Denial of Death Benefits Upheld by Court Because Decedent’s Intoxicated State Excluded Him from Coverage: Fitzgerald v. Colonial Life & Accident Ins. Co.

1366997_28152366.jpgThe wife of a man who fell off a pier and drowned filed suit against an insurance company after it refused coverage for accidental death and dismemberment benefits. The insurance company cited an exclusion for accidents involving a presumption of the influence of alcohol. A federal judge ruled in Fitzgerald v. Colonial Life & Accident Ins. Co. that the exclusion applied to the decedent. It found that the decedent’s blood alcohol content exceeded Maryland’s legal limit for intoxication, and that the decedent’s own negligence contributed to his death.

The decedent, Jeffrey Fitzgerald, had been drinking during the evening of September 19, 2009 at a marina in Edgewater, Maryland. According to witness statements, Fitzgerald was observed carrying a forty-two-inch television to a boat docked at the pier. He apparently fell into the water, and his body was found later in fifteen to twenty feet of water about twenty feet away from the pier. The autopsy concluded that drowning was the sole cause of death. A toxicology test performed several hours after his death found a blood alcohol level between 0.27 and 0.31 percent, between three and four times the legal limit in the state of Maryland.

Fitzgerald had a term life insurance policy issued by Colonial Life & Accident Insurance Company that named his wife, Lynette Fitzgerald, as beneficiary. She filed a claim for benefits. After reviewing the police report and other documents, Colonial agreed to pay the full $100,000 under the policy certificate, but concluded that she was not entitled to accidental death and dismemberment benefits. Colonial cited an exclusion in the policy certificate for accidental losses related to illegal drug use or a blood alcohol percentage that would cause a presumption, under Maryland law, that the person was under the influence of alcohol. Maryland’s legal limit for driving under the influence offenses is 0.08 percent.

Lynette Fitzgerald filed suit against Colonial in Prince George’s County Circuit Court. Citing ERISA’s applicability to the policy and the plaintiff’s claim, Colonial removed the case to the U.S. District Court for the District of Maryland. Both parties filed motions for summary judgment. The court denied the plaintiff’s motion and granted summary judgment for Colonial.

Colonial argued that the court should apply § 10-307(g) of Maryland’s Courts and Judicial Proceedings Code, which creates a presumption that someone is under the influence of alcohol if their blood alcohol content is 0.08 percent or higher. The plaintiff argued that this presumption only applies when a person is operating a vehicle or vessel. The court found some merit to the argument, but it concluded that the presumption should apply. In reaching this conclusion, it cited cases from other states that applied the standard for driving while intoxicated to situations that did not directly involve driving. The court also found that the exclusion applied not only to intoxication in a criminal context, but to any situation where a decedent behaved irresponsibly in a way that contributed to the death. In this sense, the court applied Maryland’s contributory negligence rule.

The personal injury lawyers at Lebowitz & Mzhen are skilled at pursuing justice for people in Maryland who have been injured due to the negligence or illegal acts of others. Contact us today online or at (800) 654-1949 for a free and confidential consultation.

More Blog Posts:

Maryland Supreme Court Reconsiders Contributory Negligence Doctrine, Maryland Accident Law Blog, September 23, 2012
Man Sentenced to More than Two Years in Prison for Fatal Drunk Driving Crash, Maryland Accident Law Blog, September 18, 2012
Maryland Appeals Court Rules on Issue Preclusion and Contributory Negligence in Auto Accident Case, Maryland Accident Law Blog, July 12, 2012
Photo credit: ‘pier in morning mist’ by Ayla87 on stock.xchng.

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