Malin v. Metropolitan Life Insurance

845 F. Supp. 2d 606, 2012 WL 603676, 2012 U.S. Dist. LEXIS 23877
CourtDistrict Court, D. Delaware
DecidedFebruary 22, 2012
DocketCivil No. 10-0661 (JBS/AMD)
StatusPublished
Cited by5 cases

This text of 845 F. Supp. 2d 606 (Malin v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering District Court, D. Delaware primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Malin v. Metropolitan Life Insurance, 845 F. Supp. 2d 606, 2012 WL 603676, 2012 U.S. Dist. LEXIS 23877 (D. Del. 2012).

Opinion

OPINION

SIMANDLE, District Judge:

I. INTRODUCTION

This matter concerns the somber topic of the untimely death of Stephen J. Malin, husband to Plaintiff Stacey Malin. Mr. Malin died of a gunshot wound to the head on February 21, 2009. At the time of his death, Mr. Malin was a participant in a group employee insurance plan administered by Defendant Metropolitan Life Insurance Company (“MetLife”), which included a supplemental life insurance benefit and an accidental death insurance benefit. Plaintiff, Mr. Malin’s wife and designated beneficiary under the plan, sought recovery of the supplemental life and accidental death benefits after Mr. Malin died. Plaintiffs application was denied by Defendant, however, because Defendant determined, based on the records submitted by Plaintiff, that Mr. Malin died as a result of suicide, which was a listed basis for the denial of coverage under the plan. Consequently, Plaintiff brought this action, contesting that denial of benefits.

Presently before the Court is Defendant MetLife’s motion for summary judgment. [Docket Item 22.] The parties disagree over what question the motion requires the Court to answer. The motion does not, as Plaintiffs counsel suggests, call on the Court to determine if there is a question of fact over whether Mr. Malm’s death was the result of an accident or the result of suicide. Instead, this motion calls on the Court to determine a more narrow question: whether a genuine dispute of fact exists as to whether, based on the administrative record, MetLife’s determination that Mr. Malin died as a result of suicide was an abuse of discretion. As explained below, the Court finds that it was not an abuse of discretion based on this record, and will therefore grant Defendant’s motion for summary judgment.

II. BACKGROUND

The following facts are taken from the undisputed administrative record, which includes, inter alia, Mr. Malin’s benefits plan documents, Mr. Malin’s certificate of death, the contemporaneous New Castle County police reports, and Mr. Malin’s medical records from February 21, 2009.

A. Mr. Malin’s Death

According to Plaintiffs contemporaneous statements, memorialized in the police reports contained in the administrative record, on the evening of February 20, 2009, Plaintiff and Mr. Malin had been out socializing and drinking until early in the morning of February 21. Dykovitz Rep., Def.’s Ex. D, ML000258.1 On the drive [608]*608home, they began to argue, and the argument continued after they returned to their house in Newark, Delaware. After exiting the vehicle they had been driving home, Mr. Malin got into a different car that was parked in the driveway, and sped up and down the street a few times before reparking the car in the driveway and entering the house. Abram Rep., ML000269.

The argument grew in intensity when they entered the house and culminated in the living room with Mr. Malin brandishing a revolver. Police accounts differ as to what happened next with the gun; in one account, Plaintiff reported that Mr. Malin threw the gun at her. Dykovitz Rep., ML000258. In another account, Plaintiff reported that she slapped the gun out of Mr. Malin’s hand. Abrams Rep., ML000269. When Mr. Malin recovered the gun, Plaintiff reported to one of the investigating police officers that Mr. Malin removed some bullets from the gun. M2 In all accounts, Plaintiff reported that after recovering the gun, Mr. Malin pointed it at his own head. Plaintiff said that she then closed her eyes and begged Mr. Malin to stop. Id. She reported that she heard him pull the trigger and the gun made a click, apparently because there was no bullet in the chamber. Dykovitz Rep., ML000260. Plaintiff reported that she continued yelling at him to stop and put the gun down; however, he pulled the trigger a second time and this time the gun discharged, firing a bullet through Mr. Malin’s head. Devine Rep., ML000265.

