1. A death resulting from sunstroke, the insured having under
normal conditions voluntarily exposed himself to the sun while
playing golf, is not within the meaning of a policy insuring
against death effected solely by external and accidental means. P.
291 U. S.
495.
2. That an injury was accidental in the understanding of the
average man -- that the result was something unforeseen or
extraordinary --
Page 291 U. S. 492
is not enough to establish liability under a policy which limits
liability to such injuries as are effected by external accidental
means. Pp.
291 U. S. 495,
291 U. S.
497.
65 F.2d 232 affirmed.
Certiorari, 290 U.S. 614, to review a judgment affirming a
judgment against the claimant on policies of insurance in two cases
which were consolidated for trial in the district court.
Page 291 U. S. 494
MR. JUSTICE STONE delivered the opinion of the Court.
This case comes here on certiorari to review a judgment of the
Court of Appeals for the Sixth Circuit, 65 F.2d 232, which affirmed
a judgment of the District Court denying recovery on two policies
of accident insurance. Separate suits brought by petitioner, the
beneficiary of the policies under which her deceased husband was
the insured, were consolidated and were heard and decided on
demurrer. The insured, while playing golf, suffered a sunstroke,
from which he died. Petitioner sought recovery
Page 291 U. S. 495
of amounts stipulated, in one policy, to be paid if death should
result
"directly and independently of all other causes from bodily
injuries effected through external, violent and accidental means,
and not directly or indirectly, wholly or partly from disease or
physical or mental infirmity,"
and, in the other policy, if death should result "from bodily
injuries effected directly and independently of all other causes
through external, violent and accidental means."
Both declarations, in each of four counts, alleged that the
deceased, in the month of August, while in good health and while
playing golf in his accustomed manner at a place where many others
were playing without injury, was suddenly and unexpectedly overcome
from the force of the sun's rays upon his head and body, and that
shortly afterward he died; that an autopsy revealed that there was
no bodily infirmity or disease which could have been a contributing
cause of his death. In one count of each declaration it was alleged
that, at the time the insured received the injury resulting in his
death, there was, unknown to him, a temporary disorder or condition
of his body, not amounting to a physical or mental infirmity within
the meaning of the policies, which, for the time being, rendered
him more than ordinarily sensitive to the heat of the sun, and that
this temporary and unknown condition
"intervened between his intentional act of playing golf, which
he intended and expected to perform safely and which others did
perform safely at the same time and place, and the injury which
followed."
Petitioner argues that the death, resulting from voluntary
exposure to the sun's rays under normal conditions, was accidental
in the common or popular sense of the term, and should therefore be
held to be within the liability clauses of the policies. But it is
not enough, to establish liability under these clauses, that the
death or injury
Page 291 U. S. 496
was accidental in the understanding of the average man -- that
the result of the exposure "was something unforeseen, unexpected,
extraordinary, an unlooked-for mishap, and so an accident,"
see
Lewis v. Ocean Accident & Guarantee Corp., 224 N.Y. 18,
21, 120 N.E. 56, 57;
see also Aetna Life Insurance Co. v.
Portland Gas & Coke Co., 229 F. 552, for here, the
carefully chosen words defining liability distinguish between the
result and the external means which produces it. The insurance is
not against an accidental result. The stipulated payments are to be
made only if the bodily injury, though unforeseen, is effected by
means which are external and accidental. The external means is
stated to be the rays of the sun, to which the insured voluntarily
exposed himself. Petitioner's pleadings do not suggest that there
was anything in the sun's rays, the weather, or other circumstances
external to the insured's own body and operating to produce the
unanticipated injury, which was unknown or unforeseen by the
insured.
We do not intimate that injuries resulting from as impalpable a
cause as the inadvertent introduction into the body of noxious
germs may not be deemed to be effected by external accidental
means.
See Western Commercial Travelers' Assn. v. Smith,
85 F. 401;
Jensma v. Sun Life Assur. Co., 64 F.2d 457. Nor
do we say that, in other circumstances, an unforeseen and hence
accidental result may not give rise to the inference that the
external means was also accidental.
