Insurance – Motion for Summary Judgment –
Coverage under Accidental Death Policy
Coverage under Accidental Death Policy
Appellate court concluded that
the district court erred in granting the defendant insurance company’s motion
for summary judgment. The Plaintiff decedent’s
estate sought to recover proceeds of accidental death policy issued by the Defendant.
The policy limited coverage to “bodily injuries … that result directly from
an accident and independently of all other causes.” The Defendant argued
that decedent was not entitled to proceeds of the policy since the pulmonary
embolism was not a consequence of injury, but rather was consequence of surgery. The Court of Appeals found that the Plaintiff
was entitled to judgment since defendant had failed to make any plausible
showing that surgery, rather than accident that necessitated surgery, caused the
decedent’s death.
the district court erred in granting the defendant insurance company’s motion
for summary judgment. The Plaintiff decedent’s
estate sought to recover proceeds of accidental death policy issued by the Defendant.
The policy limited coverage to “bodily injuries … that result directly from
an accident and independently of all other causes.” The Defendant argued
that decedent was not entitled to proceeds of the policy since the pulmonary
embolism was not a consequence of injury, but rather was consequence of surgery. The Court of Appeals found that the Plaintiff
was entitled to judgment since defendant had failed to make any plausible
showing that surgery, rather than accident that necessitated surgery, caused the
decedent’s death.
Reversed
Prather v. Sun Life and Health Ins. Co., No.
16-1861 (December 13, 2016) C.D. Ill.
16-1861 (December 13, 2016) C.D. Ill.