A judge has ordered an insurance company to pay out nearly a half-million dollars to the
widow of a Pennsylvania man who died following a motorcycle accident in Colorado in late 2008.
In a memorandum that was filed in the Eastern District of Pennsylvania Aug. 3, and posted on Aug. 6, U.S. District Judge Eduardo C. Robreno ordered Life Insurance Company of North America to pay $400,000 to Hetty A. Viera, whose late husband, Frederick A. Viera, died from injuries sustained in a motorcycle accident in Grand Junction, Colo. back on Oct. 14, 2008.
Viera’s bike had struck a car head-on; he ended up surviving for about three hours during a stay at the hospital before he was pronounced dead.
The insurance company initially denied benefits to Viera’s widow, who resides in East Stroudsburg, Pa., under an accidental death and dismemberment policy.
The woman soon filed suit against the insurer at the Philadelphia Court of Common Pleas, with the case subsequently removed to the federal court in Philadelphia.
The complaint alleged that Frederick Viera had been approved for two accidental death and dismemberment insurance policies in July 2007, which would provide coverage of up to $400,000 in the event of an accident.
The lawsuit accused the insurance company of breach of contract, bad faith and intentional infliction of emotional distress.
The court found in favor of the plaintiff following a bench trial earlier this summer, the record shows.
According to background information contained within the judicial memorandum, the insurance company had obtained a report from a medical expert who determined that Viera’s pre-existing medical conditions and the medications in his system could have contributed to his death, since they would have made it difficult for doctor’s to resuscitate the man.
An expert retained by the plaintiff, however, refuted those findings, the record shows.
In his memorandum, Robreno wrote that the court found the plaintiffs’ expert witness’s testimony more persuasive than that of the defense witness.
Robreno wrote that the “contemporaneous medical records” don’t show that any pre-existing condition or drugs that may have been in Viera’s system at the time contributed to his death “to the extent that his injuries would not have resulted in his death regardless” of those other circumstances.
“Accordingly, Viera died from the injuries sustained in his head-on motorcycle accident,” the judge wrote.
Robreno concluded that the insurance company failed to satisfy its burden that the policy excludes the plaintiff’s coverage, and that it did not properly deny the plaintiff’s claim.