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Law360 Features ERISA Case Won by Grace in Maryland

October 6, 2015

Kathryn Grace (Partner-Virginia) prevailed on summary judgment on an ERISA matter in the U.S. District Court for the District of Maryland – a win that was recently reported on Law360 in the article, “Insurer Dodges Coverage for Post-Heart Attack Drowning.” Wilson Elser represented an insurance company that was sued by a widow of an insured under an accidental death benefits policy. The insured passed away during a boating excursion, where following a heart attack, he fell into the river. The coroner determined that the cause of death was heart disease, complicated by drowning.

When the insured’s widow filed for insurance benefits, the insurer denied coverage based on certain exclusions within the policy. The policy specifically excluded coverage if the death resulted in whole or in part from a natural and probable consequence of an excluded risk, even if the proximate or precipitating cause of the loss is accidental bodily injury. The enumerated excluded risks included sickness, disease, mental incapacity, influence of intoxicants, and stroke or cerebrovascular accident or event.  The Court found in favor of the defense, ruling that the policy excluded coverage as the insured’s heart attack contributed to his death in an immediate and significant manner.

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