*1 OF NORTH AMERICA v. INSURANCE COMPANY D. AUFENKAMP DARREL Term, 154, September 1980.] [No.
Decided October 1981. *2 J., and Smith, before Murphy, C. argued The cause was Rodowsky, JJ. Cole, Davidson Digges, Eldridge, Galiher, Clarke, with whom were Gallagher, Wade J. brief, for appellant. Donnelly Martell & on Bennett, Sperling Millard S. with whom were Donald N. brief, Helfand, Stein, Bennett, on the & P.A. Sperling appellee. Eldridge
Digges, J., opinion delivered of the Court. Davidson, JJ., J., in the concur result. Eldridge, filed a infra, concurring opinion page 516 at Davidson, J., concurs.
On April Sunday, Easter J. Aufenkamp Melva injuries died from fall story sustained from the second *3 bedroom the apartment window of in Silver Spring, Maryland, where she resided with her and spouse son. The husband, appellee Darrel D. Aufenkamp, submitted proof of loss and made a for proceeds claim under policy an insurance by issued the Company America, Insurance of North the here, appellant and the to upon refusal of INA the discharge provided benefits by policy, the in assumpsit action was by instituted beneficiary the named the husband Circuit Court for Montgomery County to enforce contract.
The "personal and special insurance,” hazards as titled, it was issued INA in the summer of and provides for payment specified the benefits a upon loss suffered as a result a which, "covered occurrence” as case, pertinent to this policy defined in "bodily the as injury [suffered by appellee, the Aufenkamp Mrs. or their children] resulting directly independently of all other (here causes from an accident...” referred as the coverage clause). The payable benefits to the as primary husband beneficiary in of a event covered occurrence are keyed loss, nature of the life, include loss of dismemberment disability. In its pay any declination to moneys INA, under policy, relying upon investigations police medical examiner and the as
conducted both the insured, history of the asserted well as medical death benefits” "ineligible for accidental appellee was intentional, resulted from an the demise of his wife because not a risk assumed under injury self-inflicted which was founded company’s position contract. The opin- of the which in this upon following provision to as the suicide exclusion clause: ion we refer for, the does specifically provided Except directly or resulting, loss caused or not cover any one or more indirectly, wholly partially, or following: injuries, suicide Intentionally A. self-inflicted thereat, or while sane any attempt insane.... plea, at issue the insurer’s put
After the case was discovery pre-trial procedures parties engaged from, and his submission of for admissions appellee’s request to, an appellee INA. When demanded interrogatories 27, 1970, July Darrel D. that "on or about admission application for life insurance Aufenkamp submitted North America which would cover Company of Insurance the insurer Aufenkamp,” his wife Melva J. himself and answered, Likewise, response "admitted.” to inter- application had been rogatories as to whether made "for insurance,” "issuefd] appellant of life whether ...,” Aufenkamp to Melva J. policy of life insurance whether, issued, policy was in full if "the said life insurance *4 died,” wife] the insurance [the force and effect at the time Armed query each the affirmative. company answered beneficiary the moved for acknowledgements, with these summary urging at the outset that "the sole issue judgment, not an exclusion from by [appellant] raised the is whether or suicide, in the event of bars policy, payment the which bars recovering.” Aufenkamp Mr. then [appellee] policy was provision the suicide exclusion of reasoned existed) (and coverage by thus that rendered unenforceable was he contended 410(a)(5) 48A, which Article of section INA’s concessions virtue policy applicable to this made pro- enactment This insurance contract. this was life that a vides: or
(a) be delivered shall life insurance policy No pro- a if it contains delivery in this State for issued liability for death or restricts excludes vision which occurring manner specified caused in a certain status, except that specified a has while insured excluding or may provisions contain policy such in the therein as specified restricting the follow- any more of one or under event circumstances: ing (2)
(5) years from the date Death within two suicide, while sane as a result of policy issue 48A, (1957, Vol.), Art. Repl. [Code or insane. 410(a)(5).1] § summary for opposition in its to the motion
INA countered personal "a acci- issued it was judgment that insurance,” special and therefore dent and hazards which, terms, limited in applica- governed its summary judgment granting to life An order tion insurance. trial who beneficiary signed by judge, was favor reasoned, for denying as INA’s motion he later verbalized void reconsideration, the suicide exclusion clause was (i) grounds: that the by virtue of 410 on either of two section policies had admitted these constituted company (ii) that, "Article 48A ... demonstrates is here a matter of law that life insurance timely appeal A noted to the Court of involved....” entry summary Appeals judgment, from the Special discovery ruling claims was based on answers to INA beartrap requests nothing less than "a under were in effect more than 1. It is had been conceded INA that years at the two time of the wife’s death. *5 500
