LDS Hospital, a Division of Intermountain Health Care, Inc. v. Capitol Life Insurance Co.
765 P.2d 857
Utah
1988
Check Treatment

*1 dispense as one that does not need written request by

for a notice and State, Rockmore v. prisoner. Ariz.App. People (1974); see v. 519 P.2d

Masselli, A.D.2d N.Y.S.2d 929 Darr, Sweat v. 235 Kan. cf. (1984) (failure

correctly request prosecut- address a to a

ing attorney took inmate out of substantial IAD).

compliance with

Defendant failed to written notice to

the warden or other official who had custo- Thus,

dy protection of him. III article invoked,

never and the time limits of article apply.

IY Defendant was tried within 120

days of his arrival Utah. His conviction

is therefore affirmed.

HALL, C.J., STEWART, ZIMMERMAN, JJ.,

DURHAM and

concur. HOSPITAL,

LDS A IN DIVISION OF CARE,

TERMOUNTAIN HEALTH INC., corporation, a Utah Plaintiff and

Appellant,

v. LIFE

CAPITOL INSURANCE COMPA NY, Appellee, Defendant and Miller,

Joel Miller and Marsha Appellants.

Defendants and CLINIC, INC., INTER-MOUNTAIN Duffin, Scheffler, Thomas A. M. Hans Appellant, Plaintiff and City, Hosp. Salt Lake for LDS Inter- Clinic, Mountain Inc. CAPITOL LIFE INSURANCE COMPA Yengich, City, Ronald J. Salt Lake for NY, Appellee, Defendant and Joel Miller and Marsha Miller. Slagle, City, Cap- David W. Salt Lake Miller, Appellant. Joel Defendant and itol Life Ins. Co. Nos. Court Utah. HALL, Chief Justice:

