The U.S. Court of Appeals for the Fifth Circuit has affirmed a district court's decision denying coverage under an accidental death and dismemberment ("AD&D") group policy that excluded coverage for a death caused directly or indirectly by "self-inflicted injury" or "suicide."
The Case
Jason Freeman's 17-year-old son died instantly when he pulled the trigger of a revolver, the barrel of which he had inserted in his mouth immediately after he had spun the gun's cylinder and twirled the gun around his finger.
Shortly after Mr. Freeman's son's death, it was determined that the revolver had had only one cartridge in the cylinder – an apparent incident of Russian Roulette.
The deputy medical examiner of Bexar County, Texas, concluded that the manner of Mr. Freeman's son's death was suicide.
At the time of his son's death, Mr. Freeman was employed by Kohl's Department Stores, which maintained a group AD&D policy issued by Securian Life Insurance Company. Mr. Freeman's son was covered under the AD&D policy as his dependent.
The AD&D policy was maintained by Kohl's in accordance with the Employee Retirement Income Security Act of 1974 ("ERISA"). Under the policy and ERISA, Securian had the exclusive right and sole discretion to interpret the policy's terms. Securian's exercise of such discretionary authority of interpretation was conclusive and binding on all persons "unless it [could] be shown that the determination was arbitrary and capricious."
Securian denied Mr. Freeman's claim under the AD&D policy, which excluded coverage for death "caused directly or indirectly by . . . (1) self-inflicted injury . . .; or (2) suicide. . . ."
Mr. Freeman sued, and the parties moved for summary judgment.
The U.S. District Court for the Western District of Texas granted Securian's motion, and Mr. Freeman appealed.
The Fifth Circuit's Decision
The Fifth Circuit affirmed.
In its decision, the circuit court agreed with the district court that, regardless of the fact that Mr. Freeman's son's death was classified as a suicide by the medical examiner, his death was excluded from coverage under the AD&D policy.
The circuit court reasoned that suicide was "one of two disjunctive causes of death" excluded from coverage under the AD&D policy; the other was "self-inflicted injury."
Because Mr. Freeman's son's death was "irrefutably the result of his self-inflicted injury," the circuit court concluded, Securian's exclusion of his death from coverage under the AD&D policy was not arbitrary and capricious.
The case is Freeman v. Securian Life Ins. Co., No. 18- 51078 (5th Cir. Oct. 1, 2019).
Steven A. Meyerowitz
Steven A. Meyerowitz, a Harvard Law School graduate, is the founder and president of Meyerowitz Communications Inc., a law firm marketing communications consulting company. He may be contacted at [email protected].