## In the



# U n ited S ta tes Co urt o f Ap p ea ls

F o rth eS e v e n th C ir cu it
N o. 10

- 1448 A UD REY Y. S ELLERS, P laint if f-A ppell ant, v. Z URI CH A MERI CAN I NSURANCE C OMPAN Y, D efend a nt-A pp ellee.

A pp eal from the United S t ates Di strictC ourt fo r the E astern Di stricto f Wisc onsin
. No . 08 C224

—L ynnA delm an, Judge .
A RGUED S EP TE MBE R 30, 2010

— D ECI DE D D ECE MBE R 3, 2010

B efore F LA UM, M A NI ON, a nd T INDER, C ircu it Judges . F LA UM, Ci r c u i tJu dge . On N ove m ber16 , 20 06, A nt hon y Sell ers ha d su rgery to rem ove a broke n w ire fr o m hi s kne e . T r a g i c a l l y, Mr
. S e l l e r s di e d n i ne days l ate r fro m an a cute pul m onar y e m bol i sm with infa rct, ca us ed by hi s i m m o bi l i za ti o n f o l l o wi ng th e o per at i o n. T he w ire th at ne cess itated t h e N ovem ber 16 su rgery ha d b ee n i ns erted o ve ra y ea re ar l i erdur i nga pr ev i o us2 N o. 10

- 1448 oper ati on t o re pai r M r. S el l er s’ s pate l l a t endon, wh i ch he to re wh i l e per f or m i ng tr ai ni ng exe rci ses atwork. A t i ssue i n thi s ca se, wh i ch ar i ses under the Em plo yee Reti re m ent Incom e S ecuri ty A ct o f19 74 ( “ERISA ”) , 29 U
. S. C. §§ 1001 ets eq . , i s w h et h er M r. Selle rs ’s d ea th is co v e r e d b y th e a c c i d e n t a ld e a th a n d d i s me mb e r m en t ( “A D& D”) i nsurance p ol i cy i n hi s e m plo yer ’ s e m plo yee w el f ar e be nefi t pl an. The A D& D poli cy cove rs acc idental deaths o ccurring w i thi n 365 days ofthe acci dent. Thus, th e qu est i on be f or e us i s whether M r. S el l er s’ s death can be t ra ced to an a cci dent thato ccurr ed w i thi n a y ear o f hi s death. Zuri ch A m er i can Insurance Com pany, wh i ch i ssued the A D& D poli cy, co ncl ud ed that i t co uld not, an d the di st r i ctc o ur t defer r ed to tha t det er m i na ti o n. Forthe f ol l owing re aso ns, we affir m the dist ri ct cour t’ s j ud gm ent.

I . B a c kg r o und M r. Selle rs w or ke d at T im e W ar n er C ab le C o mpa n y a nd p a r t i c i p a t e d i n T i me Wa r n e r ’ s E R I S Ag o ve r ne d e m pl o y ee wel f ar e b en efi t pl an, whi chi ncl ud ed an AD & D poli cy. On S eptem ber15 , 20 05, M r . S el l er s to r e a te ndo n in h i s k ne e whi l e per f o r m i ng tr aini nge xe r ci se s at wor k

. M r . S el l er s unde r went surg er y t o re pai r the torn tendon o n Se ptem ber29 , 20 05. H is surgeon, Dr. Rosem ary Sch ultz, ins er t e d a m etal w ire i n M r. S elle rs ’ s knee t o ass i st i n the heal i ng pro cess . P rior to th e s u rg er y, D r . Sc h u ltz ex p lain ed th atsh e like ly w oul d rem ove the w i re f our to si x m onths aftersur gery.N o. 10

- 1448 3 O n Ap r i l3 , 2 0 0 6 , Mr
. S e l l e r s s a w Dr
. S c h u l t z f o r a f o l l o wup a ppo intment
. Be ca us e M r . S el l er s was no t ha ving any knee pain a t th at ti m e, Dr. S chult z deci ded notto rem ove th e w ire un tilsym p tom s occu rred

