Where an insured's death was caused by a car accident rather than a seizure that may have contributed to the accident, MetLife was required to pay accidental death benefits the United States Court of Appeals for the Tenth Circuit has ruled in Kellogg v MetLife, No. 07-4213 (10th Cir. December 4, 2008).
The insured's van suddenly careened out of control and crashed into a tree. Despite wearing a seat belt, the driver, Brad Kellogg, suffered severe head injuries from blunt trauma and died. The coroner did an autopsy and concluded that it was an accidental death. MetLife denied the claim for accidental death benefits, asserting that medications the driver was taking had caused a seizure, which, in turn, caused him to lose control of the vehicle, crash and die from the crash. Since the medications were for a physical illness, MetLife argued that benefits were not payable because death from physical illness was excluded from coverage.
The court rejected MetLife's argument, noting that insurance policies must be construed against the insurance company and that numerous courts had rejected MetLife's position. Therefore, the court ruled that benefits must be paid because the insurance policy "does not contain an exclusion for losses due to accidents that were caused by physical illness, but rather excludes only losses caused by physical illness."
Robert L. Abell
