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Jordan v. United Insurance Company of America

Court of Appeals of Georgia
May 13, 1981
281 S.E.2d 286 (Ga. Ct. App. 1981)

Summary

interpreting identical language

Summary of this case from Westbrook v. Safeco Life Ins. Co.

Opinion

61663.

DECIDED MAY 13, 1981.

Action on policy. Crawford Superior Court. Before Judge Morgan.

Franklin E. Remick, for appellant.

Wallace Miller III, for appellee.


Plaintiff-insured brought suit against defendant-insurer after its refusal to compensate plaintiff for the loss of his leg. Although we sympathize with plaintiff's suffering, we have no recourse but to affirm the judgment of the court below, granting defendant's motion for summary judgment.

In his complaint, plaintiff stated that on or about November 17, 1978, he fell and broke his leg, severely scraping and bruising his left foot, and that the amputation of his left leg was the result of complications arising from that injury. Plaintiff contended that the loss of his leg was covered under the terms of his policy with defendant.

That policy reads in pertinent part as follows: "United Insurance Company of America [defendant] . . . Does hereby insure the person named as the Insured [plaintiff] . . . against loss of life, limb or sight resulting solely from bodily injury received during the term of this policy and effected directly and independently of all other causes through bodily injury by accident. . ." (Emphasis supplied.)

On motion for summary judgment, defendant presented the expert opinion of plaintiff's physician that the loss of plaintiff's leg was attributable to arteriosclerotic occlusion (hardening of the arteries) — that there was no causal relationship between the gangrenous condition of plaintiff's left foot (which necessitated its amputation) and his fall and fracture of that foot. Plaintiff presented no evidence in rebuttal. We find that the defendant's uncontradicted evidence that plaintiff's loss did not result "solely from bodily injury . . . effected directly and independently of all other causes" mandates a verdict in its favor.

Even assuming, as plaintiff contends, that there was a causal relationship between the fracture of plaintiff's leg and its gangrenous condition, defendant presented uncontradicted evidence that independent diseases suffered by plaintiff were, at the very least, a contributing factor to the loss of his leg. Plaintiff's skeletal complaint alleging that "complications" from his fall led to the amputation of his leg does not address defendant's evidence that those complications were due to diseases suffered by the plaintiff. Since plaintiff did not rebut defendant's evidence with evidence that the gangrenous condition of his foot did "result solely from bodily injury" — that the fall and fracture were the direct and independent cause of the condition of his foot — plaintiff is precluded from recovering against the defendant under the terms of his policy with defendant. Compare Life Ins. Co. v. McDaniel, 141 Ga. App. 746, 747 ( 234 S.E.2d 379); United Ins. Co. v. Monroe, 115 Ga. App. 747 ( 156 S.E.2d 99); Metropolitan Life Ins. Co. v. Abbott, 118 Ga. App. 587 ( 164 S.E.2d 859).

Inasmuch as expert opinion testimony was essential to a determination of the causal factors in the gangrenous condition of plaintiff's leg, the expert testimony of plaintiff's attending physician was sufficient to support the grant of defendant's motion for summary judgment. Howard v. Walker, 242 Ga. 406 ( 249 S.E.2d 45).

Judgment affirmed. Birdsong and Sognier, JJ., concur.

DECIDED MAY 13, 1981.


Summaries of

Jordan v. United Insurance Company of America

Court of Appeals of Georgia
May 13, 1981
281 S.E.2d 286 (Ga. Ct. App. 1981)

interpreting identical language

Summary of this case from Westbrook v. Safeco Life Ins. Co.

In Jordan v. United Ins. Co., 158 Ga. App. 520 (281 S.E.2d 286) (1981), the exception was applied to a contract action against an insured for refusal to compensate the plaintiff for loss of a leg.

Summary of this case from Holley v. Smallwood

In Jordan v. United Ins. Co. of America, 158 Ga. App. 520 (281 S.E.2d 286) (1981), which involved a claim for specific member benefits for the loss of a leg by amputation following a fracture, the plaintiff's physician testified that the amputation had been necessitated by gangrene resulting from hardening of the arteries and that there was no causal relationship between the gangrene and the fracture.

Summary of this case from Colonial Life c. Ins. Co. v. Donaldson
Case details for

Jordan v. United Insurance Company of America

Case Details

Full title:JORDAN v. UNITED INSURANCE COMPANY OF AMERICA

Court:Court of Appeals of Georgia

Date published: May 13, 1981

Citations

281 S.E.2d 286 (Ga. Ct. App. 1981)
281 S.E.2d 286

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