Verla Hancock participated in a group benefit plan sponsored by her employer, Intermountain Healthcare. The plan’s claim fiduciary was Metropolitan Life Insurance Co. (MetLife). Under the plan, Verla obtained basic life insurance, supplemental life insurance and accidental death and dismemberment coverage (AD & D).
The plan stipulated that in order to benefit from the AD & D coverage, the policy holder had to be 1) Injured in an accident; 2) The accident had to be the sole cause of injury; 3) The accident had to be the sole cause of death; 4) The death had to occur within 365 days of the accident. The District Court found that policy beneficiary Terri Hancock had failed to demonstrate that she had a claim against MetLife for accidental death and dismemberment in her mother’s death.
Would Terri Hancock’s appeal be successful? Let’s look at the facts surrounding Verla Hancock’s death.