The 7th U.S. Circuit Court of Appeals recently held that a death resulting from an intentionally self-inflicted injury was excluded from coverage under its insurance policy. A man had strangled himself while performing autoerotic asphyxiation, the act of intentionally cutting off oxygen to the brain for sexual pleasure. A medical examiner had determined the cause of death was accidental.
At the time of his death, the man had basic life and supplemental life insurance coverage under two group policies. He also had accidental death coverage under riders to the policies. The insurance company had paid $500,000+ under the life coverage, but denied the claim for an additional $60,000 under the riders. The man’s wife sued under the Employee Retirement Income Security Act, and the U.S. District Court ruled that the death was accidental under the terms of the riders. However, the 7th Circuit majority overturned that ruling.
The court looked at the plain meaning of the word “injury” and that an ordinary person would consider choking oneself by hanging from a noose to be an injury. “Some people enjoy harming themselves, the harm is still an injury, regardless of how popular it is or the pleasure some people may derive from it” Judge Michael B. Brennan wrote. The majority further concluded that the man’s injury was intentionally self-inflicted. The Majority wrote, “Because the act itself is an injury, this injury falls under the policy exclusion for intentionally self-inflicted injuries”.
Accordingly, fine distinctions matter greatly when you need to contest a denial of claim from an insurance company. In these instances, it is wise to retain an attorney who specializes in such denials. Please call us if you have any questions or are facing any coverage issues.