Arata v. California-Western States Life Insurance

Opinion

TAYLOR, P. J.

This appeal by the insurer from a judgment in favor of the widow of the insured for double indemnity death benefits presents a question of first impression in this state as to whether the exclusionary clause of the insurance policy issued by California-Western comes within the “prime or moving cause” rule of

Brooks

v.

Metropolitan Life Ins. Co.,

27 Cal.2d 305, 310 [163 P.2d 689], as the court below found. For the reasons set forth below, we have concluded that the judgment must be affirmed.

The matter was submitted to the court below as a question of law on stipulated facts as follows: the insured, who died on November 3, 1971, was a member of the State Bar of California, had been actively engaged in the practice of law and was insured under a group policy issued by the insurer. The pertinent portion of the policy provided double indemnity accidental death benefits if the insured dies as a result of accidental bodily injury, directly and independently of all other causes, within 90 days after the date of injuiy, but also stated that the benefit was not payable “... if death ... is contributed to by:

“(1) disease or bodily or mental infirmity . . . .” The court found the facts as follows:

At all pertinent times, the insured had hemophilia type 8, a congenital condition present since his birth. On October 30, 1971, the insured slipped and fell to the floor, an accidental occurrence. The bodily injuries sustained by the insured in his fall proximately caused a subdural bleeding that commenced at the time of the fall. This subdural bleeding, due to his preexisting condition of hemophilia, continued from the time of the fall until his death several days later. The subdural bleeding or subdural hemotoma was the direct and immediate cause of his death. If the preexisting condition of hemophilia type 8 did not exist, the accident and the resulting subdural bleeding alone would not have

[824]

caused the death of the insured. A person who did hot have hemophilia type 8 would not have died from the accident or from the subdural bleeding. In the absence of the accident, the insured would not have died from his preexisting condition of hemophilia.