MH Prevails in California AD&D Case
Oakland, CA – In August 2021 and after a nearly two-year court battle, MH obtained a summary judgment in favor of the firm’s life insurance client in a case seeking accidental death benefits under a group policy governed by ERISA.
This protracted litigation commenced in Kentucky state court, was removed to federal court in Kentucky and then transferred to the United States District Court for the Northern District of California. In California, the district court ultimately denied plaintiff’s motion for summary judgment and granted the insurer’s cross-motion. The court held the insurer did not abuse its discretion in determining the insured’s death, which resulted from a prescription drug overdose, did not meet the policy’s definition of accidental death, which required the death result from a bodily injury “evidenced by a visible wound or contusion.”
Importantly, the district court also confirmed that California Insurance Code Section 10110.6, by its terms, applies only to California residents and enforced the plan’s grant of discretion. After entry of judgment in favor of the insurer, MH pursued a fee recovery under the provisions of ERISA which resolved with the plaintiff waiving all appeal rights.
Originally Published on September 14, 2021