Background
An employee covered by a group policy with life and accidental death benefits died when the motorcycle he was driving left the road and hit a fence. His blood-alcohol level was 0.19, and the death certificate listed acute alcohol intoxication as a significant contributing condition. Hartford paid the $42,916.04 life benefit but denied the accidental death benefit, which would have doubled the payment to his young daughter. It said the death did not result from an “accidental bodily injury” and, alternatively, fell within the exclusion for intentionally self-inflicted injury.
The district court upheld the denial under Wickman while calling the result an “extraordinarily hard rule of law.” A three-judge panel reversed, reasoning from statistics that a death was not “highly likely” from drunk driving. The full court then reheard the case and vacated the panel opinion.
What the court held
The en banc court reversed the judgment for Hartford on a narrower ground. When it denied the claim, Hartford had used a looser standard focused on whether the death was a foreseeable result of drunk driving. In litigation it defended the denial under Wickman’s stricter “highly likely to occur” test. Because those positions were fundamentally inconsistent, the denial could not be sustained. The court also rejected Hartford’s fallback argument that intoxication was itself an “intentionally self-inflicted injury.” That reading was unreasonable because it would make the policy’s separate drug exclusion meaningless, and it was another after-the-fact rationale: the initial denial letter had treated the fatal head injury, not the drinking, as the self-inflicted injury. The case was returned to Hartford to apply the standard it now said should govern. Judge Bright, joined by two judges, concurred. Judge Gruender, joined by three judges, dissented and would have upheld the denial.
Why it matters
King is a reminder that a plan administrator is generally held to the reasons it actually gave in the claim file, not new ones offered later. For an AD&D denial, read the denial letter closely for the definition of “accident” the insurer used, and compare it with what the policy says. The decision does not resolve whether drunk-driving deaths are accidents; compare Lennon and Kovach in the Sixth Circuit.
Read the opinion
King v. Hartford Life & Accident Ins. Co., 414 F.3d 994 (8th Cir. 2005) (en banc) (CourtListener). Opinion read in full November 2, 2026.
Not legal advice. This page summarizes general rules and the specific statutes cited. Your policy's wording, the state whose law applies, and whether the coverage came through an employer can all change the result. See the disclaimer and editorial policy.