In an action upon a policy of insurance by which the insurer
agreed to pay the sum insured to the beneficiary within ninety days
after sufficient proof that the insured within the continuance of
the policy had sustained bodily injuries, effected through
external, violent and accidental means, and that such injuries
alone occasioned death within ninety days from their happening, but
that no claim should be made when the death or injury was the
result of suicide (felonious or otherwise, sane or insane), the
burden of proof is on the plaintiff (subject to the limitation that
it is not to be presumed as matter of law that the deceased took
his own life or was murdered), to show that the death was caused by
external violence and by accidental means, and no valid claim can
be made under the policy if the insured, either intentionally, or
when insane, inflicted upon himself the injuries which caused his
death or if his death was caused by intentional injuries inflicted
upon him by some other person.
The case as stated by the Court was as follows:
This is a suit upon what is commonly called an accident policy
of insurance. There was a verdict and judgment against the
insurance company for the sum of $5,600 and costs. The case is here
upon alleged errors of law committed at the trial to the prejudice
of the defendant.
The policy, by its terms, insures the life of George P.
McConkey, in the sum of five thousand dollars, for the term of
twelve months, commencing at noon on the 7th of November, 1882,
"the said sum insured to be paid to his wife, Sadie P.
Page 127 U. S. 662
McConkey, if surviving (in event of her prior death, said sum
shall be paid to the legal representatives of the insured), within
ninety days after sufficient proof that the insured, at any time
within the continuance of this policy, shall have sustained bodily
injuries, effected through external, violent, and accidental means
within the intent and meaning of this contract and the conditions
hereunto annexed, and such injuries alone shall have occasioned
death within ninety days from the happening thereof, or if the
insured shall sustain bodily injuries by means as aforesaid which
shall, independently of all other causes, immediately and wholly
disable and prevent him from the prosecution of any and every kind
of business pertaining to the occupation under which he is insured,
then, on satisfactory proof of such injuries, he shall be
indemnified against loss of time thereby in a sum not exceeding
twenty-five dollars per week for such period of continuous total
disability as shall immediately follow the accident and injuries as
aforesaid, not exceeding, however, twenty-six consecutive weeks
from the time of the happening of such accident."
The policy also contained these provisions:
"Provided always that this insurance shall not extend to hernia,
nor to any bodily injury of which there shall be no external and
visible sign, nor to any bodily injury happening directly or
indirectly in consequence of disease, nor to any death or
disability which may have been caused wholly, in part, or jointly
by bodily infirmities or disease existing prior or subsequent to
the date of this contract or by the taking of poison or contact
with poisonous substances, or by any surgical operation or medical
or mechanical treatment, nor to any case except where the injury is
the proximate and sole cause of the disability or death, and no
claim shall be made under this policy when the death or injury may
have been caused by dueling, fighting, wrestling, lifting, or by
overexertion, or by suicide (felonious or otherwise, sane or
insane), or by sunstroke, freezing, or intentional injuries
inflicted by the insured or any other person, or when the death or
injury may have happened in consequence of war, riot, or invasion,
or of riding or driving races, or of voluntary exposure to
unnecessary danger, hazard
Page 127 U. S. 663
or perilous adventure, or of violating the rules of any company
or corporation, or when the death or injury may have happened while
the insured was, or in consequence of his having been, under the
influence of intoxicating drinks, or while employed in mining,
blasting, or wrecking, or in the manufacture, transportation, or
use of gunpowder or other explosive substances (unless insured to
cover such occupation), or while engaged in or in consequence of
any unlawful act, and this insurance shall not be held to extend to
disappearances nor to any case of death or personal injury unless
the claimant under this policy shall establish by direct and
positive proof that the said death or personal injury was caused by
external violence and accidental means."
The petition setting out the plaintiff's cause of action alleged
that the insured, on or about January 2, 1882,
"was accidentally shot through the heart by a pistol or gun,
loaded with powder and ball, by a person or persons unknown to
plaintiff, by reason of which accidental injury said George P.
McConkey then and there instantly died, of which accident and death
said defendant was duly and legally notified,"
etc.
