Santos v. Minnesota Life Insurance Company

District Court, N.D. California·Decided November 15, 2021·No. 4:20-cv-06707·Unknown

Opinion

Case No. 20-cv-06707-PJH Plaintiff,

v. ORDER GRANTING PLAINTIFF’S MOTION FOR JUDGMENT AND MINNESOTA LIFE INSURANCE DENYING DEFENDANT’S MOTION COMPANY, FOR JUDGMENT Defendant. Re: Dkt. Nos. 49, 50

Plaintiff and defendants’ cross-motions for judgment under Federal Rule of Civil Procedure 52 came on for hearing before this court on October 7, 2021. Plaintiff appeared through her counsel, Lee Harris and Adrian Hern. Defendant appeared through its counsel, Charan Higbee. Having read the papers filed by the parties and carefully considered their arguments and the relevant legal authority, and good cause appearing, the court hereby rules as follows. This is an ERISA case. Samuel Chong (“decedent” or “insured”) was a fifty-five- year-old engineer and employee of Apple, Inc. Plaintiff Eva Marie Santos, Chong’s cousin, brings this action in her capacity as the administrator of his estate. Defendant Minnesota Life Insurance Company (also known as Securian Financial Group, Inc.) issued a group insurance policy for accidental death of Apple employees, including Chong. A. The Insured’s Death check by the San Francisco Police, after he was a “no show” at work and missed a psychotherapy appointment a few days prior. ML 114 (Dkt. 49-1 at 117).1 He was found on the floor in the kitchen, near a table. ML 115 (Dkt. 49-1 at 118). The gas oven door was found open, but the oven was not in use at the time Chong was discovered. ML 115 (Dkt. 49-1 at 118). Blood was noted near his head and flowed a short distance from the body. ML 115 (Dkt. 49-1 at 118). There also was dried vomit near his head. ML 115 (Dkt. 49-1 at 118). The autopsy report lists the cause of death as blunt force head trauma with subdural hematoma consistent with a fall to the back of the head. ML 126 (Dkt. 49-1 at 129). Under the category “contributing,” “methamphetamine present” is listed. ML 126 (Dkt. 49-1 at 129). The manner of death is listed as “accident.” ML 126 (Dkt. 49-1 at 129). The comment section of the report states:

The autopsy findings are most consistent with a mechanism of injury from a fall to the back of the head in an individual under the influence of methamphetamine. There are no additional injuries that would suggest the involvement of a second party. ML 126 (Dkt. 49-1 at 129). The toxicology report found methamphetamine, amphetamine, and Temazepam present in the decedent’s blood and urine. ML 128 (Dkt. 49-1 at 131). The level of methamphetamine in the blood sample was 2258 ng/mL, and the level of amphetamine was 307 ng/mL. ML 128 (Dkt. 49-1 at 131). The corrected death certificate lists the immediate cause of death as blunt force head trauma with subdural hematoma. ML 209-10 (Dkt. 49-1 at 212-13). The section for “other significant conditions contributing to the death but not resulting in the underlying cause” notes “methamphetamine present.” ML 209-10 (Dkt. 49-1 at 212-13). In the section describing how injury occurred (events which resulted in injury), the death certificate lists “drug related.” ML 209-10 (Dkt. 49-1 at 212-13). The death certificate

1 The citation designation “ML” denotes the Minnesota Life Bates number of the provides a series of check boxes regarding the available options for manner of death, including “natural,” “accident,” “homicide,” “suicide,” “pending investigation,” and “could not be determined.” ML 209 (Dkt. 49-1 at 212). From these options, the manner of Chong’s death is “accident.” ML 209-10 (Dkt. 49-1 at 212-13). Chong had a history of manic-depressive psychosis, a long history of methamphetamine abuse with past rehabilitation, and many years of psychotherapy. ML 114-15 (Dkt. 49-1 at 117). His psychotherapist reported Chong had a long-standing methamphetamine addiction, chronic suicidal ideations, and depression. ML 115, 117 (Dkt. 49-1 at 118, 120). No notes were found in the residence. ML 115 (Dkt. 49-1 at 118). Chong’s physician would later certify that he “did not ever prescribe methamphetamine or its FDA approved brand-name medication Desoxyn” to the decedent. ML 218 (Dkt. 49-1 at 221). B. The Life Insurance Policy At the time of his death, Chong was covered under two group insurance policies issued by Minnesota Life to Apple. Group Term Life Insurance Policy No. 34017-G provided a basic life insurance death benefit of $311,000 for the insured. ML 15, 28, and 335-408 (Dkt. 49-1 at 18, 31, and 338-411). Group Accidental Death and Dismemberment Policy No. 33957-G issued by Minnesota Life to Apple (“the Policy”) provided an accidental death benefit in the amount of $311,000 for the insured (i.e. twice his annual salary). ML 26, 28 (Dkt. 49-1 at 29, 31). The basic life insurance death benefit was already paid by defendant to plaintiff—only the accidental death benefit is the subject of plaintiff’s complaint in this action. The Policy’s accidental death benefit is to be paid “upon receipt at our home office of written proof satisfactory to us that you died . . . as a result of a covered accidental injury.” ML 73 (Dkt. 49-1 at 76). The Policy contains the following definition:

Accidental death or dismemberment by accidental injury means that an insured’s death or dismemberment results, directly and independently of all other causes, from an accidental injury ML 72 (Dkt. 49-1 at 75). The Policy contains specific exclusions. Relevant to this case and Chong’s death, the Policy states:

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