leaves.” This Court issued its prior writ of certiorari to the appellate intermediate court’s consideration of the matter. view, summary judgment In our by entered the circuit by supported theory court can be neither that INA made binding concession that the insurance here involved insurance, of finding one life that the nor by statutory made so as a of matter law definition. As for the former, we are not the to recognize first that the term "life insurance,” general usage, enjoy does not a well delin unambiguous signification. eated and See National Life & Lokey, 174, 45, Accident Ins. Co. v. 166 Ala. 52 So. 46-7 (1910); Co., Metropolitan 343, 132 Julius v. Life Ins. 299 Ill. 435, (1921); Co., N.E. 437 Jones v. Prudential Ins. 208 Mo. 679, 429, (1922); 236 App. S.W. 432 Culbreth v. Prudence 46, 132, Life Insurance 241 Company, S.C. 127 S.E.2d (1962); Bkg. 135-36 American Trust & Lessly, Co. v. 171 (1937). 561, 552, 551, 111 Tenn. 106 S.W.2d A.L.R. 59 The presented by appeal, main issue this to which we shall turn shortly, Here, is in fact a product ambiguity. of this respondent attempts adversary, by way effect to hold his general discovery of references at that this one of life discovery to a conclusion that the concessions only 48A, can refer to life defined Article insurance) section 63 (defining and used in section 410 (a) (5) (limitation liability suicide), in case of when in fact usage statutory nor the neither the technical definition was discovery sure, specified requests. party To be need legal not understand the full ramifications a factual admission, but, concession before he is bound as a constrained, prerequisite being so party certainly must be put sufficiently specific discovery on notice requests of the factual nature of that he is required he yielded answer before can be held to have on the point. procedure While the pre-trial established for admissions goal narrowing serves the laudable the factual issues to be tried so as to necessity proof avoid the at trial of matters dispute, not in see Mullan Contracting Co. v. International Corp., 248, Bus. Machs. Md. 151 A.2d (1959), objective is not advanced proce- use imprecise (by utilization unwary dure to bind We to be conceded. not intended to admissions requests) *6 tendered and admission interrogatories say that cannot and facts which inquiry identified appropriately INA The term "life insurance” admit. answer and appellant was to pay to a contract normally connotes everyday parlance be policy, and this person, death of some upon the benefits of this insurance, the embrace falls within or life it accident receive, Aufenkamp is entitled Mr. in that general usage, upon the circumstances, benefits insurance certain under however, that the insurer say, This is not of his wife. technically a life contract that this insurance has conceded used in section in section 63 and as defined policy insurance 410(a).2 judge, primary trial and the holding of the
The alternate Court, this respondent before contention of as a matter of law in this case is involved code, in the insurance phrase is used life insurance as As an aid problem. more troublesome presents a somewhat with the circuit disagreement of our explanation to the on the preface we our remarks ruling point, court’s on this that, in the observation determination with propriety of that view, narrowly on the suicide exclusion by focusing our court have parties and the trial policy, clause of the both of this insurance contract purpose dominant overlooked the myopia This has resulted as reflected the risk assumed. certain factual determinations both in the failure to make law, as a matter of ought precede judgment which may well not need legal question in the of a resolution resolve this contractual properly to have been answered to judicial Probably purported a result of the dispute. as contract was one of life present of INA that the admissions this was concentrated on whether all concerned (either or as a matter of law such a admission definition), that if it statutory assumption on the apparently on, ruling raise, these parties whether 2. The and we indicate no do law, admissions, subject seemingly to concession are matters ostensible through Maryland 421. discovery. 417 and See Rules were, coverage would exist under since the suicide exclusion clause of the contract would be voided section (a) (5). Thus, INA’s failure to specifically ground its argument on clause of the policy may have contributed to granting the erroneous of a summary judg- which, ment proper, order to be must have been predicated on the supposition that without the suicide clause, exclusion coverage would exist policy. under the The question factual whether Mrs. Aufenkamp’s demise was a act, result of her own intentional under this approach, was seen consequence if, to be of no argued by appellee, this truly compact. life insurance In posture, the issue court, came before and was disposed byof the circuit and not surprisingly, the case is before us now with the issues identi- cally framed.
