March 2014 Bad Faith Cases: Where Facts Did Not Support Application Of The Policy’s Terms, There Was No Contractual Obligation To Pay And No Bad Faith (Middle District)

In Kitsock v. Baltimore Life Ins. Co., Plaintiff beneficiary brought breach of contract and statutory bad faith claims for the insurer’s refusal to pay accidental death benefits under a life insurance policy, from fatal injuries sustained by the insured when the insured fell and struck his head on his bed rail. The parties agreed to resolution of the matter before a Magistrate Judge.  The matter was presented via the carrier’s summary judgment motion.

The court stated that the accidental death benefit under the policy applied when the insured’s death occurred “solely through external, violent and accidental bodily injury,” but the accidental death benefit did not apply “to a death that results solely or partly from . . . mental or bodily infirmity, illness, disease or infection.” The decedent suffered from a menagerie of serious medical problems.  On the day of his death, he was found to have seemingly fallen, but the circumstances were unclear.  The court found it was not possible for a jury to find that death could be attributed solely to a fall, and not also to one or more of the myriad other conditions.  Thus, summary judgment was entered on both counts.

Kitsock v. Balt. Life Ins. Co., 3:12-CV-01728, 2014 U.S. Dist. LEXIS 2155 (M.D. Pa. January 8, 2014) (Schwab, M.J.)