The case raises awkward questions involving heroic efforts to extend insured individuals’ lives
A federal court in the US has ruled against a widow who tried to collect a payout from her deceased husband’s US$100,000 accidental death insurance policy, saying that the man died too late.
As reported in InsuranceNewsNet, the policy was administered by Transamerica Premier Life Insurance Company, which inherited it from the original issuer, Peoples Benefit Life Insurance, through a merger and a corporate name change.
Under the terms of the policy, the death “must occur within 90 days of the accident” in order for beneficiaries to collect a payout. The insured, Charles Thomas Blosch, died on August 12 last year — 94 days after he fell, struck his head on a sidewalk, and went comatose. He was placed on life support, but a subdural hematoma coupled with medical complications from the fall took their toll in the end.
Darlene Blosch, the widow, sued Transamerica in hopes of forcing a payout. Her lawyer, Albert Selkin, questioned the legality of the 90-day provision, pointing out in court documents that it was not included with the rest of the policy’s exceptions or exclusions provisions. He insisted that the clause offended “the public policy of Virginia” as it required the policy holder to die in an “unreasonably short period of time.”
“It is absurd that the policy doesn't cover the accidental death of one who is hospitalized and invalid from the day of the accident," Selkin said. "This is accidental life insurance. The policy should be honoured.”
But while the policy would otherwise cover Blosch’s accident and death, Transamerica’s lawyers maintained that the lateness of his passing meant they did not have to pay. The judge sided with the company, noting the lack of Virginia case law to support Selkin’s argument and that the Virgini Bureau of Insurance has signed off twice on the Transamerica policies, including the 90-day provisions.
John Midgett, a veteran lawyer with 40 years of experience in estate planning, was not surprised that the court sided with the insurer. “When it says 90 days, it means 90 days. Not 91. Not 89,” said Midgett, who had no involvement with the case.
But Kevin Martingayle, a former president of the Virginia State Bar, and Gerald Schwartz, a past president of the Virginia Trial Lawyers Association, pointed out that Blosch’s death had likely been delayed because doctors intervened following his fall.
“If an insured individual's life is extended by heroic medical means, it seems absurd and unfair that those medical efforts can relieve an insurance company from having to pay simply because the life was artificially extended past a deadline,” Martingayle said.
Schwartz also made note of the awkward position policy holders’ families would be placed in as they would have to make end-of-life decisions based on an “arbitrary and unnecessary deadline.”
“It's particularly bad in today's times, where doctors take all measures to save and prolong someone's life," he said.