What overlooked, however, has been is that whether *7 coverage exists under this insurance contract turns in the first upon principal instance purpose policy of the coverage exhibited its clause. See Bowles v. Mutual Ben. (4th Ass’n., 44, & Health Accident 99 F.2d 47-8 1938); Cir. Iullo, Capitol Life Ins. Co. v. Di 116, 98 Colo. 1183, 53 P.2d (1936) (en banc); Brunswick v. Co., Standard Acc. Ins. (1919). 278 Mo. 213 S.W. Only 47-48 if it is deter- mined that the contractually insurer has assumed the risk particular for the type malady suffered in given a case will it be necessary proceed to a determination whether that risk, otherwise undertaken in the clause which delineates the contingencies against, specifically insured is disclaimed policy, and, so, elsewhere in the if whether that exclusion is legally enforceable. Capitol Life Iullo, Ins. Co. supra; v. Di Co., Brunswick v. Here, Standard Acc. Ins. supra. centering initially clause, on the exclusion legal deter- mination that INA owes benefits under on what its face appears to policy when, fact, be is made there — has been judicial no consideration of a threshold issue whether suicide a is risk assumed the insurer under the Indeed, clause. the trial court effectively deter- mined that this is a life without having ever considered specifically the nature of the risk for which the liable, contractually inquiry insurer which is where should be directed to whether is one determine As Supreme insurance. was stated Court of issue, Colorado when faced with a similar [may liability [t]here be] no on part insurer, suicide, not because the insured committed accident, and, but there because was no as we have seen, indemnity the double clause provides payment only in case of death It does accident. may just cover nonaccidental death. It rea- as sonably held straight be that on a life insurance policy, providing for payment money on the insured, death of the insurer is liable where death, there has been no as hold that on a providing money paid be death shall case of accident, the insurer liable where there has been [Capitol no accident. Life Ins. Dilullo, Co. v. supra, P.2d at 1184. also See Brunswick v. Stan- Co., dard Acc. Ins. supra, 47-48.] 213 S.W. at Thus, here, liability contractual has been determined even death, though suicide, arguably a may not be "covered includes, occurrence” under the policy which applicable case, only "bodily injury resulting directly indepen- dently of all other causes from an accident....”
Under view take, we the threshold question here should factual, have been viewed as and one that was not resolved: Was Mrs. Aufenkamp’s result, death the direct independent all causes, other of an If the accident? were caused, determined to have been so nothing then would *8 lingered have for analysis, liability the policy under would clearly have existed. The resolution of this factual dispute would not necessarily have disposed of this litigation, however, for if trier of fact were have concluded contrarily, that Mrs. Aufenkamp took her own life jumping window, her bedroom as a theoretical matter the insurance would company necessarily have been liability free from under the contract. so This is because generally recognized principle, to which this State
subscribes,
taking
one’s own life while insane
undeniably
intention,
accomplished
without
see
(1875)
Peters,
414,
Knickerbocker Ins. Co.
42 Md.
417-21
v.
(coverage
"by
exclusion for death caused
his own hand or
recovery by
act” held
prevent
not to
insured who "killed
insanity
himself in a fit of
an insane
he
impelled
impulse
resist”), and thus is an "accident”
could not
within the
meaning
policies.
of that term as used
See Couch
(1962)
authorities).
41. 197,
§
(citing
on Insurance 2d
p.
Therefore,
policy,
unless otherwise excluded
suicide
normally
contractually
while insane
is a risk
assumed under
Here,
course,
agreement.
such an insurance
the insurance
insane,
document
excludes
for suicide while sane or
disavowal,
which
unless rendered void
statute or other
considerations,
Accord,
public policy
Bigelow
is enforceable.
286,
Co.,
v. Berkshire Life Ins.
93 U.S.
Life insurance is insurance on human granting includes also the of: *9 (1) benefits; Endowment
(2) in the event of death Additional benefits means;
accident or accidental (3) disability benefits the event Additional of sight;
dismemberment or loss (4) disability operating benefits Additional lapse, pro- from or to
safeguard the contract value, special surrender or special vide benefit, annuity, in the of total and or event disability; and permanent (5) proceeds modes of settlement Optional
life insurance. not include workmen’s com- Life insurance does but does include burial insur- pensation insurance 48A, (1957, Vol.), Repl. Code 1979 Art. [Md. ance. added).] (emphasis urges policy clearly provides this respondent The wife, his to the extent coverage for the loss of the life of does, encompassed that it should be viewed as within the statutory definition, on human life.” To broad "insurance INA that constitutes position counter limi- governing insurance and that the statute health thus immaterial, liability Aufenkamp tation of for suicide is Mr. section the insurance code expressly asserts that 437 of inapplicable makes the health insurance subtitle to life insurance:
Nothing apply this subtitle shall to or affect:
* * * (3) insurance, only Life ... which contain such
provisions relating health insurance as: (i) Provide additional benefits case of sight, or loss of or
dismemberment accidental (1957,1979 Vol.), Repl. [Code means.... 48A, § Art. 437.] view,
Reliance on the in our neither just-quoted provision, beneficiary’s primary adds nor detracts the husband thrust that this is life for this statute contributes little to the resolution of the issue. While section 437 does indeed health inapplicable make the insurance subtitle *10 insurance, including provisions normally health related found in it policies, such is not informative or definitive as is, matter, to whether in the nature this a threshold of life or health insurance. is,
We are convinced that the issued INA title, special consonant with the contract’s accident and haz- which, applicable statutory ards insurance under life, health, In terminology arriving and not insurance. at determination, very preliminarily we observe that structure of the insurance code leads us to conclude that the there, (1957, types various of insurance defined see Code Vol.), 48A, 63-74, §§ Art. Repl. separate constitute categories part mutually of insurance which for the most are not, say exclusive. This is not to that there is and that the legislature recognize, inherently did not that overlap varying exists between the under some of these types fact, of insurance. This in litigation, springs — — overlap types between two of insurance life and health which in respects presents perhaps example some the best seemingly coinciding coverage. Appleman, See 1 Insurance (1965). Practice, Law and 44 p. But we think both the in general par- structure of the insurance article as well as Assembly ticular sections therein that the indicate General cognizant ambiguity, attempted of this and specifically define as either other nor- one the risks mally commonly undertaken and the benefits incident to conclusion, arriving each of insurance. In at this there single policy no intimation that a of insurance cannot contain coverage falling statutory into more than one cate- gory. recognize commonly We that one insurance contract will against provide insure various risks and benefits for harm, code, sundry kinds and except specific and exceptions, practice. well-delineated does not affect this What we determine is under an insurance covering risks, normally various each risk assumed will by only constitute a kind of encompassed one stat- definition, utory governed by regulations applicable category to that alone.
