Prather v. Sun Life and Health Ins. Co.

Federal 7th Circuit Court
Civil Court
Insurance
Citation
Case Number: 
No. 16-1861
Decision Date: 
December 13, 2016
Federal District: 
C.D. Ill.
Holding: 
Reversed

Dist. Ct. erred in granting defendant-insurance company’s motion for summary judgment in action by plaintiff-decedent’s estate seeking to recover proceeds of accidental death policy issued by defendant under circumstances where: (1) decedent tore his left Achilles tendon playing basketball; (2) on day before scheduled surgery, plaintiff displayed symptoms of deep vein thrombosis (blood clot) in his injured leg; and (3) shortly after his surgery, plaintiff died when blood clot from injured leg became lodged in his lung. While defendant argued that decedent was not entitled to proceeds of policy since instant pulmonary embolism was not consequence of injury, but rather was consequence of surgery, Ct. of Appeals found that plaintiff was entitled to judgment since defendant had failed to make any plausible showing that surgery, rather than accident that necessitated surgery, caused decedent’s death.