The answer denies that the death of the insured was occasioned
by bodily injuries effected through external, violent, and
accidental means (or effected through external violence and
accidental means) within the meaning of the contract of insurance.
It alleges: 1. that his death was caused by suicide; 2. that it was
caused by intentional injuries inflicted either by the insured or
by some other person.
As the argument addressed to this Court had special reference to
the charge to the jury, the following extract from it is given, as
showing the general grounds upon which the court below
proceeded:
"The plaintiff exhibits the policy in evidence, and gives
evidence of the fact that the insured was found dead within the
life of the policy from a pistol shot through the heart. This
evidence satisfies the terms of the policy with respect to the fact
that the assured came to his death by 'external and violent means,'
and the only question is whether the means by which he came to his
death were also 'accidental.' "
Page 127 U. S. 664
"It is manifest that self-destruction cannot be presumed. So
strong is the instinctive love of life in the human breast and so
uniform the efforts of men to preserve their existence that suicide
cannot be presumed. The plaintiff is therefore entitled to recover
unless the defendant has, by competent evidence, overcome this
presumption and satisfied the jury by a preponderance of evidence
that the injuries which caused the death of the insured were
intentional on his part."
"Neither is murder to be presumed by the jury; crime is never to
be presumed; but if the jury find from the evidence that the
insured was in fact murdered, the death was an accident as to him
the same as if he had been killed by the falling of a house or the
derailment of a railway car in which he was a passenger. If the
jury find that the injuries of the insured resulting in his death
were not intentional on his part, the plaintiff has a right to
recover."
"But if the jury find that the injuries inflicted upon the
assured causing his death, whether by the assured himself or any
other person, were intentional on the part of the assured, the
plaintiff cannot recover in this action."
"The inquiry, therefore, before the jury is resolved into a
question of suicide, because if the insured was murdered, the
destruction of his life was not intentional on his part."
"The defendant, in its answer, alleges that the death of the
insured was caused by suicide."
"The burden of proving this allegation by a preponderance of
evidence rests on the defendant. The presumption is that the death
was not voluntary, and the defendant, in order to sustain the issue
of suicide on his part, must overcome this presumption and satisfy
the jury that the death was voluntary."
The court also said:
"In order, therefore, to sustain the plea of suicide, the
defendant must have given to the jury evidence sufficient to
overcome the presumption to which I have referred and to convince
the jury that the injury from which the insured died was voluntary
or intentional on his part."
As further illustrating the views of the learned judge who
Page 127 U. S. 665
presided at the trial, it may also be stated that the defendant
asked the court to instruct the jury as follows:
"The burden of proof is upon the plaintiff to establish by a
preponderance of credible testimony that the deceased came to his
death from injuries (or an injury) effected through external,
violent, and accidental means within the intent and meaning of the
contract and conditions expressed in the policy."
That instruction was given with the following explanation or
qualification:
"That it does clearly appear from the evidence that the insured
came to his death from injuries or an injury effected through
violent and external means, and that the presumption is that the
means were unintentional on the part of the insured, which the
court holds satisfies the contract. This presumed fact is not
conclusive, and may be overcome by evidence, if such there is in
the case that the injuries were voluntary or intentional."
The defendant also asked the following instructions:
"Plaintiff must establish by direct and positive proof that the
death was caused by external violence and accidental means, and,
failing in this, she will not be entitled to a verdict. . . .
Plaintiff's case must not rest upon mere conjecture, but her proof
must be such as to lead directly to the conclusion that the death
was effected by accidental means within the meaning of the policy,
and unless she have adduced proof of that character, your verdict
should be for the defendant."
These instructions were given with the following
qualifications:
"The external violence appearing in the fact that the death
ensued from a pistol shot through the heart, the presumption is
that it was accidental -- not intentional -- on the part of the
assured, which facts, proved and presumed, make out the plaintiff's
case unless the defendant has satisfied the jury by affirmative
proof that the means of death were intentional on the part of the
insured. "
Page 127 U. S. 666
MR. JUSTICE HARLAN, after stating the case, delivered the
opinion of the Court.