In 1963 the insurance code of repealed this State was a new one enacted in place represented its in large part product the work of the Study Governor’s Commission to General Insurance Maryland. Laws of A perusal of this enactment, substantially identical form with present 48A, that, Article pursuit reveals objective "to classify recodify subject matter of the insurance laws into a form,” convenient and Report usable of the Governor’s Commission to Study the General Insurance Laws of Maryland Legislative Council, iii, To: p. October, 1961, par- ticular limitations and applicable restrictions to each of var- — types ious of insurance life, defined the insurance code — health, property, casualty, surety and title are collected in subtitles pertaining only to one of these delineated categories of (1957, insurance. See Vol.), Code Repl. *11 48A, Art. addition, subtitles In 23-30. some effort has been made to precisely define the nature of various benefits nor- mally payable given under a type policy. of
In the case of insurance, the definition contained in section 63 pertaining subtitle, to that in addition to describing the nature of by the risk assumed such a contract as insurance on lives, human includes among other payments, earlier, as noted "[additional benefits event of death means,” accident or accidental "[additional disability benefits event dismemberment or sight,” loss of "[additional disability benefits operating to safeguard the lapse, contract from or to provide a special value, surrender benefit, or special or annuity, in the event of total and permanent disability.” Thus, payments which might perceived otherwise be to be insurance, health such as double indemnity payable benefits upon accidental death or types various disability payments, are expressly designated as life insurance. In sec- 66, tion health insurance is defined as
insurance of human beings against bodily injury, disablement, or accident or accidental 508
means, thereof, expense against or or sickness, resulting or or expense disablement childbirth, incurred in against expenses or sickness, care, every or dental prevention thereto. Health insurance appertaining compensation does not include workmen’s insur- (1957, Vol.), 48A, § Art. 66 Repl. [Code ance. added).] (emphasis insurance coverage it clear that con- makes provision
This tingent specifically on a death caused as a result of an acci- through dent or accidental means is denominated health though possible it is to char- conceptually even pays it coverage, upon acterize this because benefits death, Fidelity Logan a as life insurance. See v. and Casu- (1898). Therefore, Co., alty 146 Mo. 47 S.W. what might perceived otherwise be to be life insurance is specifically delineated to be health insurance section 66. Accord, Company, Culbreth v. Prudence Life Insurance then, at It that not all supra, apparent, 127 S.E.2d 136. the death payment triggered insurance benefits whose provide are conceived to life insurance person properly Moreover, coverage defined in the statutes of this State. appellee strongly on which as we have seen section (and relies, statutory complements furthers this scheme sec- 63) by making legislative regulations tion regarding only inapplicable health insurance to life insurance but in case also to "additional benefits of dismemberment or loss means,” sight, or of death accident or accidental operates safeguard "to such contracts against lapse, give special special or to surrender value or *12 annuity or an in the event that benefit insured ... totally (1957, and permanently becomes disabled....” Code 437(3) (i) (ii). Vol.), 48A, § Art. and Section Repl. then, by way tracks of those benefits defined to exclusion be life Any lingering insurance section 63. doubt as to the exclusivity corresponding of the subtitles to the various insurance, types dispelled by knowledge of should be following provision, originally contained in the 1963 bill which, introduced, enacted, as when made substantial code, changes prior passage: the insurance was deleted Mutually 62. Not Definitions Exclusive. coverages may
Certain insurance come within of the definitions two or more kinds insurance as subtitle, defined in this inclusion such coverage within one shall definition not exclude it to any other kind of insurance within the defi- such coverage may nition which be likewise rea- sonably Maryland [See included. 1963 Laws of ch. 553, 1, 48A, § indicating prior Art. deletion enactment.]
