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First Circuit Affirms Denial of Accidental Death Insurance Benefits Based on Suicide Exclusion

In Alexandre v. Nat’l Union Fire Ins. Co. of Pittsburgh, PA, No. 21-1140, __F.4th__, 2022 WL 18778 (1st Cir. Jan. 3, 2022), Plaintiff-Appellant Mary Alexandre appealed the district court’s judgment upholding Defendant-Appellee National Union Fire Insurance Company’s decision to deny Alexandre $500,000 in accidental death insurance benefits for her husband who National Union determined died by suicide. The First Circuit affirmed the district court’s decision.

First, the court addressed Alexandre’s argument that the federal common law of the Eleventh Circuit should apply since the case was filed in Florida before it was transferred to Massachusetts pursuant to 28 U.S.C. § 1404(a). The First Circuit disagreed. The court found that its decision in AER Advisors, Inc. v. Fidelity Brokerage Services, LLC, 921 F.3d 282 (1st Cir. 2019) governs. In AER Advisors, the court held that when one district court transfers a case to another, the norm is that the transferee court applies its own Circuit’s cases on the meaning of federal law. Thus, the district court did not err in ruling that the decisional law of the First Circuit applies, namely, that the analytical framework for interpreting the term “accident” set forth in Wickman v. Northwestern National Insurance Co., 908 F.2d 1077 (1st Cir. 1990) applies to this case. The court declined to apply the Eleventh Circuit’s presumption against suicide as articulated in Horton v. Reliance Standard Life Insurance Co., 141 F.3d 1038 (11th Cir. 1998).

Regarding the merits of the benefits determination, the court noted that the term “accident” is not defined in the AD&D policy. The policy does exclude losses caused by suicide, attempted suicide, or intentionally self-inflicted injury. Under Wickman, when the term “accident” is undefined, for an insured’s death to qualify as a covered “accident,” “the beneficiary must demonstrate that the insured did not expect an injury similar in type or kind and that the suppositions underlying this expectation were reasonable,” from the perspective of the insured. Considering the abuse of discretion standard of review that applies to National Union’s decision, the court found that substantial evidence indicates that the insured’s death was intentional. The medical examiner’s investigative summary detailed that the insured sprinted out of a hotel room and hurtled himself over the 10th floor railing of a high-rise hotel. The evidence showed he landed one floor below the railing and his brother yelled to him “no, no, keep still, don’t do it,” right before he rolled off the ninth-floor ledge to his death. Initially, the insured’s brother told investigators at the scene that he was sleeping when the insured grabbed and squeezed his hand before sprinting towards the door. In a later affidavit, he contradicted this statement and said that his brother did not seem disturbed or alarmed as he went out the door. The final Death Certificate lists the insured’s death as a suicide. The court agreed with the district court that the contemporaneous and impartial documents authored by state officials in the exercise of their official duties are probative and more credible than the brother’s later sworn declaration. The court found that National Union’s determination that the insured’s death was excluded from coverage because it was not accidental was not an abuse of discretion.


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*Please note that this blog is a summary of a reported legal decision and does not constitute legal advice. This blog has not been updated to note any subsequent change in status, including whether a decision is reconsidered or vacated. The case above was handled by other law firms, but if you have questions about how the developing law impacts your ERISA benefit claim, the attorneys at Roberts Disability Law, P.C. may be able to advise you so please contact us.

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