Joshua Bachrach (Partner-Philadelphia, PA) and Angela Heim (Of Counsel-Philadelphia, PA) convinced the U.S. Court of Appeals for the Eleventh Circuit to reverse the judgment of the Southern District of Florida against our firm insurer client. The plaintiffs submitted a claim for $500,000 in accidental death benefits following the disappearance and presumed death of their father while mountain climbing in Pakistan. The district court concluded that because there was no evidence that the insured committed suicide, the denial of benefits was arbitrary and capricious under ERISA. In a published decision, the Eleventh Circuit reversed and remanded for entry of judgment in favor of our client. In doing so, the Eleventh Circuit adopted the Wickman test, which is used in seven other circuits for deciding whether a loss is an accident. Under this test, a court asks “whether a reasonable person, with background and characteristics similar to the insured, would have viewed [injury or death] as highly likely to occur as a result of the insured’s intentional conduct.” Here, the insured, a medical doctor, attempted to ascend a major peak solo after his climbing partner, a certified climbing instructor, concluded that it was too dangerous due to hidden crevasses and black ice that broke off and offered no grip. Based on these facts, the appellate court concluded that “[a] reasonable mountain climber likely would have expected a higher risk of injury or death from a summit attempt on an already dangerous winter climb.” The Eleventh Circuit rejected the claimants’ argument that the burden should shift to the insurer to prove there is no coverage when the actual cause of death is unknown. The appellate court also rejected the claimant’s argument that death while mountain climbing should be considered an accident because there is no mountain climbing exclusion in the policy. Accordingly, the Eleventh Circuit reversed the district court judgment and directed the district court to enter judgment in favor of our insurer client.