Holsinger v. New England Mutual Life Insurance

765 F. Supp. 1279, 1991 U.S. Dist. LEXIS 8699, 1991 WL 114120
CourtDistrict Court, E.D. Michigan
DecidedJune 10, 1991
Docket90-72471
StatusPublished
Cited by15 cases

This text of 765 F. Supp. 1279 (Holsinger v. New England Mutual Life Insurance) is published on Counsel Stack Legal Research, covering District Court, E.D. Michigan primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Holsinger v. New England Mutual Life Insurance, 765 F. Supp. 1279, 1991 U.S. Dist. LEXIS 8699, 1991 WL 114120 (E.D. Mich. 1991).

Opinion

MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S 5 APRIL 1991 MOTION FOR SUMMARY JUDGMENT

GADOLA, District Judge.

FACTS

The essential facts are not in dispute. The plaintiff’s decedent ingested a quantity of drugs which resulted in his death. Plaintiff made a claim, through the decedent’s ERISA plan, against the defendant insurance company based on the accidental death of her decedent. The defendant denied the claim, claiming that the death was not accidental. This suit followed.

Defendant filed a motion for summary judgment on 5 April 1991. Plaintiff responded on 3 May 1991. No oral argument was heard. The matter will be disposed of by the following written opinion.

CONTENTIONS

Defendant makes three contentions in support of summary judgment. First, defendant claims that plaintiffs loss was not a result of a bodily injury effected solely through external, violent or accidental means, directly and independently of all other causes. Second, defendant contends that plaintiffs loss resulted directly or indirectly, wholly or partially, from intentionally self-inflicted injury. Third, plaintiffs loss was not free from contribution by a bodily or mental infirmity. In response, plaintiff argues, at length, that the language of the insurance contract regarding accidental means is ambiguous and, therefore, precludes summary judgment.

STANDARD OF REVIEW

Under Rule 56(c) of the Federal Rules of Civil Procedure, summary judgment may be granted “if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law.” “A fact is ‘material’ and precludes grant of summary judgment if proof of that fact would have [the] effect of establishing or refuting one of the essential elements of the cause of action or defense asserted by the parties, and would necessarily affect [the] application of appropriate principle^] of law to the rights and obligations of the parties. [Citation omitted]. Kendall v. Hoover Co., 751 F.2d 171, 174 (6th Cir.1984) (quoting Black’s Law Dictionary 881 (6th Ed.1979)). The Court must view the evidence in a light most favorable to the nonmovant as well as draw all reasonable inferences in the non- *1281 movant’s favor. See United States v. Diebold, Inc., 369 U.S. 654, 655, 82 S.Ct. 993, 994, 8 L.Ed.2d 176 (1962); Bender v. Southland Corp., 749 F.2d 1205, 1210-11 (6th Cir.1984).

The movant bears the burden of demonstrating the absence of all genuine issues of material fact. See Gregg v. Allen-Bradley Co., 801 F.2d 859, 861 (6th Cir.1986). The initial burden on the movant is not as formidable as some decisions have indicated. The moving party need not produce evidence showing the absence of a genuine issue of material fact; rather, “the burden on the moving party may be discharged by ‘showing’ — that is, pointing out to the district court — that there is an absence of evidence to support the nonmoving party’s case.” Celotex Corp. v. Catrett, 477 U.S. 317, 325, 106 S.Ct. 2548, 2554, 91 L.Ed.2d 265 (1986). Once the moving party discharges that burden, the burden shifts to the nonmoving party to set forth specific facts showing a genuine triable issue. Fed.R.Civ.P. 56(e); Gregg, 801 F.2d at 861.

To create a genuine issue of material fact, however, the nonmovant must do more than present some evidence on a disputed issue. As the United States Supreme Court stated in Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986),

There is no issue for trial unless there is sufficient evidence favoring the nonmov-ing party for a jury to return a verdict for that party. If the [nonmovant’s] evidence is merely colorable, or is not significantly probative, summary judgment may be granted.

Id. at 249-50, 106 S.Ct. at 2511. (Citations omitted); See Catrett, 477 U.S. at 322-23, 106 S.Ct. at 2552; Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586-87, 106 S.Ct. 1348, 1355-56, 89 L.Ed.2d 538 (1986). The standard for summary judgment mirrors the standard for a directed verdict under Fed.R.Civ.P. 50(a). Anderson, 477 U.S. at 250, 106 S.Ct. at 2511. Consequently, a nonmovant must do more than raise some doubt as to the existence of a fact; the nonmovant must produce evidence that would be sufficient to require submission to the jury of the dispute over the fact.

ANALYSIS

Having reviewed the pleadings and exhibits and being otherwise familiar in the premises, the court finds that the policy language “accidental means” is ambiguous and, therefore, summary judgment cannot be entered on that basis. Alternatively, determination of whether an injury is by accidental means under federal common law 1 involves a question of fact: whether the insured reasonably exyected the injury in question to result from his actions.

The court’s conclusion is consistent with Wickman v. Northwestern Nat. Ins. Co., 908 F.2d 1077 (1990). In Wickman, the court noted that in order to find that an injury was accidental the “fact-finder [must] determine[ ] that the insured did not expect an injury similar in type or kind to that suffered[.] [T]he fact-finder must then examine whether the suppositions which underlay that expectation were reasonable.” Id. at 1088 (emphasis added).

On the other hand, the court finds that the language “self-inflicted injury” is unambiguous. In Wickman, the court, in commenting on identical language, noted that “[w]e are bound by this ylain lan- guage_” Id. at 1084 (emphasis added). When applied to the undisputed facts 'of this case, the self-inflicted injury exclusion supports summary judgment.

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Cite This Page — Counsel Stack

Bluebook (online)
765 F. Supp. 1279, 1991 U.S. Dist. LEXIS 8699, 1991 WL 114120, Counsel Stack Legal Research, https://law.counselstack.com/opinion/holsinger-v-new-england-mutual-life-insurance-mied-1991.