A Virginia Beach man died 94 days after a fall. Those last 4 days cost his widow $100,000.
If the 75-year-old man had died four days earlier, his widow would have probably collected on a $100,000 accidental death insurance policy.
But he didn't. So she won't.
A federal judge ruled last week for the Transamerica Premier Life Insurance Company, saying Blosch's policy was clear: The death "must occur within 90 days of the accident."
"On the basis of these undisputed facts, defendant is not required to pay," U.S. District Judge Rebecca Beach Smith wrote.
Attorneys for Transamerica and Blosch's widow declined or did not respond to requests for comment.
A veteran lawyer with 40 years experience in estate planning, however, said the court's ruling was not surprising.
John Midgett compared the lawsuit in question to a Hail Mary in football. There wasn't much the lawyer, or the judge, could do in light of the facts of the case and the policy's restrictive nature.
"When it says 90 days, it mean 90 days. Not 91. Not 89," said Midgett, who was not involved in the case.
Kevin Martingayle, a past president of the Virginia State Bar, and Gerald Schwartz, a past president of the Virginia Trial Lawyers Association, said that doesn't make it right since Blosch would likely have died sooner had doctors not intervened following his fall.
“If an insured individual’s life is extended by heroic medical means, it seems absurd and unfair that those medical efforts can relieve an insurance company from having to pay simply because the life was artificially extended past a deadline," Martingayle said. He believes the General Assembly should consider getting involved to prevent future problems.
Schwartz said the law places a policy holder's family in the awkward position of having to make end-of-life decisions based on an "arbitrary and unnecessary deadline."
"It's particularly bad in today's times, where doctors take all measures to save and prolong someone's life," he said.
Darlene Blosch, the widow, sued Transamerica last year in the hopes of forcing the company to pay.
Her husband, a former Marine who worked 20 years as an electrician for Peabody Coal, had secured the group accidental death insurance policy in 1998. The original policy was issued by Peoples Benefit Life Insurance, which later merged with Monumental Life Insurance Company, which later changed its name to Transamerica.
Following Blosch's Aug. 12, death, however, Transamerica balked at paying.
Yes, Blosch fell May 10, 2018, struck his head on a sidewalk, slipped into a coma and placed on a ventilator. Yes, he was hospitalized until he died from a subdural hematoma and medical complications arising from the fall. And yes, such a death would typically be covered by the policy.
But, Transamerica's attorneys argued, Blosch waited too long to die.
"The clear, plain meaning of the policy terms precludes recovery in this case," Michele Dallman wrote earlier this year.
Albert Selkin, Darlene Blosch's attorney, attacked the legality of the policy's 90-day provision. Among other things, he said in court documents, it was not included with the rest of the policy's exceptions or exclusions provisions and that the clause offended "the public policy of Virginia." He said it required the policy holder to die in an "unreasonably short period of time."
"It is absurd that the policy doesn't cover the accidental death of one who is hospitalized and invalid from the day of the accident," Selkin wrote in court documents. "This is accidental life insurance. The policy should be honored. That's what it covers."
The judge disagreed, noting that there is no Virginia case law supporting his argument and that the Virginia Bureau of Insurance has twice signed off on Transamerica policies, which included the 90-day provisions.
"Plaintiff has not provided the court with any basis upon which to conclude that the policy should not be enforced as written," Smith wrote in her order.
In an interview, Midgett questioned the value of an accidental death life insurance policy, comparing them to extended warranties stores sell people when they buy new stereos or lawn mowers. He said such policies are generally very restrictive and rarely result in payments.
Midgett went on to urge people to read their insurance policies before they sign and not blindly accept them like a website's terms and conditions.
"They control everything. They are of critical import," he said, explaining that is the only way to know a policy really covers. "Insurance companies are not in the business of giving money away."
Scott Daugherty, 757-446-2343, email@example.com
Jeff Sodoma, MPA, Esq. is a lawyer based in Virginia Beach, Virginia
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