Case Law Watch

ERISAMetropolitan Life Insurance v. Parker
(Arizona Ninth Circuit Court, Feb. 2, 2006)
Ruling: At issue in this case was that although the insurer declared that it owed various proceeds under an Employee Retirement Income Security Act (ERISA)-governed life insurance policy, it could not identify the proper beneficiary. Therefore, it filed an interpleader action. The Ninth Circuit Court narrowed the field of beneficiaries from three to two, and remanded the case to the district court for further findings. The court noted that “[t]his is a cautionary tale for ERISA administrators.”

Life, Health and DisabilityCertain Underwriters
at Lloyd’s London v. Rychel
(Colorado Appeals Court, Division II, Jan. 23, 2006)
Ruling: In this dispute, an insured hockey player who acted as “enforcer” of the team claimed disability benefits under a professional athlete disability insurance policy as a result of injuries sustained during a fight in hockey game. The insurer brought declaratory judgment action seeking a determination that the insured was not covered for the subject loss.

The trial court granted summary judgment to the insurer and held that the injury did not occur as a result of an “unexpected event” because the insured intentionally engaged in a fight, i.e., there was no accident within the definition of the policy. The policy defined “‘accident” as a “single sudden and unexpected event that occurs at an identifiable time and place, and which causes unexpected bodily injury at the time it occurs.”

On appeal, the insured argued that the injury occurred not when he was punching his adversary but when his hand inadvertently got caught in the fabric of his opponent’s sweater. As such, from the insured’s point of view, this was an unexpected event and should have been sufficient to create an issue of fact to deny the summary judgment motion. Also, the insured argued that the relevant “unexpected” event must be measured from the precise moment when his hand was injured.

The appellate court disagreed and in affirming the trial court, it held that the reasonable interpretation of the phrase “sudden and unexpected event” refers to the “precipitating event” without which the injury would not have occurred. In this case, that precipitating event was the fight between the players. Thus, the insured’s narrow interpretation was flatly rejected.

Workers’ CompensationOttesen v. Food Services of America Inc.
(Washington Appeals Court, Jan. 24, 2006)
Ruling: The trial court had granted summary judgment to the widow of an employee that had been struck and killed by a truck owned by the employee. At the time of the accident, the deceased plaintiff was working in a “mixed use” parking lot. The Appellate Court held “[b]ecause the uncontradicted evidence was that there were both job activities and employee parking in the staging yard (i.e. a mixed use area).” Therefore, the exclusivity provisions of the workers’ compensation law did not bar recovery.

Goldberg Segalla LLP is a best practices law firm with offices in Buffalo, Rochester, Albany, White Plains and New York. Kevin T. Merriman, a partner with the firm, compiled this information. Copyright 2006 Goldberg Segalla LLP, all rights reserved.

Topics Lawsuits