Judy Fulkerson v. Unum Life Ins. Co. of Am.

36 F.4th 678
CourtCourt of Appeals for the Sixth Circuit
DecidedJune 3, 2022
Docket21-3367
StatusPublished
Cited by10 cases

This text of 36 F.4th 678 (Judy Fulkerson v. Unum Life Ins. Co. of Am.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Judy Fulkerson v. Unum Life Ins. Co. of Am., 36 F.4th 678 (6th Cir. 2022).

Opinion

RECOMMENDED FOR PUBLICATION Pursuant to Sixth Circuit I.O.P. 32.1(b) File Name: 22a0120p.06

UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT

┐ JUDY FULKERSON, │ Plaintiff-Appellee, │ > No. 21-3367 │ v. │ │ UNUM LIFE INSURANCE COMPANY OF AMERICA, │ Defendant-Appellant. │ │ ┘

Appeal from the United States District Court for the Northern District of Ohio at Cleveland. No. 1:19-cv-01180—David A. Ruiz, Magistrate Judge.

Argued: December 8, 2021

Decided and Filed: June 3, 2022

Before: SUTTON, Chief Judge; SILER and READLER, Circuit Judges. _________________

COUNSEL

ARGUED: Brett K. Bacon, FRANTZ WARD LLP, Cleveland, Ohio, for Appellant. Robert P. Rutter, RUTTER & RUSSIN, LLC, Cleveland, Ohio, for Appellee. ON BRIEF: Brett K. Bacon, Olivia Lin Southam, FRANTZ WARD LLP, Cleveland, Ohio, for Appellant. Robert P. Rutter, RUTTER & RUSSIN, LLC, Cleveland, Ohio, for Appellee. _________________

OPINION _________________

CHAD A. READLER, Circuit Judge. Daniel Tymoc died in a car crash while speeding and driving recklessly. Tymoc’s mother, Judy Fulkerson, pursued accidental death benefits under Tymoc’s life insurance policy, issued by Unum Life Insurance Company. Unum, however, denied those benefits, invoking a policy exclusion for “losses caused by, contributed to No. 21-3367 Fulkerson v. Unum Life Ins. Co. of Am. Page 2

by, or resulting from . . . commission of a crime.” Fulkerson successfully challenged Unum’s interpretation of the crime exclusion in the district court and was awarded the $100,000 accidental death benefit. Unum now appeals. Because reckless driving falls within the unambiguous plain meaning of crime, we reverse that aspect of the district court’s judgment.

I.

Daniel Tymoc died in a single-car accident. At the time of the accident, Tymoc was traveling between 80 and 100 miles per hour, well above the 60 mile per hour speed limit. As Tymoc attempted to pass multiple cars, the gap between a car in the right lane and a box truck in the left lane closed. In an apparent attempt to avoid a collision, Tymoc veered to the right, causing his vehicle to drive off the road, roll down an embankment, strike multiple trees, and flip over several times before coming to rest at the bottom of a hill. Tymoc died at the scene.

Through his employer, Tymoc was covered by a Unum life insurance policy that provided both basic life insurance coverage and an additional accidental death benefit. His mother, Judy Fulkerson, sought to recover benefits as the policy’s beneficiary. Unum approved a $100,000 payment of group life insurance benefits. But it withheld $100,000 in accidental death benefits on the basis that Tymoc’s conduct at the time of the accident—speeding and reckless driving, conduct Fulkerson does not dispute—caused his death, thereby triggering the policy’s crime exclusion.

Invoking the Employee Retirement Income Security Act of 1974, 29 U.S.C. §§ 1001– 1191d, Fulkerson sued Unum to recover, as relevant here, the accidental death benefits. See 29 U.S.C. § 1132(a)(1)(B). The parties cross-moved for judgment on the administrative record, which the district court entered in Fulkerson’s favor as to the accidental death benefits. Unum timely appealed.

II.

Unum prevails if either reckless driving or speeding triggers the policy’s crime exclusion. Concluding, as we do, that the former falls within the crime exclusion, we need not consider the latter. No. 21-3367 Fulkerson v. Unum Life Ins. Co. of Am. Page 3

A. Tymoc’s employer provided him a life insurance policy as part of an employee benefit plan. For a “participant or beneficiary” who seeks “to recover benefits due to him under the terms of his plan,” ERISA provides the policyholder or beneficiary a statutory cause of action. 29 U.S.C. § 1132(a)(1)(B). That is the provision Fulkerson, as the beneficiary of Tymoc’s life insurance policy, invokes here.

With ERISA governing today’s appeal, two threshold principles deserve emphasis. One, the parties agree that we should review the crime exclusion’s applicability here de novo. See Clemons v. Norton Healthcare Inc. Ret. Plan, 890 F.3d 254, 264 (6th Cir. 2018) (noting the different standards of review that may apply in an ERISA case). Two, when interpreting an ERISA-covered insurance policy, “we apply federal common law rules of contract interpretation.” Perez v. Aetna Life Ins. Co., 150 F.3d 550, 556 (6th Cir. 1998) (en banc). To do so, we begin with the policy’s text. See id. Unless that text is ambiguous, we presume the policy means what it says and therefore give effect to its “plain meaning in an ordinary and popular sense.” Farhner v. United Transp. Union Discipline Income Prot. Program, 645 F.3d 338, 343 (6th Cir. 2011) (quoting Williams v. Int’l Paper Co., 227 F.3d 706, 711 (6th Cir. 2000)). On that score, a policy is ambiguous only if it “is susceptible to multiple reasonable interpretations, not just because clever lawyers can disagree over the meaning of terms.” Clemons, 890 F.3d at 269.

B. With these legal tools in hand, we begin the job before us: interpreting the crime exclusion in Tymoc’s life insurance policy. We start with the policy’s text. It excludes accidental death benefits for “any accidental losses caused by, contributed to by, or resulting from . . . an attempt to commit or commission of a crime.” And it frames the question underlying this appeal: is reckless driving a “crime” within the meaning of the exclusion?

1. As the policy does not expressly answer that question, we first turn to dictionaries to determine the term’s plain meaning. See, e.g., Adams v. Anheuser-Busch Cos., 758 F.3d 743, 748 (6th Cir. 2014); Kovach v. Zurich Am. Ins. Co., 587 F.3d 323, 332–33 (6th Cir. 2009). Black’s Law Dictionary defines “crime” as “[a]n act that the law makes punishable; the breach of a legal duty treated as the subject-matter of a criminal proceeding.” Crime, Black’s Law Dictionary (11th ed. 2019). Merriam-Webster’s Collegiate Dictionary agrees. It defines “crime” as “an illegal act for which someone can be punished by the government; especially: No. 21-3367 Fulkerson v. Unum Life Ins. Co. of Am. Page 4

a gross violation of law,” “a grave offense especially against morality,” and “criminal activity.” Crime, Merriam-Webster’s Collegiate Dictionary (last visited June 2, 2022). The American Heritage Dictionary similarly instructs that a crime is “[a]n act committed in violation of law where the consequence of conviction by a court is punishment, especially where the punishment is a serious one such as imprisonment,” “[u]nlawful activity,” and “[a] serious offense, especially one in violation of morality.” Crime, American Heritage Dictionary of the English Language 430 (5th ed. 2011). Read together, these lexiconic sources indicate that the plain meaning of “crime” is “an illegal act for which someone can be punished by the government.”

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