Having a legislative established intent separate to create generic insurance, categories of each for the most dis- part other, tinct from it clear that death benefit contem- by plated the insurance before contract us either constitutes a payment on insurance, life insurance or health it be cannot both. The issue here raised be cannot resolved a simple examination the terse and tautological somewhat statutory definition of life comparison that definition with the fact that benefits under this are payable, in part, upon death being. of a human Rather, the answer our view derived from an examina- tion of normally the risks assumed insurer under a policy, health a juxtaposition of those risks with those assumed INA under policy. While the distinction between life and health insurance is at times somewhat obscure, this obfuscation should not befuddle one into the belief types that the two of policies essentially are the same so as to render statutory provisions pertinent to one applicable to dissimilarity both. The emerges from an understanding of the divergent risks assumed under life and policies, health a distinction which we believe have been best stated the Ohio Appeals: Court of
Life generally includes the occurrence accident as one conditions which call for payment by company, as well as death *13 510 include policies Accidental death
from other causes. death, and to that causing only injuries Yet, of life. nei they provide extent each is for that reason policies kinds of ther these two policy. In other brought the same class within words, death is the policy of life in a if it be against; and the result insured contingency accident, but an incidental an the accident is factor; policy, accidental death the acci an while against, insured and thing death is causing dent incidents which creates is but one the death Clark, T. Co. Bank & v. liability. [Oglesby-Barnitz 415, 175 31, Ops 15 Ohio 2d N.E.2d App. 112 Ohio (1959). also, 98, 1337, 1344 See 103, A.L.R.2d 83 285 F. Casualty Company, v. Continental Simmons (D. aff'd, 1968), 997, 410 F.2d Supp. 1002-03 Neb. (8th 1969); & Ins. National Life Accident 881 Cir. 45, (1910); 174, 46 Lokey, Co. v. 166 Ala. 52 So. 337, Co., 5 134 Kan. Loades v. Woodmen Accident (1931); Ins. 798, P.2d Jones v. Prudential 798-99 679, 429, (1922); Co., 432 App. Mo. 236 S.W. Company, Prudence Life Insurance Culbreth v. (1962).] S.C. 127 S.E.2d 135-36 differently, contingency Stated somewhat insured is against policy under a life the occurrence an inevitable — — unless regardless specifically result of its cause Therefore, excepted by assuming with policy. compliance coverage, upon the terms continuation of issuance of such a the insurer undertakes an absolute risk of loss estate at his acquires and the insured an immediate death is in accordance with terms of the transferred hand, (except contract. On the other an accident is benefits) indemnity contin- perhaps its death an contract gent on and unforeseeable unexpected of an happening therefore, occurrence, in this evitable event. The risk only contingent, policy assumed insurer (or only beneficiary) interest obtained insured inchoate and defeasible. mind, are,
With we observe there these distinctions legislature thought, public as we our reasons believe *14 protecting beneficiary for the under a life insurance contract suicide, compact from for by an exclusion death because that inis the nature of an investment whose date of return is the only public policy factor which is uncertain. Those con- however, siderations, champion of do not the extension the insurance, insurer, statutory restrictions to health since the by insurance, accepts liability this of for death manner, only occurring expec- in a limited and the insured’s tation is in by happening the nature of a bonus created the Note, of an and unexpected unfortunate event. See Insur- Applicability ance: Suicide to Missouri Statute Acci- Indemnity dent Policies Double Provisions of Life Policies, U.L.Q. Insurance 1959 No Wash. 183-88. reason has been presented why legislature to us would have intended liability apply that exclusions from for suicide to and, accident in policies, insurance of a absence much more intent, definitive statement of legislative we refuse to (a) (5), 63, read section 410 with combination section do so.
Moreover, we also that if point beneficiary out were correct insurance, that health to the extent it death pays benefits, is life insurance as defined the code and that therefore 410 applicable, section restrictions are there could be no accident insurance death paying benefits in this State. This is because section 410 provides "[n]o of be shall delivered if it provision ... contains a liability excludes restricts for death caused in a specified certain .,” manner . . except that the policy may contain any five exceptions enumerated from which death by accident is conspicuously Therefore, absent. extent we were to hold death payable benefits under accident policies to be life coverage restriction to occurring only be would void virtue section (a). 410 Quite clearly, that was leg- intention islature, which, in 66, section specifically defined this type of contractually assumed risk to be health insurance and contemplated its existence as such. recovery impediment created
Faced
with
Logan Fidelity
scheme,
Aufenkamp
Mr.
musters
v.