There is no escape from the conclusion that under the issue
presented by the general denial in the answer, it was incumbent
upon the plaintiff to show from all the evidence that the death of
the insured was the result not only of external and violent but of
accidental means. The policy provides that the insurance shall not
extend to any case of death or personal injury unless the claimant
under the policy establishes by direct and positive proof that such
death or personal injury was caused by external violence and
accidental means. Such being the contract, the court must give
effect to its provisions according to the fair meaning of the words
used, leaning, however, where the words do not clearly indicate the
intention of the parties, to that interpretation which is must
favorable to the insured.
National Bank v. Ins. Co.,
95 U. S. 678;
Western Ins. Co. v. Cropper, 32 Penn.St. 355;
Reynolds
v. Commerce Fire Ins. Co., 47 N.Y. 604;
Anderson v.
Fitzgerald, 4 H.L.Cas. 484, 498, 507;
Fowkes v. Manchester
&c. Life Association, 3 B. & S. 925.
The requirement, however, of direct and positive proof as to
certain matters did not make it necessary to establish the fact and
attendant circumstances of death by persons who were actually
present when the insured received the injuries which caused his
death. The two principal facts to be established were external
violence and accidental means producing death. The first was
established when it appeared that death ensued from a pistol shot
through the heart of the insured. The evidence on that point was
direct and positive, as much so, within the meaning of the policy,
as if it had come from one who saw the pistol fired, and the proof
on this point is nonetheless direct and positive because
supplemented or strengthened by evidence of a circumstantial
character.
Were the means by which the insured came to his death also
accidental? If he committed suicide, then the law was for the
company, because the policy, by its terms, did not extend to or
cover self-destruction, whether the insured was
Page 127 U. S. 667
at the time sane or insane. In respect to the issue as to
suicide, the court instructed the jury that self-destruction was
not to be presumed. In
Mallory v. Travelers' Ins. Co., 47
N.Y. 54, which was a suit upon an accident policy, it appeared that
the death was caused either by accidental injury or by the suicidal
act of the deceased. "But," the court properly said, "the
presumption is against the latter. It is contrary to the general
conduct of mankind; it shows gross moral turpitude in a sane
person." Did the court err in saying to the jury that upon the
issue as to suicide, the law was for the plaintiff unless that
presumption was overcome by competent evidence? This question must
be answered in the negative. The condition that direct and positive
proof must be made of death having been caused by external,
violent, and accidental means did not deprive the plaintiff, when
making such proof, of the benefit of the rules of law established
for the guidance of courts and juries in the investigation and
determination of facts.
Upon like grounds, we sustain the ruling to the effect that the
jury should not presume from the mere fact of death that the
insured was murdered. The facts were all before the jury as to the
movements of the insured on the evening of his death, and as to the
condition of his body and clothes when he was found dead at a late
hour of the night upon the floor of his office. While it was not to
be presumed as a matter of law that the deceased took his own life
or that he was murdered, the jury were at liberty to draw such
inferences in respect to the cause of death as, under the settled
rules of evidence, the facts and circumstances justified.
We are, however, of opinion that the instructions to the jury
were radically wrong in one particular. The policy expressly
provides that no claim shall be made under it where the death of
the insured was caused by "intentional injuries inflicted by the
insured or any other person." If he was murdered, then his death
was caused by intentional injuries inflicted by another person.
Nevertheless the instructions to the jury were so worded as to
convey the idea that if the insured was murdered, the plaintiff was
entitled to recover -- in other
Page 127 U. S. 668
words, even if death was caused wholly by intentional injuries
inflicted upon the insured by another person, the means used were
"accidental" as to him, and therefore the company was liable. This
was error.
Upon the whole case, the Court is of opinion that by the terms
of the contract, the burden of proof was upon the plaintiff, under
the limitations we have stated, to show from all the evidence that
the death of the insured was caused by external violence and
accidental means; also that no valid claim can be made under the
policy if the insured, either intentionally or when insane,
inflicted upon himself the injuries which caused his death, or if
his death was caused by intentional injuries inflicted upon him by
some other person.
The judgment is accordingly reversed and the cause remanded
with directions to grant a new trial and for further proceedings
consistent with this opinion.