Court Affirms Denial of Benefits to Drunk Driver

December 20, 2006 (PLANSPONSOR.com) - The US District Court for the Middle District of Florida has granted summary judgment in favor of the administrator of an accidental death and dismemberment plan who denied benefits to a man paralyzed following a drunk-driving accident.

In its opinion, the court said, while Linsel Witcher did not purposefully crash his vehicle, the accident was still self-inflicted due to his intentional decision to drive the vehicle while intoxicated. Further, the court said there was not enough evidence to support Witcher’s arguments that he was not the driver of the vehicle and that his complete quadriplegia was due to hospital medical personnel dropping him, and not by the accident.

After Witcher’s vehicle veered off the road and hit a palm tree on December 8, 2003, a person who lived nearby went to the accident scene and observed Witcher lying in the back seat of his car. No one else was observed at or near the accident. Subsequent tests confirmed Witcher’s blood-alcohol level to be more than twice the legal limit for Florida drivers.

While one scan at the hospital found nothing unusual about Witcher’s spine, another done almost three hours later found a fracture – a point Witcher tried to use to prove to the plan administrator he was paralyzed after he was dropped by medical personnel and not because of the accident. Witcher’s wife filed for benefits under his employer-sponsored plan with the plan administrator, Life Insurance of North America (LINA) who denied the claim.

After Witcher and his wife appealed the benefits denial, claiming Witcher was not driving at the time of the accident and his quadriplegia was caused by medical negligence, a doctor hired by LINA said it was possible quadriplegia could have resulted hours after the accident, but due to the accident. A medical examiner hired by LINA also said a fall could not have resulted in such an injury.

LINA also interviewed the person whom Witcher claimed was driving the car at the time of the accident and that person denied he was the driver. After his claim was denied again, the Witcher’s filed their lawsuit.

The case is Witcher v. CIGNA Group Insurance, M.D. Fla., No. 3:06-cv-00318-VMC-TEM, 12/11/06.

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