Man Shot By Off-Duty Policeman Not Eligible for Accidental Death Benefits

>Michael DiVigenze, a sheet metal worker and member of the Sheet Metal Workers International Association Local 27 Health and Welfare fund, was shot and killed by an off-duty police officer after brandishing a knife and coming after him. Aetna, DiVigenze’s insurer, paid life insurance benefits to the man’s estate, but refused to pay accidental death benefits. His estate then sued Aetna for the benefits.

>In his ruling, US District Judge Jerome Simandle of the US District Court for New Jersey stated that DiVingenze’s death was not an accident, and thus his estate was not eligible to receive such benefits. Although Aetna did not define “accidental” in its policy, Simandle claimed that “accidental” has a clear definition with respect to the law.

“Giving this term its plain meaning and interpreting it in light of the applicable body of case law in which this term is used in the context of accidental death and dismemberment benefit plans, the meaning of the term ‘accident’ becomes readily apparent in Aetna’s Plan,” Simandle ruled.

>Regarding DiVingenze’s situation specifically, the judge ruled that “by entering into an altercation with a deadly weapon, [DiVigenze’s] own death was a foreseeable and expected consequence of his actions. Such a result therefore cannot be deemed accidental. Here, [DiVigenze] knew or should have known that serious bodily injury or death was a probable consequence substantially likely to occur as a result of his volitional act.”

>The ruling in Labo v. Aetna Life Insurance is available  here .