Drunk driving "accidents" under ERISA

  In applying ERISA law governing insurance policies, the Sixth Circuit held that Nancy Lennon's son was not involved in an "accident" when he caused a motor vehicle collision while driving drunk.  26 year-old David Lennon was a GMAC accountant, and at the time of his death, his blood alcohol was three times the legal limit.  The Trial Judge had held that while he was "grossly negligent", his death was still an "accident" under the Met Life policy.

        The Sixth Circuit judges reversed, holding that it was not "arbitrary and capricious" to treat Lennon's "gross negligence" as tantamount to intentional conduct, because his behavior rendered the risk of serious injury or death "foreseeable."  The court relied heavily upon the common sense recognition that the risk associated with driving under the influence increases as the level of intoxication increases, and stressed that it was not upholding the suggestion that death caused by any ingestion of alcohol could be excluded from ERISA coverage.

        Of the three judges on the panel, one would apply a generous interpretation to the concept of "reasonable forseeability", one would hold the plan administrator to a high standard of proof (i.e., proving "gross intoxication" to establish "intent") , and the third dissented:  the latter judge would interpret the language of the policy as written and require proof of an intentionally-caused injury. 

         It seems that the policy language is only interpreted "as written" when it disadvantages a consumer:  when the language, as here, is inconvenient to the insurer, the Court applies its own interpretation of common sense to avoid the impact of black and white rules.  This young man did not "intend" to injure himself or anyone.  He was, however, stupidly negligent.  The ERISA policy, however, did not exclude injuries caused by "gross stupidity":  it excluded injuries caused intentionally.  No ordinary person we know would suggest that in normal parlance, as a culture we equate drunk driving with intentional suicide.