Widow of Bee Sting Victim Loses Benefit Fight

January 3, 2008 (PLANSPONSOR.com) - The administrator of an accidental death benefit plan was within its rights in deciding that the widow of a participant who died after suffering an allergic reaction to a bee sting was not due a benefit payout, a federal appellate court has decided.

The 4 th U.S. Circuit Court of Appeals ruled that U.S. District Judge Glen E. Conrad of the United States District Court for the Western District of Virginia was correct when he upheld the benefits denial by Metropolitan Life Insurance Co. in November 2005.

The insurer, which administered the policy for General Electric workers, contended that Tommie B. Hall’s allergy to bee stings represented a pre-existing disease. That finding put the claim by Hall’s widow Jennifer for $284,208.00 in benefits properly under a plan exclusion, Circuit Judge Allyson K. Duncan wrote for the appellate court.

According to Duncan’s opinion, the July 2004 sting on the bridge of the 37-year-old Hall’s nose caused a major reaction within minutes. Hall’s tongue swelled and he stopped breathing and lost consciousness.

Emergency personnel were unable to revive him and he was pronounced dead little more than an hour after he was stung.

A consulting doctor hired by MetLife asserted that Hall likely had an allergy to stinging insects that was not reflected in his medical records and that this allergy caused the reaction resulting in his death.

Jennifer Hall argued that when an injury activates a dormant disease, the injury should be held to be the direct and exclusive legal cause of death.

The ruling in Hall v. Metropolitan Life Insurance Co.,   4th Cir., No. 05-2432, unpublished 12/27/07, is here .