LINA loses drunk driving unintentional demise coverage dispute

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Senior 6th Circuit Judge Ronald Lee Gillman, who sat on the 9th circuit panel by designation, wrote to the court that LINA erroneously concluded that Scott Jr’s death was not covered because driving in his condition was “substantially certain” to cause a serious or fatal wreck .

“There is no doubt that ‘drunk driving is ill-advised, dangerous, and easily avoidable’,” he wrote, quoting from a 6th Circuit opinion he had authored in 2009, as reported by Reuters. However, the judge added that road accidents typically involve some element of negligence or reckless conduct, such as intoxication or speeding, yet death from such conduct is “a statistical rarity”.

Wolf’s lawyer, Glenn Kantor of Kantor & Kantor, said the decision should “discourage carriers from trying to shoehorn an exclusion for alcohol-related accidents into a policy that doesn’t have one” – which pushed Wolf to sue LINA in federal court in Tacoma in 2020 for denying the $50,000 claim.

“He was a very angry father. He had suffered a tragedy and felt the insurance company had ‘piled on’ by denying coverage,” Kantor said, as reported by Reuters. “He wanted to send LINA a message: ‘Don’t do this to anybody else’.”

Meanwhile, LINA argued it had gone beyond the requirements of ERISA, the federal law governing employee-benefit plans, when it found that the car crash was substantially certain. With Wolf’s policy defining an accident as an “unforeseen event,” the insurer said it only needed to know that the crash was “reasonably foreseeable”.

“LINA did not present that argument to the district court, nor to Wolf, when it denied his claim, so it has forfeited that argument here,” Gilman wrote, along with Circuit Judges Sandra Ikuta and Eric Miller, as reported by Reuters.

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