. M r. Se ll ers s a w Dr
. S c hu l t z f o r a no t he r of f i ce v i si t l ate r that spri ng, atwh i ch tim e he com pla i ned that hi s knee w as sw ell ing. D r. Schu ltz recom m en d ed that M r. Sel lers und er go surg er y t o re m ove the w i re afterx- ra ys r e v e a l e d th a ti th a d b r o k e n i n t o th r e e p i e c e s . O n N o v e mbe r1 6, 2 00 6, M r . S el l er s ha d s ur g ery t o r emov e th e br o k enwi r e. Dr
. S ch ultz ’ s su r g i ca lno te s st at ed th atthe fac t t h atth e w ire h ad br ok en w as , “inm an y d eg re es , . . . expected. ” N i ne days l ate r, o n N ove m ber25 , 20 06, M r. S el l er s di ed fro m w h at an auto psy dete rm i ned to b e a c u t e pul mon a r y e mb o l i s m w i th i n f a r c t, d u e t o i mm ob iliza tio n follow in g th e w ire rem ov al. I n Ma r c h o f2 0 0 7, Au d r e y S e l l e r s , M r . S e l l e r s ’ s wi d o w, subm i tte d a cl ai m forbene fi ts und erthe A D& D poli cy to Zur i ch, the Pl an adm i ni str ato r. The acc i dentaldeath pr o vi si o ns o fthe po l i cypr o vi de th atb en efi ts ar e due “[i]f inj u ry to a C ov er ed P er so n res u lts in L os s o f L ife . .

. w i thi n 365 days ofthe accid ent. ” The pol i cy defines “i nj ury ” a s “ an acc i dentalbo dil y inj ury w hi ch i s a di r ec t r es ul t, i nde pen den t o fa l lo th erc au se s o fa hazard setf or th i n the ‘ Descri pti on o fH azar ds. ’ ” The pol i cy d oe s n o t d e fin e “ ac c id en t,” or “ ac c id en ta l.” Ins te ad , i t g r an ts Zur i ch “di sc r et i o na r y a utho r i tyt o de te r m i ne el i g ibi l i tyf o rb en efi ts a nd t o c o ns true the t er m s o fthe pl an . ” Expr es sly e xc l ud ed fr o m c o ve r ag e unde rthe pol i cy ar e deaths cause d b y “ i l l ness[ , ]
. . . si cknes s, di se as e, b o di l y i nfi r m i tyo rm edi ca lo rs ur g i ca lt r ea tment4 N o. 10

- 1448 ther eof, o r bacte ri alo r vi ral i nfe cti on, r ega rdl ess o f how co ntra cted. ” Zuri ch de n ied M rs . S el l er s’ s cl ai m . To the exte nt that M r. S el l er s’ s death could b e traced to the Se ptem ber15 , 2005 knee i njury, Z urich conc lud ed that M rs. Sell ers w as not enti tl ed to bene fi ts because the acci dent occ urr ed m or e than 365 days bef or e M r. S el l er s’ s death. Zuri ch rej ecte d M rs . Se l l er s’ s posi ti on that the w i re br eak age co ns ti tu te d an “ac ci den ta lb o di l y i nj ur y, ” r ea so ni ng that such m ed icaldevi ce f ai l ures ar e no t a cci dents u n d er th e p olic y. A fter exh au stin g h er i nt erna l ap p eals, M rs. Sell ers b r o ughts ui ta g a i ns tZ ur i c h und e rER I S A, 2 9 U. S
. C. § 1 132( a) ( 1) ( B), to r eco verdeath b enefi ts. The part i es fi l ed cr oss - m oti ons f orsum m ar y j ud gm ent. The dis tr i ct co ur t f ou nd tha t Zur i chha d f ai l ed to s uppo r t i ts c o ncl us i o n tha t th e br ea ki n the w ire w as no t ana cc i den t unde rthe p o l i c y wi th a de qu a t e fi nd i ng s a nd r e a s o ni ng. Forthatr eas on, the dist ri ct c ourtr em anded the case to Z u ric h for a n ew d et er m in at ion of M rs . Seller s’s cla im
. U pon re consi derat i on, Zuri ch ag ai n denie d M rs . Se l l er s’ s cl ai m , co nclu ding that the wir e br eak age was no t ana cc i den ta li nj ur y unde rthe po l i cy . In r ea ch i ng that concl usi on, Zuri ch d efin ed the ter m “a cci dent” as an “unexpected eve nt[ ] o fa f or tui to u s nature. ” Rel yi ng o n the s tat em ent in Dr. S chult z’ s no tes that“the wir e has bro ken, wh ich i n m any deg re es, i s e xpected, ” Zuri ch concl ud ed the w i re br eak age co uld notbe consi dered acc iden tal be c a u s e i t w as ex p ecte d

