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Ruiz v. Monumental General Ins. Co.2/18/1992
Rehearing Denied March 24, 1992.
Certiorari Denied September 10, 1992
ELIAS RUIZ, APPELLANT,
v.
MONUMENTAL GENERAL INSURANCE COMPANY, INC., APPELLEE.
Appeal from the District Court of Oklahoma County; Jack Parr, Judge.
Mike McNulty, Mark T. Koss, Oklahoma City, for appellant.
Mary S. Robertson, Oklahoma City, for appellee.
REVERSED AND REMANDED.
MEMORANDUM OPINION
The opinion of the court was delivered by: HANSEN, Vice Chief Judge.
Elias Ruiz (Ruiz) appeals from an order of the trial court granting summary judgment in favor of Appellee (Monumental). The matter below, as well as on appeal, turns on a single question - whether a disability resulting from carpal tunnel syndrome may be defined as an accidental injury under Oklahoma law, as it pertains to an "accident disability income policy".
Ruiz was the insured, and Monumental the insurer, under such an insurance policy. Monumental was to pay Ruiz monthly benefits if he became totally disabled due to injury while the policy was in force. The policy defined "injury" as an:
. . . accidental bodily injury that occurs while this policy is in force.
Ruiz filed his disability claim with Monumental, reflecting carpal tunnel syndrome as the cause of disability. The portion of the claim form requesting the date on which disability commenced was left blank; however, in the "history" portion of the form, Ruiz noted symptoms related to the disability began in November 1988, and the date he ceased work because of the disability was May 19, 1989. Monumental denied the claim, stating in its denial letter benefits were not payable because the "disability was not accident related". Ruiz then filed this action to recover benefits.
Monumental moved for summary judgment. Included in the statement of uncontroverted facts supporting the motion was that Ruiz had filed a claim in Workers' Compensation Court, and that the stated cause of the employment related accident was cumulative trauma, resulting from "repetitive use of hands in removing cold dairy products and stocking stores". Monumental argued the bodily effect of cumulative trauma is not an "accident" as defined under insurance law in Oklahoma. It therefore asserted it was entitled to judgment as a matter of law.
In his response to the motion for summary judgment, Ruiz adopted Monumental's statement of uncontroverted facts, adding only the finding from the Workers' Compensation Court order that "on May 19, 1989 claimant (Ruiz) sustained an accidental personal injury the right hand and left hand". Ruiz contended that in a cumulative trauma injury, there is a "last trauma" which is the disabling factor. Ruiz argued the evidentiary material showed the date of that last trauma to be May 19, 1989, the date he was no longer able to work.
The trial court found, without specific findings, there was no substantial controversy as to any material fact, and entered judgment in favor of Monumental. Ruiz appeals from that judgment.
In reviewing a trial court order granting a motion for summary judgment, we will examine the pleadings and evidence to determine what facts are material to the cause of action, and to further determine whether the evidentiary materials introduced indicate whether there is a substantial controversy as to any material fact. Where no substantial controversy exists, summary judgment is proper. All inferences and conclusions drawn from the facts presented i
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