- Amount
- $597,000 (AD&D benefits awarded to our clients by judgment, plus interest)
- Counsel
- Interpleader Law
- Result for
- The insured's wife and two adult children, the named beneficiaries, our clients
- Case
- Murchison v. Reliance Standard Life Insurance Co.
- Court
- U.S. District Court, Western District of Tennessee
- Docket
- No. 1:19-cv-01028-JDB-jay
- Decided
- May 28, 2020
- Issue
- Whether an AD&D alcohol and drug exclusion applied when nothing in the record showed intoxication contributed to the accident
The insured had accidental death and dismemberment coverage through his employer, under policies that excluded losses to which alcoholic intoxication or the use of certain drugs was a contributing factor. He died after the ATV he was riding rolled down a creek bank. His toxicology showed alcohol and a pain medication, and the insurer denied the claim, saying both contributed to the accident.
We represented his wife and adult children, the named beneficiaries, through the plan appeal and in federal court under ERISA. The investigating officer could not confirm that alcohol or medication played a role, and the insurer’s own reviewing pathologist declined to say they contributed. The court held that the denial was arbitrary and capricious, reversed it, and entered judgment for our clients for the full benefit plus interest.
What it shows. Under a “contributing factor” exclusion, the insurer has to show that intoxication actually contributed to the loss. A blood alcohol number alone is not enough.
Read the court's order
- Order reversing the denial and granting judgment on the record (ECF No. 29, Apr. 23, 2020), GovInfo (PDF)
Past results do not guarantee a similar outcome. This summary describes the court's ruling; it is not legal advice about any other case.
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