Intentional v. Accidental/7th Cir. App.shoke2013
2-1 Decision Finds No Coverage Because Autoerotic Asphyxiation Constitutes an Intentionally Self-Inflicted Injury
In a 2-1 decision, the Seventh Circuit reversed trial court Judge Robert Dow’s ruling that death from autoerotic asphyxiation would reasonably be considered an “intentionally self-inflicted injury” not covered by portions of the decedent’s life insurance policies. The majority opinion written by Justice Brennan was joined by Justice Mannion with Justice Bauer dissenting.
The decedent died while performing an autoerotic asphyxiation act at his Wilmette, IL home. He had coverage under two life insurance policies issued by Minnesota Life, a Basic Insurance Policy and a Supplemental Insurance Policy. Together, these provided $517,000 in coverage. Each policy also included Accidental Death & Dismemberment (“AD&D”) policy riders. The Basic Insurance Policy provided an additional $10,000 of AD&D coverage and the Supplemental Insurance Policy provided an additional $50,000 of AD&D coverage. His wife filed a claim with Minnesota Life, which paid the $517,000. However, Minnesota Life denied her claim for the additional $60,000 in AD&D coverage based on two identical provisions in the policy riders and asserted that the husband’s death was not “accidental” as required under the riders. The insurer also took the position that the husband’s death fell under an exclusion for intentionally self-inflicted injury, which states: “In no event will we pay the accidental death or dismemberment benefit where an insured’s death or dismemberment results from or is caused directly by any of the following: … intentionally self-inflicted injury or any attempt at self-inflicted injury, whether sane or insane … .”(emphasis added).
The wife then brought an action under the Employee Retirement Income Security Act (“ERISA”), seeking coverage under the AD&D riders. After reviewing the stipulated facts, Judge Dow held that Minnesota Life had conceded the death was accidental and the only issue in dispute was whether autoerotic asphyxiation qualified as an “injury” under the policy’s language. After reviewing autoerotic asphyxiation precedent from other federal circuits, the court determined that reasonable minds could disagree about whether the husband’s intentional inducement of cerebral hypoxia was a self-inflicted injury within the meaning of the AD&D rider language. Because all policy ambiguities must be resolved in the policyholder’s favor, Judge Dow ruled that the exclusion for intentional injuries did not apply to autoerotic asphyxiation entering judgment in favor of the wife. Minnesota Life appealed.
The Seventh Circuit reversed, finding that the husband’s fatal act was intentional even if it was not intended to result in death. In so doing, it disagreed with Second and Ninth Circuit opinions that found coverage because the intent underlying the act was sexual gratification and not death. The Seventh Circuit opinion reasoned that this distinction “artificially” separated what was one continuous act into two parts. “The insured did not strangle himself in a nonlethal manner, then involuntarily shift into a different form of lethal strangulation. He pulled a necktie tightly around his neck to cut off oxygen to his brain; as the self-strangulation continued, he gradually lost consciousness and eventually died.”
The opinion reasoned that partial strangling caused an injury, and if the husband had partially strangled someone else, rather than himself, “there would be no debate he had inflicted an injury.” Notably, the medical examiner found that the cause of death was “asphyxia due to hanging, autoerotic in nature,” ultimately concluding that the death was accidental. In his dissent, Judge Bauer agreed with Judge Dow that the husband’s death was an unforeseen accident involving a common sexual act from which he had every intention to survive. He opined that Minnesota Life could remedy the ambiguity in its coverage by specifically excluding coverage for deaths resulting from the act. Tran v. Minnesota Life Insurance Co., No. 18-1723 (7th Cir. Apr. 29, 2019).