statutory
(1898)
114,
Co., 146
Thus, companies under the because accident insurance accident) statute, person pays who benefits the event legal pertinent persons to to subject requirements were insurance, held issuing nonforfeiture statute was Court. A to the accident then before the applicable to which our decision comparable statute that on Gehrmann today, absence grounded with the notable still exists and "accident.” from its of the crucial words "sickness” terms Instead, (1957, 1979 Vol.), 48A, § Art. 64. at Repl. See Code seen, separate definitions for we have there exist present, as
513 insurance, and, indeed, separate life and health subtitles establishing regulations regard distinct with to each decision, insurance. While at the of our Gehrmann time both subject health and accident insurance were restric applicable policies tions life insurance and companies, decades; much has transpired eight over interim intricate, nature of the business insurance has become more clear, it is as is evident from our prior discussion as well as below, legisla information set out the margin that the has by drawing ture risen to the task more narrowly its laws creating sets of separate regulations for the various genre of insurance.4
The Logan decision of the Supreme Missouri Court opinion the Gehrmann quoted and relied upon in is, contains broad language justifica- which with some tion, Aufenkamp cited Mr. in support of his claim that paid benefits pursuant policy coverage should be viewed as life and that a statute voiding suicide exclusion clauses in life policies, not unlike (a) (5) section us, now applicable before is also to death benefits payable under accident policies. Logan Fidelity v. Co., Casualty supra, 47 S.W. at Although 949-51. our present insurance code conclusion, leads us to a different we do not completely spurn the reasoning decision; Logan what there, was said considering the remedial nature of regulations similarity and the inherent between upon by 4. In the statute relied the Gehrmann court was amended "accident,” so enacted disablement, company casualty toas delete the words "health” and and a new section was against "any company insuring bodily injury, which made ... *16 ..., or death accident a health ana accident insurance applicable requirements subject ... and ... to all the of law to Maryland, 528, 1, 2, §§ companies.” ch. of insurance See Laws 1939 48A, later, years §§ legislature Art. 82 adopted and 82V2. Two Law, Uniform Policy Individual Accident and Sickness Provisions myriad requirements applicable established of policies of to accident and Maryland, health insurance issued in this State. See 1941 of Laws ch. 904. part major repeal As of pursuant revisions made to the and reenactment 1963, (but 25, of the in insurance code subtitle termed "health insurance” 66, now, in formerly defined insurance”), governing in limitations section to include what was called "accident enacted, comprehensive regulations was which created a of set exclusively and policies issuance content of health insurance Maryland, longer subjecting issuing and no those to the applicable casualty companies. to See 1963 Laws of Maryland, 48Á, §§ ch. Art. 437-470. 514 coverage, light in of that state’s statutes types
the two Nonetheless, logic. in possessed some force existing, then decision, Court’s WhitGeld decision Supreme and the Logan from the it to be Missouri law what surmised interpreting the courts of Logan, has caused language contained broad instance, in Brunswick v. For some consternation. that state 47-48, Co., 213 S.W. at the court supra, Acc. Ins. Standard (which directly appear to be would distinguished WhitGeld only to cases where Logan apply point) interpreted insane, committed while because died suicide the insured life, sense his "neither sound sane insured takes own when a intentionally to hold that an act us done permit nor will logic fur- The court Brunswick by a man is an accident.” sane reasoned: ther statute, materially [the
While Missouri (a) (5) Code,] Maryland of the 410 unlike section stipulations exempting all absolutely void makes and all defenses liability on account of suicide suicide, yet it nowhere the fact bottomed on action upon in an plaintiff, relieves the making proof caused an accident. of the assured was death [213 49], at S.W. Brunswick leads
Thus,
Logan
the coalescence
statute,
suicide exclusion
rather anomalous result
life,
applicable
to insurance on
pertinent
terms
its
if
policy only
under an accident
benefits payable
matter,
case,
resulted
as a factual
particular
death in the
Court’s WhitGeld
Supreme
The
from suicide while insane.
court,
great
of a
"as the utterance
distinguished
decision was
intricacies
our
unfamiliar, however,
many of the
with
also
Having generally discussed our insurance funda- between and health mental differences insurance upon by Aufenkamp, the authorities relied Mr. we now so, are particular policy, doing return this and in manifestly confronted with an insurance contract which constitutes health insurance. The that INA provides persons agrees eligible insure covered said application against loss... resulting from covered ..., except occurrence that such shall not loss death, include dismemberment or disablement due to natural The causes. words 'covered occurrence’ (a) be bodily shall defined as injury resulting directly independently of all other causes from . an accident. . .
It is evident that the risk
assumed
INA under this
is the occurrence
accident,
loss
resulting
may
death,
loss
be
form
dismemberment or disabil
ity.
appellee
The
confuses
loss
suffered with
risk
undertaken,
thereby
reaches the incorrect conclusion
that the contract is a life
policy.
insurance
The fact
particular
loss suffered
contractually
was death is
unimportant (and, indeed,
give
would not
itself
rise to
under the
liability
policy)
unless
additional
it is
evidence
shown that the death resulted from an
Capitol
accident. See
DiIullo,
1184;
Life
Co. v.
supra,
Ins.
