the jurors, and that some pleasantries in no way related to the ease might be countenanced to avoid discourtesy; and he stated that he was of the opinion that no harm had been done, but
Appellant also contends that the court erred in amending the judgment “so as to include legal interest from February 8, 1946.” As above shown, the jury returned a verdict in favor of plaintiff for $25,000 on June 30, 1947. Judgment upon the verdict was entered on July 1, 1947, for $25,000 “with interest thereon at the rate of seven per cent per annum from the date of the verdict until paid.” On July 31, 1947, plaintiff filed a notice of motion to amend said judgment to include interest on said amount at the rate of seven per cent per annum from February 8, 1946. The motion was granted on August 13, 1947, and the judgment was amended by inserting in the judgment, after the amount “$25,000.00” the following words: “to include legal interest from February 8, 1946.” The amended judgment, in the part material here, read as follows: “. . . that said plaintiff . . . recover . . . the sum of $25,000.00 to include legal interest from February 8, 1946; with interest thereon at the rate of seven per cent per annum from the date of the verdict until paid . . ..” The policy provided that the face amount of said policy, $50,000, should be payable “upon receipt at said Home Office of due proof of death.” The agreement for the additional $25,000 for death from accident, attached to the policy, provided: “If said policy shall become a claim by the death of the insured . . . and due proof shall be furnished to the Company at its Home Office in the City of New York that such death resulted directly, independently and exclusively of all other causes from bodily injuries effected solely through external, violent and accidental means, . . .” the $25,000
It is ordered that the amendment of the judgment, which amendment was made on August 13, 1947, in words and figures as follows: “to include legal interest from February 8, 1946;” be and the same is stricken from the judgment. The judgment as originally entered on July 1, 1947, is affirmed. The minute order herein dated August 13, 1947, and entered on August 20, 1947, which is as follows: “Plaintiff’s motion to amend judgment heretofore submitted is now granted so
Shinn, P. J., and Vallée, J., concurred.
Cases cited
- Brooks v. Metropolitan Life Insurance 27 Cal.2d 305 p. 398
- Fassett v. Nascimiento 108 Cal.App. 14 p. 400
- Rock v. Travelers' Insurance Co. 172 Cal. 462 p. 401
- Clarke v. New Amsterdam Casualty Co. 180 Cal. 76 p. 401
- Kellner v. Travelers Insurance Co. of Hartford 180 Cal. 326 p. 401
- Ogilvie v. Aetna Life Insurance 189 Cal. 406 p. 401
- Lafargue v. United Railroad of San Francisco 183 Cal. 720 at 724 p. 403
- Walling v. Kimball 17 Cal.2d 364 at 369 p. 403
- Canavan v. College of Osteopathic Physicians & Surgeons 73 Cal.App.2d 511 at 521 p. 404
- Engelberg v. Sebastiani 207 Cal. 727 at 729-730 p. 404