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March 2018 Archives

Is Death Resulting from Autoerotic Asphyxiation "Accidental"?

Anecdotally, the most litigated accidental death insurance claims involve drunk driving. The next most prevalent type of litigated accidental death claim are cases involving autoerotic asphyxiation. The recent ruling in Tran v. Minnesota Life Ins. Co., 2018 WL 1156326 (N.D. Ill. March 5, 2018) was one such case.

The 5th Circuit Finally Gets De Novo Review Right (Somewhat)

In Ariana M v. Humana Health Plan of Texas, Inc., 2018 WL 1096980 (5th Cir. March 1, 2018), a divided Fifth Circuit issued an en banc ruling that fiinally overturned Pierre v. Conn. Gen. Life Ins. Co., 932 F.2d 1552 (5th Cir. 1991) and concurred with every other Circuit that Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989) applies the default de novo standard of judicial review to both legal and factual determinations, thus paving the way for the Texas ban on discretionary clauses (TEX. INS. CODE § 1701.062(a), along with similar bans by 25 other states - Nat'l Ass'n of Ins. Comm'rs, Prohibition on the Use of Discretionary Clauses Model Act ST-42-3-6 (2014), http://www.naic.org/store/free/MDL-42.pdf.) to trigger de novo review of benefit denials of health and disability benefit claims.

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