Dolores Ayres v. The Prudential Insurance Company of America

This is an appeal from a summary judgment granted by the district court in favor of appellee. The district court exercised jurisdiction pursuant to 28 U.S.C. § 1332 . We have jurisdiction of this appeal under 28 U.S.C. § 1291 .

Prudential Insurance Company of America (“Prudential”), appellant here and the defendant below, issued Group Insurance Policy No. G-91550 to Getty Oil Company (“Getty”) covering Getty’s employees with life insurance and accidental death insurance. The group policy insured Getty employee Dan Ayres, now deceased, by way of two certificates of insurance. The certificates named Dan Ayres’ wife, Dolores Ayres, appellee here and plaintiff below, as Dan Ayres’ beneficiary.

Dan Ayres died in the crash of a private airplane he was piloting. Prudential paid $36,500.00 to Dolores Ayres under the regular life insurance portion of his certificate of insurance, but refused to pay under the portion which provided coverage for accidental death. Prudential contends that the following limiting provisions, found in the accidental death portions of the policy and certificates, exclude Dan Ayres from accidental death coverage:

Prudential refused payment for accidental death…

dissenting:

I am unable to concur in the opinion of my brothers because I am convinced that the district court properly interpreted the contract in the light of the California cases that are the controlling law in this diversity case.

The key provision is the exclusion clause, providing, in relevant part:

The decedent was not performing any duties aboard the aircraft connected with his employment. Prudential refused payment citing the exclusion clause and contended that the exclusion was - applicable because the decedent, as a pilot, had “duties” relating to the aircraft or its operation. The district court decided that the exclusion clause “is ambiguous because the word ‘duties’ included therein, used in conjunction with ‘Employee,’ may be interpreted reasonably to mean either employment-related duties or any duties relating to the aircraft, whether employment-related or not.” Accordingly, the district court resolved the ambiguity against the insurer and granted summary judgment to the plaintiff.

The majority opinion overturns the district court on the grounds that the policy language was unambiguous and the plaintiff’s interpretation of the policy “unreasonable” because (1)…

602 F.2d 1309 Dolores AYRES, Plaintiff-Appellee, v. The PRUDENTIAL INSURANCE COMPANY OF AMERICA, Defendant-Appellant. No. 77-1761. United States Court of Appeals, Ninth Circuit. May 23, 1979. Rehearing Denied Sept. 12, 1979. 1 Donald B. York, Adams, Duque & Hazeltine, James S. Cline, Los Angeles, Cal., for defendant-appellant. 2 Martin J. Schnitzer, Los Angeles, Cal., for plaintiff-appellee. 3 Appeal from the United States District Court for the Central District of California. 4 Before HUFSTEDLER and TRASK, Circuit Judges, and McNICHOLS, * District Judge. 5 McNICHOLS, District Judge. 6 This is an appeal from a summary judgment granted by the district court in favor of appellee. The district court exercised jurisdiction pursuant to 28 U.S.C. § 1332 . We have jurisdiction of this appeal under 28 U.S.C. § 1291 . 7 Prudential Insurance Company of America ("Prudential"), appellant here and the defendant below, issued Group Insurance Policy No. G-91550 to Getty Oil Company ("Getty") covering Getty's employees with life insurance and accidental death insurance. The group policy insured Getty employee Dan Ayres, now deceased, by way of two certificates of insurance. The…