Oct. Hospital Plaintiffs LDS and Inter-Moun- (“Hospitals”) appeal

tain Clinic a trial court denying Hospitals’ order motion sum- mary judgment granting defendant *2 Company’s (“Capi- Capitol relied to Capitol Life exclusion coverage, regard and un- tol”) no cause of action in motion for certain, apply the trial court failed to liability an accident insurance to its recognized rules of construction and erred contract. reverse. We summary denying Hospitals’ motion for dispute. not in October facts are granting Capitol’s motion for judgment and (“Miller”), defendant Joel Miller agree. no of action. We cause intoxicated, struck a vehicle driven interpretation of a written contract The accident was a head- Heinz. Robert question of law determined be on Heinz died collision. agreement.1 in the In this re- the words occurred, minutes after the accident gard, recently stated that a cardinal wé expenses incurred medical Miller lived and construing rule in the contract is to $150,000. Mil- After Heinz’s of over and, parties effect to the intentions of manslaughter pursu- pleaded guilty to ler possible, if these intentions provisions of Code Ann. ant to the Utah gleaned from an examination of the text of (1978) (amended 1985). Prior 76-5-205 § Additionally, it is axio- the contract itself.2 action, parties on this cause of to trial interpreted matic that contract should be deliberately stipulated that Miller did provisions so as to harmonize all of its and intend to harm Heinz or cause injure or terms, all of its which terms should be Furthermore, parties agreed death. possible do íf a given effect so. Miller an insured under his wife’s interprets matter trial court a contract as a However, Capitol al- policy Capitol. law, here, accord its as was the case we not cover- leged that in this case particular weight and re- construction no policy the health and accident ed under view its actions under correction-of-error expenses his medical arose out inasmuch as standard.3 exception provision of the insurance Court, Recognizing principles, this exception provides part contract. That many jurisdictions, to courts in similar as follows: to the view that ambi long subscribed Exceptions. General language guity uncertainty legally If the Insured Person is not policy must be resolved in favor insurance payment, this liable will Also, coverage. since the addition, pay a it does not benefit. insurer, ambiguities by the are con drawn charges: against party.4 strued One acknowl underlying edged rationale this sound de attempt at as- G. out of an termination is the need to afford the felony.... protection sured the he or she endeavored consideration, Upon by paying premiums.5 the trial court denied The test to secure Hospitals’ summary judgment applied determining ambiguity motion for to be by this against Capitol, granted Capitol’s motion of a contract has been stated Court action, as follows: assessed for no cause of liabili- expenses medical ty meaning the incurred Would [of against appeal, per- plain Miller. On cases were be to a insurance contract] intelligence Hospitals argue that since and under- consolidated. son fairly specifically standing, viewing the matter Capitol’s policy, and insurance Ins., Assocs., (Utah Eagle P.2d 752 P.2d Co. v. Star 568 734 1. Buehner Block Co. v. UWC 892, 895 1988). (Utah 1977); Ins. 7 Auto Lease Central Mut. Utah 2d Id. Appleman Appleman, & J. 5. See 1A J. Id. § Law & Practice at 447-54 see also 4. See Utah Farm Bureau Mut. Ins. Co. v. Orville (insurance id. vol. 13 at contracts must Sons, (Utah & P.2d Andrews liberally policyholder construed in favor of 1983); Colony Williams v. First Ins. thereof). beneficiary (Utah 1979); Casualty American P.2d reasonably, purchasing in accordance with the usual son insurance. It must not words, meaning forgotten purpose natural of insur- circumstances, insure, light existing ance is to and that construction cluding purpose policy[?]6 should be taken which will render the operative, inopera- contract rather than previously applied test We have tive. A construction which contradicts requirement the liberal construction when general purpose of the contract or *3 interpreting exclusionary an clause con- hardship absurdity pre- results in a Indeed, policy. tained in an insurance in by parties. sumed to be unintended Browning Equitable Assurance So- principles These are that are not con- ciety, we stated: Washington law, fined to are of na- right When an insured claims a to recov- application. tionwide The courts of other provisions er the accident upon states have elaborated these rules. policy, bring all he need do is himself by the court in Aetna Casual- As stated the field therein defined and within show ty Surety Company v. Haas [, proximately disability S.W.2d predominantly through 316]: caused vio- lent, external and accidental means. He strictly “Exclusion clauses are construed brought poli- then himself against insurer, has within the especially they are cy, and the terms thereof have import. may, of uncertain An insurer brings When he himself course, met.... within liability cut policy off under its insuring clause he has made his case language, with a clear but it cannot do so any exceptions ... or conditions by ambiguity. with that dulled As with relief, deny would then him which take provisions whole, policy as a so provisions, him out of the ren- exceptions liability also with the him, inoperative der them as to are mat- language must con- defense, ters of and the burden thereof pro- strued so as to the insurer the upon rests the insurer.... reasonably right tection which he had a doubts, expect; any and to that end ambiguities and uncertainties [Limitations, exceptions ... or condi- language policy used may tions which relieve the insurer from resolved in his favor.” liability, may which be set forth in the policy the court Harris Jolliff language by outside of the As in noted Michel, clause, & Inc. v. Motorists Mut. Ins. insuring or which exist out- Co., policy entirely, side of the App.2d must be made Ohio 255 N.E.2d [21 302]: escape and established the insurer to exceptions, qualifications or “Where ex liability thereunder.8 emptions into insur are introduced an general presumption contract, Similarly, Court of Wash- arises to the that that which is ington, banc, effect sitting en has reiterated: clearly operation not excluded from principles There are certain basic that op such contract is included in the apply exclusionary examination of eration thereof.”9 clauses insurance contracts. Chief among exclusionary Capitol these is that seeking clauses the instant strictly against are to escape liability by relying upon be most construed exclu- sionary the insurer. The susceptible should be inter- clause which sev- preted However, way interpretations. accordance with the eral in view of average per- would principles be understood the above-noted rules and of con- Schroeder, Royal 6. Auto Lease 7 Utah 2d at 325 P.2d at 9. Phil Inc. v. Globe Ins. (footnote omitted). 