Jorita Padfield v. Aig Life Insurance Company, a Corporation

290 F.3d 1121, 27 Employee Benefits Cas. (BNA) 2737, 2002 Cal. Daily Op. Serv. 4266, 2002 Daily Journal DAR 5447, 2002 U.S. App. LEXIS 9422, 2002 WL 1000746
CourtCourt of Appeals for the Ninth Circuit
DecidedMay 17, 2002
Docket00-57054
StatusPublished
Cited by118 cases

This text of 290 F.3d 1121 (Jorita Padfield v. Aig Life Insurance Company, a Corporation) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jorita Padfield v. Aig Life Insurance Company, a Corporation, 290 F.3d 1121, 27 Employee Benefits Cas. (BNA) 2737, 2002 Cal. Daily Op. Serv. 4266, 2002 Daily Journal DAR 5447, 2002 U.S. App. LEXIS 9422, 2002 WL 1000746 (9th Cir. 2002).

Opinions

W. FLETCHER, Circuit Judge.

This suit for recovery of benefits under the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. § 1001 et seq., arises from the death of appellant’s husband as a result of autoerotic asphyxiation. The insurer refused to pay benefits under an accidental injury and death insurance policy governed by ERISA. The district court held that the death was caused by an intentionally self-inflicted injury, and thus was not covered by the policy. We reverse.

I. Facts

The relevant facts are not in dispute. On the evening of February 9, 1999, Gerald Alan Padfield told his wife he was going to the cleaners and drove away from his home in the family’s van. He never returned. Three days later, a California Highway Patrol trooper noticed the van parked on an empty street next to a vacant lot. When he approached the van, he discovered Mr. Padfield dead on the backseat floor. According to the coroner’s report, Mr. Padfield was found sitting in an upright position behind the front passenger seat with his back against the sliding door. He was naked from the waist down. One end of a necktie was tied around his neck. The other end was tied to the sliding door hinge, which was located directly above him. The two back seats were folded down, and on top of them were numer[1124]*1124ous sexual devices and a backpack. Inside the backpack were pornographic materials and a small bottle containing a liquid later identified as Chlorohexanol, an industrial solvent. Another bottle of the liquid was nearby.

Post-mortem tests found the industrial solvent in Mr. Padfield’s blood. The coroner reported that he found no trauma other than a deep ligature mark around the neck. The report stated that the death appeared to be the “accidental” result of autoerotic asphyxiation. The death certificate listed the cause of death as “hanging.” Mr. Padfield’s wife, who had filed a missing person report when her husband had failed to return from the cleaners, said that there were no personal problems at home and that “everything appeared to be fine.” When notified of the circumstances surrounding her husband’s death, she told officers that she knew of her husband’s sexual devices but thought he had quit using them.

Mrs. Padfield, the appellant, was the beneficiary of an ERISA-governed accidental death insurance policy that covered Mr. Padfield. Appellee AIG Life Insurance Company (AIG) issued the policy as part of an employee benefits plan with Raytheon Systems Company, where Mr. Padfield worked. Mrs. Padfield claimed benefits under the policy, listing the cause of death as “accidental death by hanging.” The policy provides for an “accidental death benefit” to be paid “[i]f Injury to the Insured Person results in death within 365 days of the date of the accident that caused the Injury.” “Injury” under the policy is defined as “bodily injury caused by an accident while this Policy is in force as to the person whose injury is the basis of the claim and resulting directly and independently of all other causes in a covered loss.” The policy also contains the following exclusion:

This Policy does not cover any loss caused in whole or in part by, or resulting in whole or in part from, ... suicide or any attempt at suicide or intentionally self-inflicted injury or any attempt at intentionally self-inflicted injury.

AIG invoked this exclusion and rejected the claim.

After pursuing an unsuccessful administrative appeal, Mrs. Padfield filed a complaint in the district court under ERISA, seeking benefits under the policy. Both parties filed motions for summary judgment. The district court granted AIG’s motion and denied Mrs. Padfield’s motion. It held that Mr. Padfield’s death by au-toerotic asphyxiation fell outside the policy exclusion for suicide, but fell within the exclusion for death resulting from “intentionally self-inflicted injury.” Mrs. Pad-field appeals both the denial of her motion and the granting of AIG’s motion.

II. Standard of Review and Applicable Legal Principles

Summary judgment is appropriate if the record discloses “that there is no genuine issue as to any material fact and that the moving party is entitled to judg: ment as a matter of law.” Fed.R.Civ.P. 56(c). Ordinarily, the denial of summary judgment is not a final order and is thus unappealable. See Abend v. MCA, Inc., 863 F.2d 1465, 1482 n. 20 (9th Cir.1988). However, an order denying summary judgment is reviewable when, as is the ease here, it is coupled with a grant of summary judgment to the opposing party. Id.; see also United States v. Alameda Gateway Ltd., 213 F.3d 1161, 1164 (9th Cir.2000). We review both a denial and grant of summary judgment de novo. See Alameda Gateway, 213 F.3d at 1164.

A denial of benefits under an ERISA-governed plan is reviewed under a de novo standard “unless the benefit plan [1125]*1125gives the administrator or fiduciary discretionary authority to determine eligibility for benefits or to construe the terms of the plan.” Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989); see also Ingram v. Martin Marietta Long Term Disability Income Plan, 244 F.3d 1109, 1112 (9th Cir.2001). It is undisputed that the plan at issue in this case does not give the administrator such discretion. Thus, we review the administrator’s determination de novo.

When faced with questions of insurance policy interpretation under ERISA, federal courts apply federal common law. Firestone, 489 U.S. at 110, 109 S.Ct. 948; Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 98, 103 S.Ct. 2890, 77 L.Ed.2d 490 (1983) (holding that federal common law of ERISA preempts state law in the interpretation of ERISA benefit plans). Under the federal common law of ERISA, we “interpret terms in ERISA insurance policies in an ordinary and popular sense as would a person of average intelligence and experience.” Babikian v. Paul Revere Life Ins. Co., 63 F.3d 837, 840 (9th Cir.1995) (internal quotations and citation omitted). As we develop federal common law to govern ERISA suits, we may “borrow from state law where appropriate, and [be] guided by the policies expressed in ERISA and other federal labor laws.” Id. (internal quotations and citation omitted).

III. Autoerotic Asphyxiation

Autoerotic asphyxiation is “the practice of limiting the flow of oxygen to the brain during masturbation in an attempt to heighten sexual pleasure.” Todd v. AIG Life Ins. Co., 47 F.3d 1448, 1450 (5th Cir.1995). The undisputed evidence indicates that Mr.

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290 F.3d 1121, 27 Employee Benefits Cas. (BNA) 2737, 2002 Cal. Daily Op. Serv. 4266, 2002 Daily Journal DAR 5447, 2002 U.S. App. LEXIS 9422, 2002 WL 1000746, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jorita-padfield-v-aig-life-insurance-company-a-corporation-ca9-2002.