United States Tenth Circuit

In an action claiming plaintiff was wrongly denied accidental death and dismemberment benefits under an employee welfare benefit plan regulated by ERISA, summary judgment for defendants is reversed with directions to enter summary judgment for plaintiff where: 1) defendant-Met Life did not in any way comply with applicable ERISA deadlines in its administrative review, and thus de novo review applies; 2) the district court erred in ruling for defendant on the grounds that plaintiff's husband did not die as a result of an "accident"; 3) her husband's death was not "caused" by his purported seizure, but by his car crash; and 4) thus, a policy exclusion did not apply.

Appellate Information

• Decided 12/04/2008
• Published 12/05/2008

Judges

• BRISCOE, Circuit Judge., Before BRISCOE, SEYMOUR, and PORFILIO, Circuit Judges.

Court

• United States Tenth Circuit

Counsel

• For Appellant:
  
• Brian S. King (James L. Harris, Jr. with him on the briefs), Salt Lake City, UT, for Plaintiff-Appellant.


• For Appellees:
  
• Jack M. Englert, Jr. (James L. Barnett, Holland & Hart LLP, Salt Lake City, UT, with him on the brief), of Holland & Hart LLP, Greenwood Village, CO, for Defendants-Appellees.