Accidental Death Life Insurance Policy

Attention life insurance lawyers.  Here is one for you.  Is dying from a mosquito bite grounds for recovering under an accidental death life insurance policy?

That was the issue in the March 2018, opinion from the United States Court of Appeals for the Fifth Circuit.  The case is styled, Gloria Wells v. Minnesota Life Insurance Company.

Melton Wells died fro complications arising from being bitten by a mosquito carrying West Nile Virus.  Melton’s wife, Gloria claimed accidental death benefits under the Minnesota Life policy and the claim was denied.  The dispute is whether or not Melton’s death was accidental and an exclusion under the policy.  The lower court dismissed the case by summary judgment.  This court reversed the lower court dismissal and remanded the case for trial.

The policy provides coverage:

only when your death results, directly and independently from all other causes, from an accidental bodily injury which was unintended, unexpected and unforeseen.  The bodily injury must be evidenced by a visible contusion or wound . . . .  The bodily injury must be the sole cause of your death. . . . Your death must occur within 90 days after the date of the accidental injury.

The policy exclusion reads:

In no event will we pay the accidental death benefit where your death is caused directly or indirectly by, results from, or there is contribution from . . . bodily or mental infirmity, illness or disease .   . . .
The terms “accidental bodily injury,” “contusion,” “wound,” “infirmity,” “illness,” and “disease” are not defined in the policy.
Minnesota’s explained their denial of the claim by stating:
We have received no information to support that [Melton’s] death resulted directly and independently from any accidental bodily injury sustained.  Rather it appears the severe [WNE] was exacerbated by his diabetes, morbid obesity and his age.  The claim is not payable as an accidental bodily injury did not cause [Melton’s] death, directly and independently from all other causes.  Rather, his death was due or there were contributions from bodily or mental infirmity, illness or disease and this is specifically excluded under the terms of the policy.
Attention readers — This case serves as an excellent example why someone who has a claim denied by an insurance company should seek the counsel of an experienced Insurance Law Attorney.