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Cranfill v. Aetna Life Insurance Company4/9/2002
us is a question of law. Wynn v. Avemco Ins. Co., 1998 OK 75, , 963 P.2d 572, 575. The absence of an express definition of a word within the policy does not necessarily render the word ambiguous. Similarly, the fact that a word cannot be precisely defined to make clear its application in every factual situation does not mean the word is ambiguous. See, e.g, Allstate v. Humphrey, 229 A.2d 70 (Md. 1970). Rather, the test to be applied in determining whether a word is ambiguous is whether the word "is susceptible to two interpretations" on its face. Littlefield v. Sate Farm Fire and Cas. Co., 1993 OK 102, 857 P.2d 65, 69.
This test for ambiguity is applied from the standpoint of a reasonably prudent lay person, not from that of a lawyer. Couch on Insurance 3d §21:14 (1995). In our view the word accident is not, on its face, susceptible to two interpretations. A reasonably prudent lay person applying for accidental death insurance would understand what an accident is. Accordingly, we conclude the word accident as used in the policy is not ambiguous. Having made this determination, we must accept the word in its plain, ordinary and popular sense. McDonald v. Schreiner, 2001 OK 58, , 28 P.3d 574, 577.
In Willard v. Kelley, 1990 OK 127, 803 P.2d 1124, 1128-29, we described an accident as an event that is "unexpected, unintended and unforeseen in the eyes of the insured" and said that the standard to be used is that of a reasonable person appraising the event from the insured's perspective. Aetna, relying on this language in Willard, argues that since Mr. Cranfill's death was a reasonably foreseeable consequence of his driving while intoxicated, his death was not accidental.
We reject this argument. In the context of life and accident insurance, contract terms are not analyzed under the tort principle of foreseeability. Otherwise, deaths resulting from almost any high-risk driving activity would be excluded from coverage under an accident insurance policy (e.g., driving at an excessive speed, failing to keep a proper lookout, failing to maintain brakes in good condition, changing lanes without using a proper turn signal, floating a stop sign). If one applied tort principles, death from such high-risk activity could be said to be reasonably foreseeable.
Foreseeability has a more specific meaning in the context of life and accident insurance. It is only when the consequences of the act are so natural and probable as to be expected by any reasonable person that the result can be said to be so foreseeable as not to be accidental. See Mid-Continent Life Ins. Co. v. Davis, 1935 OK 1019, 51 P.2d 319 Syllabus by the Court ("Death of the insured is 'accidental' within policy where it is unexpected and not [the] probable result of his conduct."). The mere fact that an insured's death may have resulted from his or her own negligence, or even gross negligence, does not prevent that death from being accidental under the plain meaning of the word accident. Id. Syllabus by the Court .
Aetna asserts there is a split of authorities on this issue and further asserts that the majority of jurisdictions, as well as the more recent decisions, support its denial of Mrs. Cranfill's claim. As it turns out, the split is between the federal courts on one hand and state courts on the other. Aetna urges us to adopt the federal rationale that is used to resolve insurance disputes that are governed by ERISA. *fn4 We decline to do so for two reasons. First, federal courts are entirely free to choose the meaning that is to be given to the critical terms in contest (i.e., the word "accident" and the phrase "intentionally self-inflicted injury"). *fn5 We, in contrast, are bound by Oklahoma's common-
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