Background
Rickie Wade Murchison, a Tennessee factory employee, had $597,000 of employer-provided accidental death and dismemberment coverage. In September 2017 he died after his ATV left a dirt trail and rolled down a creek bank; there were no witnesses, and the sheriff’s report called the death accidental. Toxicology showed a blood-alcohol level of 0.144 and a hydrocodone level well above the therapeutic range.
The policy excluded losses to which intoxication, or the voluntary use of a controlled or non-prescribed drug, was “a contributing factor.” Reliance Standard denied the claim on that basis and upheld the denial on appeal.
What the court held
Judge J. Daniel Breen applied the arbitrary-and-capricious standard, weighing Reliance’s conflict as both decision-maker and payer, and still reversed. The insurer’s own forensic reviewer had said Murchison died of blunt neck trauma and that alcohol and drugs did not contribute to the process of dying; at most they “may have been a risk factor” for the circumstances. The denial letters quoted the toxicology and a list of typical effects of alcohol but pointed to no evidence about how this rollover actually happened. The court called the insurer’s account conjecture, found that it had chosen the favorable parts of the record while ignoring unfavorable parts of the same documents, and held there was not enough evidence tying intoxicating substances to the death. It referred the amount of the award, interest and attorney fees to a magistrate judge.
Why it matters
A “contributing factor” exclusion sounds broad, but the insurer still has to connect the substance to the loss with evidence about the event, not just a lab number. Murchison follows the same line as Kellogg v. Metropolitan Life in the Tenth Circuit, which the court discussed: a condition that may explain why a crash happened is not the same as the cause of death. Compare Danouvong and Kovach, and see the AD&D guide and the Tennessee page.
Read the opinion
Murchison v. Reliance Standard Life Ins. Co., No. 1:19-cv-01028-JDB-jay (W.D. Tenn. Apr. 23, 2020) (official court opinion via GovInfo).
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.