Plaintiff then called for emergency assistance. Id. Mr. Malin was transported by EMS to Christiana Hospital. Devine Rep. ML000265. The investigating police officers classified the incident under a “crime code” of “8102 — Suicide.” Abram Rep., ML000267. Plaintiff reported to investigating officers that Mr. Malin had previously thrown the revolver at her in the past, broken objects inside the residence when they argued, and on two prior occasions Mr. Malin had “placed the gun to his head after an argument, and pulled the trigger” which Plaintiff characterized as “playing a game of Russian roulette.” Dykovitz Rep., ML000258; Abram Rep., ML000269. Plaintiff reported that Mr. Malin had attended psychiatric counseling and was taking medication to control his behavior. Dykovitz Rep., ML000258.

Mr. Malin died at Christiana Hospital later in the day on February 21, 2009, after his treating physicians determined that he would not recover from his injuries. Def.’s Reply Ex. A, ML000399.

The next day, Assistant Medical Examiner Dr. Jennie Vershvovsky performed an external examination of Mr. Malin’s remains at the Medical Examiner’s Office. Abram Rep., ML000270. Dr. Vershvovsky finished her investigation and completed Mr. Malin’s certificate of death on February 23, 2009, determining the cause of death as “gunshot wound to head.” Certificate of Death, Def.’s Ex. C, ML00014. In a separate section on the certificate of death, titled “manner of death”, Dr. Vershvovsky checked a box labeled “suicide” and left blank a box labeled “accident.” Id.

B. Insurance Benefits Plan

Mr. Malin’s coverage under the employer-funded Siemens Corporation Group In[609]*609surance and Flexible Benefits Program (“the Plan”) began effective January 1, 2009. Wales e-mail, June 24, 2009, Def.’s Ex. B, ML00016. The Plan, which is administered by Defendant, is an employee benefit plan regulated under the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. § 1001 et seq. Plan at 171, Def.’s Ex. A, ML00234; Aetna Health Inc. v. Davila, 542 U.S. 200, 207-08, 124 S.Ct. 2488, 159 L.Ed.2d 312 (2004).

The Plan provided several health, medical and life insurance benefits, including life insurance benefits and personal accident insurance benefits. The life insurance benefits included a basic employee life insurance that was employer paid, and an optional “supplemental life insurance” benefit. Plan at 110, ML00173. The basic life insurance benefit was payable to the insured’s beneficiary regardless of the cause of death. Id. at 112, ML00175. The supplemental life insurance benefit, however, was not payable “in the event of suicide within two years after the effective date of the person’s coverage.” Id. at 119, ML00182.

The personal accident insurance benefit paid a premium if the insured suffered a serious injury or death as a result of an accident. Id. at 122, ML00185. The personal accident insurance did not, however, cover losses resulting from, inter alia, “intentionally self-inflicted injuries” or “suicide.” Id. at 126, ML00189. The terms “suicide” and “accident” are not defined in the Plan document.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Lann v. Metro. Life Ins. Co.
371 F. Supp. 3d 1185 (N.D. Georgia, 2019)
Riggs v. Metropolitan Life Insurance
940 F. Supp. 2d 172 (D. New Jersey, 2013)
Acree v. Hartford Life & Accident Insurance
917 F. Supp. 2d 1296 (M.D. Georgia, 2013)
Fisher v. Aetna Life Insurance
890 F. Supp. 2d 473 (D. Delaware, 2012)

Cite This Page — Counsel Stack

Bluebook (online)
845 F. Supp. 2d 606, 2012 WL 603676, 2012 U.S. Dist. LEXIS 23877, Counsel Stack Legal Research, https://law.counselstack.com/opinion/malin-v-metropolitan-life-insurance-ded-2012.