StennetNews

November 19th, 2013

Our client’s husband died after falling and hitting his head on their back patio.  The trauma caused a subdural hematoma which became mortal in less than four hours.  The death certificate classified the death as “accidental.”  The “immediate cause” of death was listed as “subdural hemorrhaging from blunt force injury to head” and a “contributing condition” was listed as “thrombocytopenia.”

Client submitted a claim to UNUM Insurance Company for benefits under an accidental death policy.  UNUM denied the claim based on a limitation in the policy that excludes coverage for accidental losses “caused by, contributed to by,  or resulting from diseases of the body.”  The disease cited by UNUM was thrombocytopenia, which was most likely a consequence of decedent’s recent bone marrow transplant performed as treatment for his carcinoma.   Thrombocytopenia is a condition that results in excessive bleeding, which UNUM asserted substantially contributed to the subdural bleeding resulting in death.

Stennett & Casino obtained a statement from the medical examiner’s office that supported their client’s position.  In effect, the medical examiner stated that though decedent’s condition of thrombocytopenia may have contributed to the bleeding there was no evidence with which one could say that decedent would have survived the fall in the absence of the thrombocytopenia.  Despite this evidence UNUM continued its denials.  Stennett & Casino filed suit on behalf of their client which resulted in a settlement of the claim.

April 28th, 2010

The client’s husband died in an auto accident when a faulty gas tank ruptured and fire engulfed his car.  The insurance company refused to pay her the accidental death benefits because of an exclusion in the policy for losses occurring when one is driving while under the influence of an intoxicant.  Here, an autopsy found morphine in the deceased husband’s blood.
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April 28th, 2010

Our client’s son died as a result of an accidental drug overdose.  The father was the beneficiary on the accidental death insurance policy.  Insurance company refused to pay the benefits claiming that the death was not “accidental.”  The question came down to whether it was reasonably foreseeable that one would die as a result of taking illegal drugs (in this case heroin).  Read more

April 28th, 2010

The 59-year-old mother of our client died of an accidental overdose of her pain medication, Oxycodone. The mother was insured with an accidental death policy; however, our client’s claim for benefits following her mother’s death was denied.
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April 28th, 2010

An accidental death insurance policy will pay benefits when the insured dies as a result of an accident.  But when the insured dies in an auto accident with a high blood alcohol rate – is that an accident?  That was the issue in a recent case we handled in which our client’s husband died in a single car accident while driving home from his brother’s house after having a few beers.  The insurance company argued that since the husband had intentionally consumed alcohol and intentionally driven home knowing he was drunk and knowing the dangers of drinking and driving, that his resulting accident was not accidental.
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