Caldwell v. Unum Life Insurance Co. of America

271 F. Supp. 3d 1252
CourtDistrict Court, D. Wyoming
DecidedSeptember 21, 2017
DocketCase No. 2:16-CV-0236-SWS
StatusPublished
Cited by3 cases

This text of 271 F. Supp. 3d 1252 (Caldwell v. Unum Life Insurance Co. of America) is published on Counsel Stack Legal Research, covering District Court, D. Wyoming primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Caldwell v. Unum Life Insurance Co. of America, 271 F. Supp. 3d 1252 (D. Wyo. 2017).

Opinion

ORDER ON CROSS MOTIONS FOR SUMMARY JUDGMENT

Scott W. Skavdahl, United States District Judge

This matter comes before the Court on Unum’s Motion for Summary Judgment or in the Alternative Motion for Judgment on the Record (ECF No. 54) and Plaintiffs’ Motion for Summary Judgment (ECF No. 56). This case arises out of Plaintiffs’ claim for accidental death benefits under a policy of group insurance Defendant Unum Life Insurance Company (“Unum”) issued to Sinclair Services Company, the employer of Plaintiffs’ late son, William Caldwell. Unum based its denial of benefits on a determination that speeding is a crime for purposes of a policy exclusion for a loss “caused by, contributed to by, or resulting from ... an attempt to commit or commission of a crime.” Plaintiffs filed this ERISA action seeking review of Unum’s determination. The Court, having reviewed the record and considered the parties’ respective motions and opposition briefs, having heard oral argument of counsel and being otherwise fully advised, FINDS and ORDERS that Defendant Unum’s motion should be granted and Plaintiff s motion denied.

Background

On June 28,2015, Plaintiffs’ son, William Caldwell, was traveling approximately 74 mph on a dirt roadway in Carbon County, Wyoming where the posted speed limit is 35 mph but the “legal speed limit is 55 mph.” (WHP Investigator’s Traffic Crash Report, R. at 103; Amended WHP Report, R. at 313, 316).1 William lost control of his vehicle. Following an investigation, Trooper Chapman of the Wyoming Highway Patrol (“WHP”) reported:

I observed a Maroon passenger vehicle on its right side lying nearly perpendicular to the roadway. The vehicle was later identified as a 1996 Chevrolet Cavalier .... It was approximately halfway off the west edge of the road. The decedent, Mr. William M. Caldwell, ... was lying face down in the middle of the road approximately 12.5 feet from the vehicle. [1256]*1256There was a line of debris from the east shoulder to the vehicle.
... I completed a forensic mapping of the scene .... The roadway is constructed of hard-packed dirt and rock road base, with some loose gravel on the surface, especially near the roadway edges.... The vehicle had been traveling northeast. In this direction of travel, there is a downhill -grade with a left curve leading into, a more gentle right curve. '-The posted speed limit at the junction with Carbon County Road 340 is 35 miles per hour.
I observed the marks near the. top of the hill leading into the left curve.... The vehicle’s rear tires began to track outside the front tires -as the vehicle was steered left in an attempt to maintain the road. At the west edge, the. vehicle straightened, then the vehicle’s rear tires began to track outside the front tires again as it was steered right.... The vehicle exited the roadway on the east side at approximately 45 degrees .... The vehicle traveled through the' air over the bottom of the ditch and collided at an angle with the embankment on the opposite side. The collision caused the vehicle’s right side to rebound upward, vaulting the vehicle approximately 30 feet, and causing it to come back down on at least one left side tire. The vehicle traveled in this manner for approximately 70 feet as it began to rotate counter-clockwise. The vehicle then tripped and 'overturned, leading with the’ passenger side, for approximately 150 feet before coming to rest on its left side. Mr. Caldwell was completely ejected ....
The placement of the tire marks are consistent with negotiating a curve at higher speeds or “cutting the corner” .... Using a conservative drag factor of 0.5, and assuming the brakes were functioning normally, a mathematical analysis results in speeds of 75 miles per hour at the first middle ordinate, and 72 miles per hour at the second.
An examination of the vehicle showed that the driver’s restraint was not in use and the airbags did not deploy....
Mr. Caldwell’s vehicle was traveling too fast for the road conditions. There was not enough friction present to allow the vehicle to stay on the roadway at the speed it was traveling. Once off the roadway, the vehiclé overturned several times and Mr. Caldwell was ejected....

Id. at 103, 316-17. William died in the resulting one-vehicle crash,

On July 29, 2015, Plaintiffs filed a claim for accidental death and dismemberment (“AD & D”) benefits under a policy of group insurance Unum issued to William’s employer, Sinclair Services Company (the “Policy”).2 Relying.on the initial WHP Report — which, despite the officer’s narrative, indicated a posted speed limit of 30 mph and estimated speed of William’s vehicle of 61 mph (see R. at 105) — Unum ultimately denied Plaintiffs’ claim pursuant to a Policy exclusion which provides: “Your plan does not cover any accidental losses caused by, contributed to by, or resulting from ... an attempt to commit or commission of a crime.” (“Crime Exclusion”) (R. at 76-77). In its initial denial letter dated October 8, 2015, Tracy McKenzie, a Unum Benefits Specialist, advised Plaintiffs; “In the state of Wyoming, speeding is a misdemeanor per Wyoming Statute Ann. § 31-5-1201 (a) & (d)(iv). Your son’s act of speeding was a violation of the law; thus, a crime.” (R. at 238.)

[1257]*1257By letter dated January 4, 2016, Plaintiffs — represented by counsel — appealed Unum’s determination, arguing that the. legal speed limit on the road where the accident occurred was 55 mph, not 30 or 35 mph.3 The appeal also asserted, inter alia, that “[s]peeding alone, even well over the legal speed limit, does not rise to the ‘commission of a crime’ as specified in the policy.” (R. at 260, 262.) By letter dated January 12, 2016, Unum Lead Appeals Specialist, Denise Legendre, asked Plaintiffs’ attorney to provide additional information to complete the appellate review, including a corrected traffic report to support Plaintiffs’ contention that the WHP Report contained inaccurate information. (R. at 304.) By letter dated February 10, 2016, Plaintiffs’ attorney provided an amended Traffic Crash Report from WHP. (R. at 306.) Trooper Chapman’s amended report contained the same narrative as in his original July 11, 2015 report. (See R. at 103, R. at 311.) Trooper Chapman changed the “posted speed” field from 30 mph in his original report to 35 mph in his amended report, and he changed the “estimated speed” field from 61 mph in his original report to 74 mph in his amended report, which is consistent with his original narrative. (R. at 311, 313.)

By letter dated April 8, 2016, Unum notified Plaintiffs’ attorney that it had completed the appeal review and determined -its initial decision to deny AD & D benefits was correct. (R. at 361-67.) Ms. Legendre explained:

We have determined the evidence supports Mr. Caldwell was speeding, which is a violation noted in Wyoming Statutes. These state statutes constitute speeding as a misdemeanor. A misdemeanor is considered a criminal offense that is less serious than a felony and more serious than an infraction, and is generally punishable by a fine or incarceration in a local jail, or both. His actions (speeding), constitutes an-offense that may be prosecuted by state and punishable by law as stated in the Wyoming Statutes.

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Bluebook (online)
271 F. Supp. 3d 1252, Counsel Stack Legal Research, https://law.counselstack.com/opinion/caldwell-v-unum-life-insurance-co-of-america-wyd-2017.