65, 68, 69, Wash.2d omitted). (emphasis original; citations (Utah 1938). 7. 94 Utah 573-75, (emphasis 80 P.2d at 350-51 deleted; omitted). citations felony the result of a under the sufficiently was not struction, dem- Capitol has not “exception” in statute.14 the contract onstrated how liability “escape allow it to question should adopt urging this Court Instead, alleges thereunder.”10 case, Hospitals argue of the terms of the injuries in case Miller’s its that it has met consequence a direct caused and were by the mere proof in this case burden accident, precipitated by his which guilty to a pleaded fact nonfelonious) (but wrongful act disagree. felony.11 We such, inju- As while intoxicated. First, Capitol’s construction of even if felony. In- out of” a ries did not “arise accurate, Capitol subject provision was deed, Capitol errone- re- required causal not established the coverage ously did occur relied to lationship the insured’s between minutes or exist until Indeed, as of law. and a violation accident, par- a fact to which the after the *4 Supreme Court expressed the Colorado Therefore, stipulated. since the “felo- ties in ny” merely incidental to and occurred was Gibson,12 to relieve the insurer in order only after the victim died and not before situations, liability in the insured such injuries the time the insured’s at engaged in a at actually have been flicted,15 coverage, Hos- as well as In Penn place time and of the against Capitol, im- pitals’ judgment was Mutual, driving under while properly denied in this case. alcohol, caused an the influence Second, of the in his death. The insurer which resulted susceptible to alterna- subject provision is death benefits accidental declined Indeed, interpretations. Hospitals con- tive from “the com- the death resulted because “felony” is modified tend that the word [ijnsured of an assault mission argue “attempt.” They that the the word Court, felony.”13 The Colorado “at- plain and use word causation, viewing as one of stat- the issue “intent,” implies a mental state tempt” ed: manslaughter offense. inapplicable to a In the instant case the insured’s Additionally, Hospitals note that “at- is not the death “of another” “felo- tempt” modifies both “assault” and ’53, And, question of C.R.S. 40-2-10. arguably assumed ny,” Capitol has at least ’53, 40-2-11 is an assault under C.R.S. resulting coverage injuries the risk of neither al- not involved since was In completed or felonies. from assaults requisite intent leged nor was contrast, “attempt,” as inter- if the word insured, the event proved.... As to the applies urged by Capitol, only preted and his his collision which caused was “assault,” the conclu- to the or refers word pre- with another automobile which injuries required is that sustained sion (but cipitated by wrongful non-feloni- attempted felony completed or a as- ous) driving intoxicated and acts of subject insur- are covered under reckless man- operating his vehicle out of policy, ner. The fact that individual] [another attempted completed felony or an injured also is not what caused [the interpreta- Accordingly, since the death. A the death are not. insured’s] fortiori P.2d at 351. 14. Id. origi- (emphasis in Browning, 418 P.2d at 52 94 Utah 41-6-44(3) nal); see also Utah Code Ann. (1988) (driving case, of alcohol 11. under the influence deciding this we do not address classifications). guilty satisfy misdemeanor plea the terms whether a would subject exception given even the construc- Capitol place 41-6-44(3) tion wishes to it. Compare Utah Code Ann. § (1988) (driving of alcohol under the influence 12. 160 Colo. (1966) (en banc). classifications) with Utah Code misdemeanor (manslaughter (Supp.1988) fel- §Ann. 76-5-205 classification). 13. ony 418 P.2d at 51. equal plausibility tions are of and since “In situations in which ‘accident’ or policy, any ambiguity drafted the ‘accidental’ are not defined in policy, must be resolved favor it is for the court to decide the definition coverage and in favor of in this properly applicable which is partic- case.16 situation, ular taking factual into consid- Third, general since the definition section eration popular what we believe to bodily inju defines accidental understanding non-technical ry as “that which is not intentional and not term....” foreseen” and the nature of other indicating exclusions there had to We Appleman: with Professor[s] part an intentional act on the of the insured “... While drunken danger- coverage similarly before would be exclud (and ous prevented) public policy, person ed under the a reasonable regards still such an accident as ‘acciden- properly could conclude therefrom that the tal’. contrary To rule to the is to exception for terminology ordinary meaning volved conscious given by public. If the insurer wants wrongdoings.17 case of Harbeintner v. Crown meaning accident, to so restrict the he Co. 18 supports determination. should specific insert a exclusion as the insured was killed while driv many do.”20 ing under the influence of alcohol. In de principle This resulting and the conclusion nying recovery, argued the insurer that the supported by existing our case law21 insured’s death was the result of a volun duty interpret and our the contract so as intentional, tary, and willful act and was harmonize all of its provisions.22 *5 solely not by caused “accidental means.” Accordingly, the trial court erred in exception upon One which the insurer re granting judgment Capitol. for Inasmuch deny payment lied to was that which ex as our decision plaintiffs necessitates that recovery injuries cluded “incurred to judgment case, be awarded in this we re- contributing which a cause is the insured’s purpose. verse and remand for that of, commit, attempt or rejecting assault or the in felony.”19 DURHAM, JJ., STEWART and argument, surer’s the court’s decision cited concur. existing Oregon Supreme Court case law ZIMMERMAN, (concurring). Justice proposition: for the I guided join majority reversing the by are on the principle the “[W]e ground appellee understanding is the common insurer has not term which shown a causal connection must be used and between the fel- not its ony technical meanings. I would not The insurance com- reach the pany may, course, grounds other majori- two insert in its advanced any ty. but, definition of ‘accident’ it chooses so, doing the absence of accept it must HOWE, Associate Chief Justice understanding common of the term (dissenting). purchas- member of the

