Sims v. Monumental General Life Ins. Co., Civ. A. No. 90-2645.

• Decision Date: 08 November 1991
• Docket Number: Civ. A. No. 90-2645.
• Citation: 778 F. Supp. 325
• Parties: Julia Brumfield SIMS v. MONUMENTAL GENERAL LIFE INSURANCE COMPANY.
• Court: U.S. District Court — Eastern District of Louisiana

778 F. Supp. 325

Julia Brumfield SIMS v. MONUMENTAL GENERAL LIFE INSURANCE COMPANY.

Civ. A. No. 90-2645.

United States District Court, E.D. Louisiana.

November 8, 1991.

Joseph Arthur Sims, Jr., Hammond, La., for plaintiff.

Covert J. Geary and Virginia Weichert Gundlach, Jones, Walker, Waechter, Poitevent, Carrere & Denegre, New Orleans, La., for defendant.

WICKER, District Judge.

The matter is before the Court cross-motions for summary judgment filed on behalf of plaintiff, Julia Brumfield Sims, and defendant, Monumental General Life Insurance Company ("Monumental"). By way of these motions, the Court has been asked to determine whether or not plaintiff, as beneficiary, can recover $150,000.00 in accidental death benefits under an Accidental Death and Dismemberment group insurance policy ("the Policy") issued by the defendant. The named insured under the Policy was the plaintiff's brother, William P. Brumfield.

After considering the briefs of counsel and the applicable law, the Court GRANTS the defendant's motion for summary judgment and DENIES the plaintiff's motion for summary judgment, for the reasons which follow:

The following facts are deemed undisputed for purposes of these motions:

(1) The insured, William P. Brumfield, obtained Group Voluntary Accidental Death and Dismemberment Insurance from Monumental, Policy No. GZ08-181, Certificate No. 14752, under which Mr. Brumfield was covered by $150,000.00 in accidental death insurance.

(2) Coverage was assumed by Monumental on June 1, 1984 under Policy No. MZ08-181, with all terms and conditions of the Policy remaining the same.

(3) Mr. Brumfield died late at night, apparently on July 24, 1989, at his home in Baton Rouge, Louisiana. He was discovered on July 26, 1989 with a rope around his neck, suspended over an iron pipe in a closet in his study, which rope was connected to an elaborate pulley system.

(4) Mr. Brumfield was discovered hanging in the den closet wearing only red undershorts. There was a large wall mirror standing on the floor against the desk approximately eight feet in front of the opened closet door where Mr. Brumfield was hanging.

(5) The pipe had old rope burn marks on the top where the rope was suspended from it. In the closet was a bag which contained the remaining part of the rope that the victim was hung with, which also had black burn marks matching the old marks on the top pipe in the closet.

(6) Mr. Brumfield was involved in an act that restricted oxygen to his brain, apparently for his own personal enjoyment.

(7) Mr. Brumfield died as a result of autoerotic asphyxiation.¹

(8) Mr. Brumfield's death was neither the result of suicide, foul play or natural causes.

(9) The Policy provides that coverage is only for death resulting from an "accidental bodily injury," which occurs independently of any other cause.²

(10) The Policy provides that accidental death benefits are not payable for "any loss resulting directly or indirectly, wholly or partly from ... an intentionally self-inflicted injury.³

Plaintiff filed this lawsuit after Monumental denied coverage on the grounds that the Policy excluded payments in this instance because Mr. Brumfield's death could not be classified as "accidental" and because the insured's death was a result of an intentionally self-inflicted injury.

Courts have reached different conclusions on the issue of whether a death by autoerotic asphyxiation can be deemed accidental.⁴ However under the facts and particular policy language of this case, this Court need not decide that issue. Even assuming arguendo that the Court would find that Mr. Brumfield's death was accidental, the Policy exclusion for "intentionally self-inflicted injury" bars coverage.

