Insurance Law

9th Circuit Holds No Coverage for DVT Under Employee Death Benefit Policy

In Williams v. National Union Fire Insurance Company of Pittsburgh, PA, 2015 U.S. App. LEXIS 11642 (9th Cir. July 7, 2015), [subscribers can access an enhanced version of this opinion: lexis.com | Lexis Advance], the Ninth Circuit Court of Appeals, applying California law, had the opportunity to consider whether a death from deep vein thrombosis (“DVT”) attributed to prolonged air travel was caused by an “accident external to the body” as required by an accidental death benefit policy.

DVT is a known hazard of long flights. In October 2010, decedent Jack Williams (“Williams”) had flown more than 15 hours from Los Angeles to Tokyo, and shortly thereafter took three additional flights, totaling almost 13 hours, from Tokyo to several Australian cities. On October 18, 2010, Williams died from DVT, which had triggered a pulmonary embolism.

Williams’ was insured under a policy that provided a $1 million death benefit for injury during air travel. The policy defined injury in part to mean bodily injury “which is sustained as a direct result of an unintended, unanticipated accident that is external to the body….” Williams’ survivors made a claim, which was denied by the insurer on the basis that Williams’ death was not the direct result of an accident external to the body, but instead the result of “an internal reaction of his body to an extended period of inactivity.” Williams’ survivors sued the insurer, arguing that Williams’ death was accidental as unintended, unexpected, and caused by prolonged sitting on planes – which was “external to the body.” Both sides moved for summary judgment, and the trial court ruled in favor of the insurer, finding that the DVT was not within the ordinary and common meaning of “accident.”

The Court of Appeals affirmed the lower court ruling, reasoning that although the confined seating may have been an external cause of death, there was nothing accidental about Williams’ seating arrangement, nor did he encounter any unusual circumstances that aggravated the impact of the prolonged seating.   The Court of Appeals stated that:

In ordinary parlance, an ‘accident’ connotes an unintended, unexpected happening that may cause injury or damage to persons or property. In other words, as popularly understood, an accident is an unexpected occurrence separate from the harm that results from it. Williams’ death does not fit that mold.

    Brian Margolies, Partner, Traub Lieberman Straus & Shrewsberry LLP

Read more at the Traub Lieberman Insurance Law Blog, Edited by Brian Margolies.

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