ing public. I dissent. I cannot that for the

purposes case, of the instant 16. See supra House, accompanying note 4 and (Supp.1979)); text. see also Ins. v. Safeco 89, (1986) (some Or.App. 721 P.2d 862 conse 17. See IB J. Appleman Appleman, & J. Insur- quences voluntary intoxication be acci 511, (1981). ance Law & Practice § at 397-99 dental); Appleman Appleman, 1A J. & J. Insur 18. 360, ance Law & Practice § 447-49 Or.App. (definition "accident”). 19. Id. at 582 n. 612 P.2d at 336 n. 1. See, e.g., supra 20. notes (quoting 612 P.2d at 335 Botts v. Accident & Indent. 284 Or. Hartford supra accompanying 22. See Appleman *6 felony of injuries and a violation insured’s necessary to constitute only on the last act “in majority I with law.” namely, injury to Houck. It felony, a liability in insurer of order to relieve the of ignored the other elements completely situations, must have injury, leading up to Houck’s crime engaged felony in at the actually a heavy intoxi- insured’s included the which That place injury.” of the time and recklessly speed of driving at cation and in case. exactly happened the instant what hour, strik- sixty per miles driving injured Miller was pickup truck ing the rear-end of Houck’s wrong on the heavy influence of alcohol for a stopped at an intersection which had He highway. light. of a divided interstate side traffic on, and then continued struck one vehicle v. Insurance Co. Gib- Penn Mutual Life killing striking the Heinz vehicle in the cases son represents an aberration Nothing be more clear than Heinz. could My exception clauses. interpreting felony engaged in a felo- actually that Miller was cited it has been research indicates that place of his The ny the time and at ap- by only an intermediate approval minutes after the fact that Heinz died five v. Schwartz Jersey in in pellate court New inconsequential. The elements Co., Insurance Hancock Mutual John Life pleaded guilty to 416, of the crime which 520, 531, 422 N.J.Super. 233 A.2d 96 death of but appellants included not (1967). significant that the precipitat- only the also the conduct of Miller which cited in the instant case have accident, namely, recklessly Jersey cases two Colorado and New ed the above a causal support their contention that wrong on side in automobile his lacking the oth- relationship here. On heavily was highway intoxicated.