P.2d
at
v.
Brunswick
Co.,
Standard Acc. Ins.
supra,
(1957,1979 Vol.), Art. 66. Repl. suicide, by its caused exclusions for death restricting germane it is to life not only is applicable terms the exclusion clause does void suicide to this not suit Therefore, Mrs. whether policy. in this contained or insane of suicide while sane died as result Aufenkamp situation, does since, coverage in either no consequence, is of the contract. exist under not one of life insur- Our determination case, only for we decide here that not conclude the ance does Aufenkamp Mr. summary favor of grant judgment the action for a trial on Accordingly, we remand this was error. the of an was result the insured’s death issue whether coverage rise under this as here giving to construed. of the Circuit Court for
Judgment County Montgomery reversed pro- for case remanded further ceedings. by appellee. paid
Costs to be J., Eldridge, concurring: case, I cannot agree
I reached in this but with result reasoning majority’s opinion. of the in the subscribe to all
I on majority question focuses of whether Initially, for an "accident” Aufenkamp’s or not Mrs. was This coverage policy. clause the insurance purposes opposition to the issue was not the basis for insurer’s summary it on judgment, motion for and was not raised on behalf of an appeal. injecting, appellant, The Court appel- has raised. The issue into the case which neither side its acquiesced, opposition lant has for purposes insurer purposes of this summary judgment, the motion for appeal from the order granting summary judgment, idea that the suicide was an purposes "accident” for coverage clause. might
It appellant’s acquiescence be that the regarding inadvertent, clause issue was not as the insur- determined, company may ance have investigation, that that, therefore, the deceased was insane and the death was any rate, accidental. At parties litigation right have issues, limit the disputed long they as "jurisdic- are not tional.”
After it has been determined summary judgment improper, because the judge improperly trial resolved the summary issues raised judgment proceeding, I would objection have no to pointing out pertinent that other issues *19 be may trial, raised either side at the including the issue, clause if one or the other so side desires. However, I Court, own, do not that believe the on its should inject this question. as a "threshold” The reversal in this case entirely should be upon based our disagreement with the trial ruling. court’s
II my In opinion, the central issue in this case whether § of Code, 48A, 410 the Insurance applies Art. to the acci- dental death provision of this contract of insurance. In deciding this question, the majority seems to proceed upon theory the 62-73, §§ that defining terms the Insurance Code divides insurance policies into exclusive substantive categories. the determination, Thus initial according to the majority, must be to decide into category which exclusive the fits, policy and then to determine particular whether or not a provision code applies Here, category. to that the Court finds that risks, a covering including assorted accidental death, fits into the category exclusive "Health Insurance” (Art. 66). 48A, § majority 48A, The further finds that Art. 410, § apply not intended policies to to of "Health Insur- ance,” and thus it apply does not here. result, agree the I do not with the agree I with
While Legislature, I that majority’s approach. doubt definitions, categorize every statutory intended to enacting type. nothing There is into an exclusive this, illogical. A and it is implying the Insurance Code may cover example, losses policy, for homeowner’s insurance theft, Obviously by fire, liability, provisions etc. those govern portions some fire insurance would Code relevant to concerning of the Code provisions and those policy, any In govern portions. would other types other of insurance one fire or case, to call impossible it would be theft, nothing obvious that would liability or of it is categorization. categorization ques- The be such a served it irrelevant to the not be asked because tion should even legislature intended real of whether not issue apply particular policy specific statutory provision provision. categorization case, uses majority
In this policy is one "Health approach, concludes that the entire 48A, 66, "Life Insurance” § Art. and not Insurance” under 410, 48A, 48A, § Art. does § Art. decides that under § Insurance,” thus "Health decides apply to I to exam- Aufenkamp’s policy. prefer Mr. apply does not (without it) artifically ine policy provision categorizing statute, Legislature to determine whether the and the apply latter to the former. intended in Art. statutory of life insurance contained The definition lives,” 48A, including also is "insurance on human *20 "technical”; not This definition is specified certain benefits. understood, ordinary, commonly it corresponds to the policy "life The insurance meaning of term insurance.” in for an accidental provision the instant includes a case clearly a of benefit clause is form death benefit. The death very general life within the on a human and falls insurance §in 63. definition of "life insurance” However, policy is not provision benefit in this of provisions all the Code of life insurance which held to rationally apply. be referring to "life insurance” can all, Specifically, it if many, is clear that of the sections in i.e., the life Code, insurance subtitle of the Insurance 386-416, §§ subtitle were not intended to apply to everything that general comes within the broad definition § "life insurance” in 63. 48A, 386, § setting
Art. forth the life scope insur- subtitle, ance makes no reference to the broad definition in § scope 63. The of this subtitle can be ascertained examining provisions of the subtitle. Section 388 pro- insurance,... vides that policy "[n]o life shall be delivered in policy issued this State” unless the all contains provisions required by However, §§ many 389-399. provisions required by §§ 389-399 logically could be applicable only "general” to a life policy, and not "limited” or provision, though even fall may both § within the definition 63. §
For example, provides if age insured’s has misstated, been under the will be for the amount premium that the paid purchased would have had the age properly been categorization stated. Under the approach of majority, this provision would presumably apply to a policy only against death, insuring accidental because such policy would come within the category defined § life insurance age under 63. largely Since irrelevant risks, accidental death Legislature hardly could have intended the majority result which the opinion necessarily — implies § apply would to an accidental death it because is a form of "insurance on a human life.” The more § interpretation reasonable is that 392 was meant to apply to "general” life insurance which age a factor in determining premiums, policies and not to limited life age immaterial, is largely although they may both § come within the 63 definition.
