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Posts tagged "accidental death insurance"

Medical complications and accidental death insurance

DeBofsky, Sherman & Casciari, PC recently won an important accidental death insurance case in the U.S. Court of Appeals - Prather v. Sun Life and Health Insurance Company, 2016 WL 7232144 (7th Cir. December 13, 2016) - /Cases/Prather-v-Sun-Life.pdf.   The case was brought on behalf of Lee Ann Prather, the widow of Jeremy Prather, who died at age 31 of a pulmonary embolism due to a deep vein thrombosis after undergoing surgery to repair his Achilles tendon which he ruptured while playing basketball.   Mrs. Prather brought a claim for accidental death insurance under a group policy issued to Jeremy's employer for the benefit of its employees.  However, the claim was denied based on coverage that was limited to "bodily injuries ... that result directly from an accident and independently of all other causes." (emphasis added).  The insurer maintained that Jeremy Prather's death was due to "complications from surgical treatment" and the district court upheld that finding.  The court of appeals reversed and awarded benefits to Lee Ann Prather.  

Is A Death Due to a Pulmonary Embolism Suffered on Account of Airplane Travel "Accidental"?

That question was answered in the affirmative in Yasko v. Reliance Standard Life Ins.Co., 2014 U.S.Dist.LEXIS 88469 (N.D.Ill. June 30, 2014), a case involving accidental death insurance that was litigated by DeBofsky, Sherman & Casciari.  See, /DeBofsky-Associates-Receives-Favorable-Ruling-in-Accidental-Death-Insurance-Case.shtml.  Alan Yasko, a physician, died of a pulmonary embolism shortly after flying from Chicago to a medical conference in Mexico after a brief stopover in Houston.  Following his death, a claim was submitted to Reliance Standard Life Insurance Company for accidental death insurance; however, Reliance denied that Dr. Yasko's death was accidental and also claimed that prior medical treatment was a contributing cause of death.  The court rejected both claims. 

Can a Law Banning Discretionary Clauses Apply to An Even Occurring Prior to the Legislative Enactment?

In Cerone v. Reliance Standard Life Ins.Co., 2014 U.S.Dist.LEXIS 46529 (S.D.Cal. March 28, 2014), after the plaintiff's accidental death claim based on the death of her husband was denied and her appeal exhausted, Debra Cerone filed suit against Reliance Standard Life Insurance Company. The issue decided in this opinion was whether the de novo or abuse of discretion standard of review applied.

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