The death of a Minnesota man who crashed his motorcycle while drunk fits the definition of an "accident" and not an "intentionally self-inflicted injury" under his employer's insurance policy, the Eighth U.S. Circuit Court of Appeals ruled Feb. 9.
"The undisputed evidence showed that [Martin] Schanus fully intended to survive his ride home," Judge Myron H. Bright wrote for the three-judge panel in King v. Hartford Life & Accident Insurance Co. (02-3934).
The facts showed Schanus left a bar in the early hours of June 10, 2000, got onto his motorcycle and drove it away without putting on a helmet. He crashed while driving around a curve too fast and died when he was thrown into a fence. His blood alcohol level tested at 0.19 percent, well above the legal level for intoxication.
Hartford paid general insurance benefits equal to 150 percent of his salary to his daughter, as called for by the policy, but balked when Alane King, the conservator for the daughter, claimed double indemnity benefits.
The policy didn't define "accident" and expressly excluded coverage for "any intentionally self-inflicted injury, suicide or suicide attempt, whether sane or insane."
Hartford quoted Black's Law Dictionary, which defined "accident" as "happening by chance, or unexpectedly; taking place not according to the usual course of things; casual, fortuitous."
The company said it its view, Schanus's intentional decision to drink and drive rendered the crash predictable.
King appealed the decision to federal court in Minnesota under the Employee Retirement Income Security Act.
Hartford, the administrator of the ERISA plan, cited a 1990 First Circuit precedent, Wickman v. Northwestern National Insurance Co., which involved a man who climbed over a guardrail on a high bridge, dangled by one hand from the ledge and then fell to the railroad tracks below. The First Circuit affirmed denial of coverage in that case.
In the Schanus case, the district judge accepted Hartford's theory that his death was the foreseeable result of driving while drunk.
The Eighth Circuit disagreed.
Bright said the panel agreed with the Wickman court that an act falls outside policy coverage when a reasonable person would have viewed injury as a "highly likely" result.
But in the Schanus case, Bright pointed out, counsel for his daughter had presented statistical evidence that deaths only rarely result from drunk driving, and "no evidence suggests that Schanus subjectively understood his risk of dying; his undisputed purpose in driving drunk was to reach his home safely."
The panel also rejected Hartford's alternative argument that Schanus's intoxication itself was a self-inflicted injury that contributed to his death.
"Because a court or plan administrator must construe policy terms as a lay person would understand them," Bright wrote, "we reject as unreasonable Hartford's contention that the term 'injury' includes the intoxication itself, which happens to result in a fatal crash."




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