Accidental Death And Dismemberment Case Update

Following is a summary of three recent and noteworthy Court of Appeals decisions upholding plan administrators' denials of ADD benefits, establishing a pattern of deference even in light of procedural errors which may be an outgrowth of the Supreme Court's decision in Conkright v. Frommert 130 S. Ct. 1640 (2010).

Sixth Circuit Declines To Re-Write Plan Terms

In the matter Hernandez v. Hartford Life & Accident Ins. Co. 2012 U.S. App. LEXIS 3293 (6th Cir. 2012), a husband and his deceased wife's estate sued seeking to recover benefits which they alleged were wrongfully denied following the death of the wife. Mrs. Hernandez died two months after suffering a leg fracture that was surgically repaired. It was undisputed that the cause of her death was a pulmonary embolism. The policy at issue expressly excluded coverage for death caused by "circulatory malfunction". The parties agreed that a pulmonary embolism is a circulatory malfunction. However, the plaintiff argued