A horticulturist who died from a cardiac event triggered by extensive air travel didn't suffer an “accidental” death that would entitle his widow to benefits, the U.S. Court of Appeals for the Ninth Circuit ruled (Williams v. Nat'l Union Fire Ins. Co. of Pittsburgh, PA, 2015 BL 216000, 9th Cir., No. 13-55719, 7/7/15).
In a July 7 opinion, the court reasoned that the ordinary activity of sitting on a plane for extended periods didn't constitute an “unintended, unexpected accident that is external to the body” under the relevant accidental death benefits plan insured by National Union Fire Insurance Co. of Pittsburgh, PA.
Following the lead of other federal courts that have considered air-travel-related deaths in the context of benefit claims, the Ninth Circuit said that cases decided under the Warsaw Convention are “tangentially relevant” to disputes brought under an Employee Retirement Income Security Act-governed plan.
Air Travel Cases
In recent years, several federal courts have grappled with the extent to which air-travel-related deaths caused by deep vein thrombosis and pulmonary embolisms qualify as accidental deaths under ERISA-governed benefit plans.
In the typical case—including this one against National Union—a plan participant's extended air travel will cause the otherwise healthy participant to experience deep vein thrombosis, which ultimately leads to a fatal pulmonary embolism. The participant's beneficiary then argues that the death was an “accident” entitling him or her to benefits under the relevant accidental death benefits plan.
In two recent cases involving the same participant and different insurance companies, the U.S. District Court for the Northern District of Illinois issued seemingly contradictory opinions that varied based on the relevant standard of review.
Specifically, the Illinois court upheld Standard Insurance Co.'s decision denying $1.2 million in accidental death benefits after finding that a plan participant's air travel was a “normal activity” that didn't satisfy the policy's definition of accident (Yasko v. Standard Ins. Co., 2014 BL 137892, 58 EBC 1725 (N.D. Ill. 2014)).
One month later, the Illinois court ruled against Reliance Standard Life Insurance Co., explaining that the insurer's decision was subject to de novo judicial review while Standard enjoyed the benefit of judicial deference (Yasko v. Reliance Standard Life Ins. Co., 53 F.Supp.3d 1059, 58 EBC 2587 (N.D. Ill. 2014)).
In both decisions, the court looked to case law developed under the Warsaw Convention for guidance in defining the term “accident.”
Excerpted from a story that ran in Pension & Benefits Daily (07/07/2015).
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