Compare Jensma v. Sun Life
Assur. Co., supra; Gustafson v. New York Life Insurance Co.,
55 F.2d 235. But, in the light of such knowledge as we have, no
such inference can arise from the bare allegation of death by
sunstroke,
compare Pope v. Prudential Ins. Co., 29 F.2d
185;
Ryan v. Continental Casualty Co., 47 F.2d 472, with
no indication that some unforeseen or unintended condition or
combination of circumstances, external to the state of the victim's
body, contributed to the
Page 291 U. S. 497
accidental result. The petitioner has thus failed to plead facts
establishing the liability defined by the policy.
In
U.S. Mutual Accident Assn. v.
Barry, 131 U. S. 100, the
insured suffered an internal injury caused by his jumping
voluntarily from a platform to the ground, a distance of four or
five feet. Recovery was allowed of amounts stipulated by the policy
to be paid upon proof of bodily injury "effected through external,
violent, and accidental means." There was evidence from which the
jury might have inferred that the insured alighted in a manner not
intended, causing a jar or shock of unexpected severity. This Court
held that the trial judge correctly left to the jury the question
whether the insured jumped or alighted in the manner he intended,
and properly charged that, if he did not, it might find that the
injury was caused by accidental means, pp.
131 U. S.
109-110.
This distinction between accidental external means and
accidental result has been generally recognized and applied where
the stipulated liability is for injury resulting from an accidental
external means.
See Aetna Life Ins. Co. v. Brand, 265 F.
6;
Lincoln National Ins. Co. v. Erickson, 42 F.2d 997;
Jensma v. Sun Life Assur. Co., supra; Order of United
Commercial Travelers v. Shane, 64 F.2d 55;
contra, Mutual
Life Ins. Co. v. Dodge, 11 F.2d 486. And injury from
sunstroke, when resulting from voluntary exposure by an insured to
the sun's rays, even though an accident,
see Ismay, Imrie &
Co. v. Williamson [1908] A.C. 437, has been generally held not
to have been caused by external accidental means.
Nickman v.
New York Life Ins. Co., 39 F.2d 763;
Paist v. Aetna Life
Ins. Co., 54 F.2d
393;
Harloe v. California State Life Ins. Co., 206
Cal. 141, 273 P. 560;
Continental Casualty Co. v. Pittman,
145 Ga. 641, 89 S.E. 716;
Semancik v. Continental Casualty
Co., 56 Pa.Super.Ct. 392;
see Elsey v. Fidelity &
Casualty Co., 187 Ind. 447,
Page 291 U. S. 498
120 N.E. 42;
Richards v. Standard Accident Ins. Co., 58
Utah, 622, 200 P. 1017;
contra, Continental Casualty Co. v.
Bruden, 178 Ark. 683, 11 S.W.2d 493;
Lower v. Metropolitan
Life Ins. Co., 111 N.J.Law, 426, 168 A. 592.
Affirmed.
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 nonetheless 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 A. 615. The suddenness of its
approach and its catastrophic nature (
Matter of Connelly v.
Hunt Furniture Co., 240 N.Y. 83, 87, 147 N.E. 366) have made
that quality stand out when thought is uninstructed in the
mysteries of science.
Lower v. Metropolitan Life
Page 291 U. S. 499
Ins. Co., 111 N.J.Law, 426, 168 A. 592, 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 cause 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,
263 U. S. 174;
Stipcich v. Metropolitan Life Ins. Co., 277 U.
S. 311,
277 U. S. 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.,
Page 291 U. S. 500
supra, (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 F. 401;
Mutual Life Ins. Co. v.
Dodge, 11 F.2d 486;
Lewis v. Iowa State Traveling Men's
Assn., 248 F. 602. [
Footnote
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, ยง 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 Sanborn,
J., in a case quoted in the margin. [
Footnote 2]
The insured did not do anything which in its ordinary
consequences was fraught with danger. The allegations
Page 291 U. S. 501
of 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.
[
Footnote 1]
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 P. 453;
Bryant v. Continental Casualty Co., 107 Tex.
582, 182 S.W. 673;
Richards v. Standard Accident Ins. Co.,
58 Utah, 622, 200 P. 1017.
[
Footnote 2]
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 produced 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.