Thereby hangs Case 06-1150, now pending in the Supreme Court on a petition for appeal. The court ought to hear this case. It's time to review the legal meaning of "accidental" death.
The facts are not in dispute. As an employee of Ames True Temper Inc., Eckelberry had obtained an Accidental Death and Dismemberment policy from ReliaStar Life Insurance Co. The policy promised benefits if the insured died "due to an accident." The plan defined "accident" as "an unexpected and sudden event which the insured does not foresee."
Eckelberry had named his wife, Michele, as his beneficiary. She filed a timely claim for $86,000 for his "accidental" death. Remarkably, the plan vested final interpretation of ReliaStar's policy in ReliaStar. When an autopsy found a blood-alcohol level of 0.15 percent, ReliaStar, unremarkably, refused to pay. The company contended that the fatal accident was not, legally speaking, an accident at all: By drinking heavily, the driver knowingly had put himself at risk of serious injury or death. Therefore, his injuries could not have been "unexpected."
Mrs. Eckelberry's suit wound up in federal court under the Employee Retirement Income Security Act (ERISA). There, U.S. District Judge Robert Goodwin found in her favor, but last November a panel of the U.S. Court of Appeals for the fourth Circuit reversed. Speaking through Judge J. Harvie Wilkinson, the court held that ReliaStar's decision was "not unreasonable." We will know in a few weeks if the high court will hear the widow's appeal.
In their petition to the high court, her attorneys make a persuasive case for the Supremes' fresh consideration of the meaning of "accident." They cite to cases in nine states since 1961 in which state courts have ruled that death as a consequence of drunk driving is "accidental." The states are Alabama, Georgia, Kentucky, Maryland, New Jersey, North Carolina, Oklahoma, Tennessee and Texas.
Standard dictionaries are not much help to the plaintiff. True, the lexicographers agree that an "accident" is simply "an unforeseen and unplanned event that results from chance rather than from design." But an accident is also "an unfortunate event resulting esp. from carelessness or ignorance." It is "an unexpected happening causing loss or injury which is not due to any fault or misconduct on the part of the person injured but for which legal relief may be sought."
For good or ill, ReliaStar itself has defined an "accident" differently. Under its policy in this case, an accident is "an unexpected and sudden event which the insured does not foresee." Surely it is beyond question that the fatal accident that night in West Virginia was sudden, unexpected and unforeseen.
That was not enough for the fourth Circuit. The test, said Judge Wilkinson, citing a case in his circuit eight years ago, is tougher. It is "whether a reasonable person, with background and characteristics similar to the insured, would have viewed the injury as highly likely to occur as a result of the insured's intentional conduct." Opinions in federal courts in Wisconsin, Rhode Island, Alabama, Michigan, Florida and Tennessee [BUT ALABAMA AND TENNESSEE ARE LISTED ABOVE AS STATES THAT HAVE RULED THAT DEATH AS CONSEQUENCE OF DRUNK DRIVING IS ACCIDENTAL] are to the same effect: "All drivers know, or should know, the dire consequences of drunk driving." A death under these circumstances "is not an 'accident' because that result is reasonably foreseeable." It follows inexorably that the $86,000 death benefit will not be paid.
Wilkinson expressed sympathy for the widow: "We in no sense intend to make light of the loss that she has suffered." The court was simply confirming as a matter of law that the insurance company's ruling was a reasonable one under the policy.
"The undisputed facts," said the court, "go a long way toward establishing that Eckelberry's death was not 'accidental.' The insured's conduct went beyond the careless and imprudent. Under the circumstances here, we think it was reasonable for ReliaStar to conclude that because the insured 'put himself in a position in which he should have known that serious injury or death could occur,' his death was not 'unexpected.'"
Judge Wilkinson's opinion in the fourth Circuit runs in opposition to an opinion just two years ago in the eighth Circuit in King v. Hartford Life and Accident Insurance. The ninth Circuit also has indicated that "accidental" deaths may be covered under ERISA. It's an issue that merits Supreme Court review.
(Letters to Mr. Kilpatrick should be sent by e-mail to kilpatjj@aol.com.)
COPYRIGHT 2005 UNIVERSAL PRESS SYNDICATE
This feature may not be reproduced or distributed electronically, in print or otherwise without the written permission of uclick and Universal Press Syndicate.
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