Reed v. Mutual Benefit Health & Accident Ass'n
Reed v. Mutual Benefit Health & Accident Ass'n
Opinion of the Court
Plaintiff sues on a group health and accident insurance policy as named beneficiary. It insured a group of Branch county officials and employees, styled in the policy as the “Branch County Clerk G-roup,” including plaintiff’s son, a deputy sheriff. The claim is for his accidental death. Prom judgment for plaintiff defendant appeals.
The policy required that defendant be given immediate notice of the accidental death of an insured. Such notice was given here by the county clerk, who paid the premiums on the policy through his office. Admitting this, defendant contends that it is not liable because of plaintiff’s noncompliance with the policy’s statutory provision that written proof of
The conclusion is inescapable that during the 90-day period defendant had all the material information and was enabled to take all the steps which would have been available to it- had plaintiff furnished, within that period, “written proof covering the occurrence, character and . extent of the loss.” The evidence does not clearly preponderate against the finding evidently made by the trial court, sitting without a jury, that plaintiff had no knowledge of the existence of thé policy or her rights under it until after the 90 days had run, that this was not dire to negligence or fault oh her part, and that she was not bound by the knowledge of the county clerk because he had not been her agent. Accordingly, her failure to give immediate notice of insured’s accidental death is excused under our holding in Rogers v. Great Northern Life Insurance Co., 284 Mich 660, which involved the same policy provisions here considered. We think the reasoning in that case equally applicable to the requirement for furnishing proof of loss. Once plaintiff had knowledge of the policy, she proceeded with dispatch, through her attorney. With equal promptness defendant advised her attorney of its denial of liability for failure to file proof of loss within the 90-day period. That waived any possible, remaining requirement that plaintiff furnish proof of loss after she learned
Defendant also seeks reversal on the ground of plaintiff’s failure to prove the death accidental. Plaintiff proved that a companion shot insured twice in the back of the head, as a result of which he after-wards died. The companion, hereinafter called witness, testified that he was 16 years old at the time of shooting insured, an older man; that insured had been making indecent advances to him over a long period of time, accompanied by threats of violence if resisted; that on the night in question insured had threatened witness’s life and that he was in extreme fear and shot in self-defense; that witness first shot insured in the back of his head while they were seated in insured’s parked automobile and while insured was bending forward to fix the heater; that witness then jumped out of the automobile and ran into the night for a distance of 40 or 50 feet; that he concluded that he was an easy target for insured and, therefore, walked back to the automobile in order to be shielded by its body; that he looked into the driver’s window and saw insured slumped over in the seat with his hands on the floor; that witness then opened the door and one of insured’s hands went to the floor a little more; that witness then jumped into the car with one knee on the seat and fired a second shot into the back of insured’s head. Insured died later that same night in a hospital. Defendant relies on Peterson v. Aetna Life Insurance Co., 292 Mich 531, holding that within the meaning of an accident policy an insured’s death resulting from intentional homicide is not accidental when culpably provoked by insured and the result of his own misconduct. Plaintiff, in turn, cites Furbush v. Maryland Casualty Co., 131 Mich 234 (100 Am St
Affirmed, with costs to plaintiff.
Reference
- Full Case Name
- REED v. MUTUAL BENEFIT HEALTH & ACCIDENT ASSOCIATION
- Cited By
- 7 cases
- Status
- Published