Stennett & Casino

Accidental Death Benefits Denied By MetLife Because Insured Was Drinking and Driving

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? Metropolitan Life Insurance Company recently denied a widow life insurance benefits when her husband died in a single car accident while driving home from his brother’s house. Met Life claimed that since decedent had been drinking beer before driving that the accident was not an accident under the law.

Met life interpreted “accident” to mean “not reasonably foreseeable.” Met Life claimed that it was reasonably foreseeable that one would become involved in a serious accident when combining drinking with driving. Thus since the accident was reasonably foreseeable it was not an accident under the law. Met Life cited court decisions from Illinois (Cozzie v. Metropolitan Life, 140 F.3d 1104 (7th Cir. 1998)) and Wisconsin (Weatherall v. ReliaStar Life Insurance 398 F.Supp.2d 918 (W.D.Wis. 2005)) to support its position.

Fortunately, the auto accident occurred in California. In California, the courts recognize that accident insurance is purchased to protect insureds from their own miscalculations, misjudgements and careless conduct. Thus, California courts interpret the term accident to include accidents where the insured did not perceive the resulting death or injury to be a “substantially certain result of his conduct.” (Padfield v. AIG Life, 290 F.3d 1121 (9th Cir. 2002)). The widow retained the law firm of Stennett & Casino who are attorneys experienced in handling life insurance and accidental death benefit claims. They pointed out the difference between Illinois and California law, and presented Department of Transportation statistics that illustrated that there is a less than 1% correlation between drinking and highway deaths. Since most drivers do not believe that combining drinking with driving is “substantially certain” to result in death then (at least in California) a resulting accident is an accident.

The widow in this case prevailed once the law was persuasively pointed out to Met Life. The accidental death benefits were paid.

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