Similarly, the legislature rationally could not have § intended that 410 apply policies to all of insurance aon human life. A more interpretation reasonable is that the § restrictions against including that suicide (a) (5), exclusions in 410 apply "general” were meant to *21 the restrictions were doubt life insurance. No policies marketing purportedly prevent to insurers designed which, fine print, in the insurance policies of life general of death. contingencies excluded various 48A, § were of Art. interpretation appellee’s If the company provide could not correct, not that would death benefits accidental causes, this not since is recovery natural for death permit § manner of of 410 on the restrictions permitted one of the it is that this majority apparent that I with the agree death. The did not intend legislature intent. legislative not the type insur- provide to some every policy, happening that life, subject provisions to all of the on a human be ance policy. life insurance general to apply would a full-blown general reiterate, majority’s disagree I with the To The all one or another. insurance must be approach that statutory fits within the has a feature which here (§ 63) and has features other definition of "Life Insurance” of "Health Insurance” with the definition which coincide (§ 66). policy as a do not mean that the But these features and not or health insurance life insurance whole either statutory merely defining I not both. do believe all terms, Assembly categorize intended to General ques- The pigeon into holes. policies of insurance exclusive Leg- is whether the must be asked each case tion which statutory to particular provision apply islature intended a The is not found policy provision. answer particular (a) (5) Thus, § 410 thing one another. calling Aufenkamp’s not policy, to Mr. because apply does Insurance,” and not "Life but policy is "Health Insurance” not intend very Legislature clear that the did because it covering only death policies, that limited life insurance means, subject be 410. accidental
Ill Finally, I majority’s approach believe that may seriously for admission value of requests undercut the discovery pretrial procedure. *22 case, appellant In responded affirmatively this INA to a request interrogatories for admission and an asking whether insurance,” application policy had been made for a "life whether such had been issued and was in effect Yet, Aufenkamp’s at the time of Mrs. death. as I read the majority opinion, any by INA is not in way bound these by answers because "life insurance” is a term defined law. However, requests normally answers to for admissions will may words, by involve words that be defined But those law. nevertheless, may plainly meaning, have a understood I answering believe that is party accordingly bound (unless the question specialized answer indicates a meaning). out, previously pointed §
As I 63 Article 48A defines "life in insurance” a manner that corresponds with common usage of why that term. There is no reason INA should not be bound this in with admission accordance commonly meaning understood ofthe ques words. While the tion of a policy whether of life insurance was issued and may effect have a I legal aspect, think it is clear that the question factual, basically was designed simply to eliminate the issue of whether a had been light issued. In answers, INA’s affirmative I do not believe that INA could deny later type that some of life insurance had been issued and Joseph Hock, Inc., was effect. See Murnan v. J. 528, 534,
274
(1975),
Md.
Judge
"In 421 Rule to fulfill unquestioned its function, to eliminate the to prove need factual matters adversary fairly at trial which the cannot contest, produced admission rule must be conclusively binding. contrary A interpretation ” would reduce the rule to a appendage.’ 'useless However, earlier, as I indicated do not believe that everything which comes commonly within the understood meaning insurance,” § of "life as embodied in subject to the life insurance subtitle of particularly the Code and did not consti- reason, responses
§ appellant’s 410. For coverage imposed on that the limitations tute an admission involved § to the of life insurance applicable are 410 INA is bound its words, I believe In other here. pol- "life it had insurance” current issued statements commonly the broad provided icy on the decedent Nevertheless, § forth in 63. definition set understood "life more limited use the term § refers to a because general policies, insurance,” only to applying on the manner applicability of limitations may carriers limit be resolved open at remained issue but admitted trial. *23 she say me concurs
Judge authorizes Davidson expressed. the views herein