U.S. District Judge Philip R. Martinez ofthe U.S. District Court for the Western District of Texas ruled that Joel Pando’s death properly fit into an exclusion of the accidental death and dismemberment plan from his employer for losses resulting from illegal drinking and driving.According to the court, when Pando was killed in the November 2004 accident, his blood alcohol level was higher than the state’s legal DUI limit.
After his death, his wife, Maria Elena, filed a claim for benefits as the plan beneficiary. Prudential Insurance Co. of America, the plan administrator, denied the claim, finding that a plan exclusion barring benefits for losses that result from the illegal use of alcohol applied to the case.
The court rejected Maria Elena Pando’s argument that the exclusion applied only where the actual consumption of alcohol was illegal. In so doing, the court said at least two other district courts within the same circuit had ruled that “illegal use of alcohol” applied to people who drove while intoxicated.
The case is Pando v. Prudential Insurance Co. of America, W.D. Tex., No. 06-CV-423-PRM, 12/20/07.