863 hand, many expenses “arising felony. er cases out of” a (1982) Certainly, Am.Jnr.2d Insurance 581 did arise out §§ Annotation, Construction and and in his felonious conduct led to which the death Ef In in Provisions or Accident supporting Heinz. For additional cases fect Life ” “Assault, Referring to surance Policies Capitol’s Miller, denial of to benefits see ” ” etc., Insured, “Felony, “Fighting, Kaminsky Co., v. Home 86 Insurance 45 Life (1962), A.L.R.2d 443 which a broader (N.Y.App. Misc.2d 258 N.Y.S.2d 266 exception 1965); interpretation Waters v. National clauses Term Life Co., support Accident exception view that Insurance 156 470 F.2d (10th Cir.1946); Country McDaniel v. applies when the Life Co., Insurance causally any aspect 93 Ill.App.3d insured connected 49 Ill. Repre of the insured’s felonious conduct. Mainer Dec. 417 N.E.2d 1087 Hospital Metropolitan v. American sentative these cases is Insurance Life Goodwin, Co., v. Insurance Co. 371 (Tex.Civ.App.1963); 166 Va. S.W.2d 717 Life 119, 123, (1936), and Barker v. 184 S.E. 210 where States California-Western Co., recognized necessity Cal.App.2d 768, the court of some 61 Life denied, cert. Cal.Rptr. causal connection between the unlawful act 390 U.S. and the death held after 88 S.Ct. L.Ed.2d reviewing subject on the cases “when the facts constitute continuous “arising felony. here was of” together succession events so linked stated, As I have heretofore it should appears to make a natural whole interpreted “arising to mean out of feloni- probable that the death a natural con respect, ous In that conduct.” it is similar sequence act, the unlawful causative ways one which murder in the connection exists will defeat recov degree may first be committed under Utah ery” of double benefits. See 76-5-202(l)(d) (1978, Ann. Supp. Code also Powell v. New York 1988). There, degree first murder is de- (Fla. 120 So.2d 86 A.L.R.2d 437 intentionally knowingly causing fined as Dist.Ct.App.1960), where it was held that person the death of another “while the death resulted from the com insured’s engaged actor was of” the commission There, felony. mission certain enumerated felonies. We held son, insured was respond shot who Johnson, v. (Utah State P.2d 1264 help mother, ed to cries of from his who gestae analysis 1987), that a res being husband, beaten her killing to the statute so that the need sured. felony, as the occur the same instant killing but that and the Appeals, The California Court of simply be oc- one continuous interrelated Romero Volunteer State Insur killing actually currence. Cal.App.3d 571, Cal.Rptr. *7 felony, viz., rape preceded vic- (1970), expressly rejected gestae analysis a res If tim’s wife. Penn Mutual Life the Colorado court exception the instant case Gibson, preferring Insurance Co. v. its of Miller looked the conduct earlier decision in Barker v. California- occurrence, one continuous interrelated Co., Western States significance oc- no Cal.App.2d Cal.Rptr. prior Heinz’s curred minutes death. denied, cert. 390 U.S. 88 S.Ct. injured, At time important L.Ed.2d to note element, progress. Only was in the final that in Insurance Co. v. namely, yet had death Gibson, exception occurred, away. minutes recovery denied “if re consideration directly indirectly sults from ... the Insured of an 463-64,

felony.” 160 Colo. P.2d at

51. The the instant case

arguably recovery broader since it denies notes 4 and Apple P.2d 657 1A J. text. & J. man, Insurance Law & Practice of Heinz only on the death ambiguous majority focuses so policy is in the insurance the sole element if that excep- That applied here. that it cannot be manslaughter. The death of crime provides will tion manslaughter not have been Heinz would attempt at as- “arising out of. an charges crime unless it had other excep- Similarly felony.” worded reckless and preceding by Miller’s caused in health and commonly found tions are Miller’s conduct conduct. Since drunken in double policies and the death of injuries caused own policies. While in life insurance clauses abundantly clear to me that language could have been particular felony” out of a injuries did “arise Miller’s purposes of artfully, more for the written stated, or, arise out of simply did that at a clear to me instant case it is conduct. felonious minimum, liable Capitol did not want entirely upon Penn expenses hospital majority relies medical and The Gibson, Mutual of its insured. felonious conduct out of the four where majori- Colo. illogical suggest, as does Supreme Court of the Colorado members only attempted Capitol excluded ty, that in- death of the held that the accidental completed felonies or ex- felonies but the commission not “result from sured did Excep- felonies. cluded intentional In that felony by the insured.” of a employed because of this nature are tions driving an automobile un- the insured was injury death to and the increased risk heavy influence of alcohol. He der engaging in felo- he is of an insured while automobile driven collided with an activity can be conduct. Felonious nious in- injured, and the Houck. Houck was commonly dangerous and is violent and majority reasoned killed. sured was resulting in police, repelled by victims and necessary to injury to Houck was that the perpetrator. Those conduct felonious and make the insured’s the insured’s present whether risks not cause the Houck’s did since reckless, as here. conduct is intentional or exception in insured’s majority’s conclu- I also dissent from apply. did not life insurance sured’s “Capitol not established sion that fallacy of the judge dissented. One relationship required causal between It focused is obvious. court’s