Announcement

Collapse
No announcement yet.

4th Cir. – Sane or Insane Suicide Exclusion

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • 4th Cir. – Sane or Insane Suicide Exclusion

    Here’s a new unpublished decision out of the Fourth Circuit entitled Jennifer Mullen Collins v. Unum Life Insurance Company of America. This is a very unfortunate case where a former Navy SEAL, after serving our country for 17 years, committed suicide after his retirement from service. He suffered from PTSD, Major Depressive Disorder, Generalized Anxiety Disorder, Chronic Traumatic Encephalopathy, and a progressive neurodegenerative disease caused by repetitive brain trauma. After his retirement, he began working for Blackbird Technologies and, after his death, his widow applied for benefits under his basic and supplemental life insurance policies. Unum paid the basic policy, but denied benefits under the supplemental policy suicide exclusion. The plaintiff presents three arguments to the Fourth Circuit. First, she argues that the exclusion violates Virginia law which prohibits insurers from using suicide as a defense unless they have an expressed provision stating “whether sane or insane, dies by his own act within 2 years.” The court disagrees with this first argument.

    We conclude, however, that Unum’s exclusion sufficiently complies with Virginia law because a policy only needs to provide sufficient notice of an exclusion and its limit of two years to comply with the statute. See New England Mut. Life Ins. Co. v. Mitchell, 118 F.2d 414, 417 (4th Cir. 1941) (ruling that a valid suicide exclusion does not need to use any “magic” words to comply with statute that governs such exclusions).
    The court then determines that the phrase “sane or insane” did not have to be specifically included.

    Second, Ms. Collins argues that Unum unreasonably interpreted “suicide” to mean any non-accidental, self-inflicted death. She contends that, because the suicide exclusion did not include a clause specifying that suicide could be “sane or insane,” the exclusion does not apply to suicides committed by insane persons. Under the abuse-of-discretion standard, however, Unum only has to offer a reasonable, and not the most reasonable, interpretation of a plan term. See McCorkle v. Metro. Life Ins. Co., 757 F.3d 452, 459 (5th Cir. 2014) (explaining that abuse-of-discretion standard prohibits a court from “substituting [its] own, narrower interpretation of the term [“suicide”] in place of [the administrator’s] reasonable, yet broader, interpretation”) (internal quotation marks omitted). Because people could reasonably understand the term “suicide” to include any non-accidental, self-inflicted death regardless of mental state, we defer to Unum’s interpretation. Moreover, courts have upheld plan administrators’ interpretations of “suicide” to include sane and insane suicide even though the phrase “sane and insane” did not appear in the exclusions. McCorkle, 757 F.3d at 459; Riggs v. Metro. Life Ins. Co., 940 F. Supp. 2d 172, 184–85 (D.N.J. 2013).
    Finally, the court concludes that because the phrase “sane or insane” did not need to appear in the exclusion, the court does not need to determine the decedent’s state at the time of his death.

    Third, under Ms. Collins’ interpretation of “suicide,” she argues the administrative record lacks substantial evidence to show that Mr. Collins was sane when he died. She contends that, during Mr. Collins’ military service, he experienced sub-concussive blasts that injured his brain and impaired his ability to resist the impulse to kill himself. Thus, she contends that Mr. Collins was not sane under Fourth Circuit law. See Reinking v. Philadelphia Am. Life Ins. Co., 910 F.2d 1210, 1215 (4th Cir. 1990) (defining insanity to include someone who suffers from “an ‘insane’ impulse that so overwhelms the will or rational thought that the individual is unable to resist”).

    Because we hold that Unum reasonably interpreted the suicide exclusion to encompass insane suicide, Mr. Collins’ sanity at death has no bearing on the outcome. Moreover, we find substantial evidence in the administrative record to support Unum’s conclusion that the suicide exclusion applied.
    The opinion is attached below.
    Attached Files
Working...
X