ERISA-Fifth Circuit Holds That Accidental Death Benefit Is Not Payable Due To Exclusion In The Plan For Drunk Driving

In Redeaux v. Southern National Life Insurance Company, No. 10-30670 (5th Cir. 2011), the Court faced the question of whether an accidental death benefit was payable from a plan subject to ERISA (the “Plan”).

In this case, Bryan Redeaux (“the Insured”) died in 2002. The Insured was covered under a life insurance policy which was held by (or which constituted) the Plan, and which was issued by Southern National Life Insurance Company (“Southern”). His mother, Connie Redeaux (“Redeaux”), was listed as the beneficiary under the Plan. The Insured was killed in a single-vehicle crash in Lafayette Parish, Louisiana. The death certificate shows that the Insured’s blood alcohol concentration (“BAC”) was 0.21 percent at the time of his death. After her son’s death, Redeaux filed a claim with Southern for benefits. Southern paid Redeaux $10,000 in life insurance benefits but denied her claim for accidental death benefits based on, among other things, a policy exclusion “for a loss which in any way results from . . . injury or death occurring as a result of the commission of a crime or the attempt to commit a crime.” Redeaux filed a law suit in state court seeking the accidental death benefits. Southern removed the case to federal court on the basis of federal question jurisdiction, as the claim was preempted by ERISA. The federal district court granted summary judgment in favor of Redeaux, and Southern appealed.

According to the Court, the only issue on appeal is whether Southern erred when it denied Redeaux’s claim on the basis of the aforementioned exclusion. The Court reviewed Southern’s denial using a deferential standard. The question became whether the Insured’s death occurred as the result of committing a crime. Driving a vehicle while intoxicated is a crime under Louisiana law. The applicable statute stated that the crime of operating a vehicle while intoxicated occurs when:

(a) The operator is under the influence of alcoholic beverages; or
(b) The operator’s blood alcohol concentration is 0.10 percent or more by weight based on grams of alcohol per one hundred cubic centimeters of blood.

Here, the Insured was operating a motor vehicle at the time of his death, and his BAC while driving. was .21 percent, more than twice the legal limit under Louisiana law. The Insured was not charged with a crime, but such a charge is not required to conclude that he was driving illegally. The Insured’s blood sample was drawn and tested by the coroner’s office. The police report did not note any weather, vehicle, or road conditions that may have contributed to the car crash. As such, the Court concluded that Southern did not err in finding that the accidental death benefit was not payable from the Plan, due to the Plan’s exclusion for death occurring as the result of committing a crime. Accordingly, the Court reversed the lower court’s decision and rendered judgment in Southern’s favor.