The plaintiff suggests that Mr. Brumfield's death, and whether he intended that death, should be the focal point of the Court's inquiry, since death was ultimately the consequence of Mr. Brumfield's willful participation in the practice of autoerotic asphyxiation. However the Policy exclusion reads: "suicide or attempt thereat or intentionally self-inflicted injury." Were death considered an intentionally self-inflicted injury, then the word "suicide or attempt thereat" would be redundant and mere surplusage. Furthermore, all parties agree that Mr. Brumfield's death was not the result of suicide. He apparently had engaged in the practice of autoerotic asphyxiation on other occasions and clearly did not intend to die. Mr. Brumfield's death then is not the "injury." Rather it is only the basis of the loss claimed under the Policy. The Court then must decide what injury, if any, "directly or indirectly", "wholly or partly" led to this loss and whether that injury was "intentionally self-inflicted" so as to be excluded from coverage under the Policy.

The Louisiana insurance cases on intentional injury concern insureds who injure another and are distinguishable both by their facts and by the policy language at issue. See generally Breland v. Schilling, 550 So.2d 609, 611 (La.1989); Menard v. Zeno, 558 So.2d 744 (La.App. 3rd Cir.1990). However, other jurisdictions have considered whether an accidental death policy exclusion for "intentionally self-inflicted injury" (as opposed to an exclusion for suicide) was invoked by an insured's death that resulted from autoerotic asphyxiation.

In Sigler v. Mutual Benefit Life Ins. Co., 506 F.Supp. 542 (S.D.Iowa), aff'd, 663 F.2d 49 (8th Cir.1981), the Court addressed cross motions for summary judgment on the issues of whether the plaintiff therein, the widow of the deceased insured, could recover the proceeds of a $50,000.00 accidental death group insurance plan under which her husband was covered, and whether the plaintiff was entitled to actual and punitive damages because of the defendant insurance company's denial of her claim under the policy. The policy at issue in Sigler excluded from coverage an "intentionally self inflicted injury of any kind." Id. at 543-44. In reaching its conclusion that recovery was barred under the policy, inter alia, in light of the exclusionary language of the policy, the Court stated:

Even if the insured's death was found to be accidental within the meaning of the policy, recovery would be barred by the clause excluding from coverage an "intentionally, self-inflicted injury of any kind." Although the insured did not intend to produce the unconsciousness that resulted in his death, his voluntary acts were intended to temporarily restrict his air supply to heighten the sensations of masturbation. Therefore, the elements of "intentionally, self-inflicted" are satisfied. The only question remaining is whether self-inflicted hanging is an "injury of any kind." The Court believes that it is. If someone else had placed the insured in the same position as he placed himself to temporarily restrict his ability to breathe, it would have been an injury. In the Court's opinion, it continues to be an injury even when it is self-inflicted.

Id. at 545.

The holding of the Sigler court differs from that of the Texas appellate court in Connecticut General Life Ins. Co. v. Tommie, 619 S.W.2d 199 (Tex.Civ.App.1981). In Tommie, the Court affirmed a jury award of $120,000.00 in accidental death benefits to the deceased insured's wife and mother, who were joint beneficiaries under a group insurance policy. At trial, the jury found that the insured's death, although a consequence of the autoerotic practice, was not the result of a self-inflicted injury. Thus, the beneficiaries were not affected by the policy exclusion for any loss which results directly or indirectly from an intentionally self-inflicted injury.

In upholding the jury's finding as to the self-inflicted injury exclusion, the Tommie court stated:

The evidence reveals that Mr. Tommie put a rope around his neck with the intent to tighten it to a degree necessary to reduce the amount of oxygen to the brain.... We must determine from the record if a reduction of the supply of oxygen to the brain in order to produce a state of hypercapnia⁵ is an injury within the normal and usual meaning of that term.

There is abundant evidence that Mr. Tommie, aside from his propensity to unusual sexual practices, was a well-adjusted, happy individual who was looking forward to the future, and that he did not intend to commit suicide. There is also evidence that a state of hypercapnia simply alters the amount of oxygen in the brain, thus heightening or intensifying certain body sensations, and that it may be accomplished by

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