. M rs. Sell ers appeal ed, r ely i ng, i n pa r t, o n o urde ci si o n in Se nki e rv.N o. 10

- 1448 5 Har t f or d L i f e& Acc
. Ins . Co. , 948 F.2d 105 0 (7th C ir. 1991). M rs. Sell ers a r g u e d that, un d er Sen k ier, i fa pati ent di es as a r esul t o fsur gery that i s ne cess i tat ed by an acc i dent, thei r death i s a cci dental

. M rs . S el l ers c onte nd ed that M r. Sel ler s un d erw en t the N ovem ber 2006 surgery b ecause o fthe w i re br eak

— whi c h s he a r g ue d wa s an a c c i d en t

— and thus hi s dea ths ho ul d b e dee m ed ac ci den

tal

. Zuri ch r esponded by m ai ntai ni ng tha t the w i re br eak w as not an acc i dent. Aft e rZ u r i c h ’ s s e c o nd de n i a lo fMr s . S e l l e r s ’ s c l a i m, the p a r t i e s a g a i n fi l e d c r o s s - mot i o ns f o rs ummar y j udgm ent in the dist rict c ou rt
. In an o rderdated F ebr uary19 , 2 0 1 0 , th e d i s t r i c tc o u r tg r a n t e d Z u r i c h ’ s mo t i o n f o rs u mm ary j udg m en t. Appl y i ng an a rbi tr ary a nd c apr i ci o us sta nd ar d ofr evi ew , the dist ri ct c ourtco ncl ud ed that Zuri ch’s d eci si on denyi ng M rs . S el l er s a bene fi t be cause th e w ire break w as ex p ect e d w a s reason able. M rs. Sell ers t i mel y a pp e a l e d.

I I . Discussi on W e rev i ew a di st r i ctc o ur t’ s dec i si o n o n c r o ss - m o ti o ns f o rs um m ary j udg m en t wi th o utde fer en ce , c ons tr ui ng al l i nfer en ce s i n f av o r o f th e par ty ag ains t w hom the m o t i on u n d er co n sid er at ionis m ad e. Tegt m e i e rv. M i d wes tOp e ra t i n gEng ’ rs Pe n s i o n Tr u s tF und, 390 F. 3d 1040, 10 45 ( 7th Ci r. 20 04)
. S um m ar y j ud gm ent i s pro per when th er e i s no ge nu i ne i ss ue o fmate r i alf ac t an d the m oving par ty i s e nti tl ed to j ud gm en t as a m att ero f law . Fed . R. C iv. P . 56(c ); A nders on v. Libe rty Lobby Inc. , 47 7 U .S. 24 2, 25 5 (1 98 6).6 N o. 10

- 1448 I n the c o nt ex t o fa de ni alo f benefi ts unde rERI S A, the properst andard ofr evi ew tur ns o n two f acto rs : ( 1) wh etherthe pla n gi ves the pl an adm i ni str ato r discre ti on t o const rue pol i cy ter m s, and (2 ) the basi s for th e dec i si o n t o de ny c o ve r ag e. W he r e th e pl ang i ves the pla n adm i ni strat ordi scr eti on t o const rue pol i cy ter m s, an d the d ecision to d en y coverag e i s base d on an i nt erpr et at i o n o fthe pl an, we apply a n arbi tr ary a nd c ap ric iou s s ta n d a r d of re vie w . See Hess v. Reg -E llen M a ch i neTool Corp. , 423 F.3d 653 , 658 (7th C ir. 2005). W here e i th erthe pl ang r an ts no s uchdi sc r et i o n, o rthe d en ialof ben efi ts d eterm ination is based on an interp r e t a t i o n o fl a w, we appl y a d e n o v o s t a n d a r d o fr e v i e w. See i d.; M eyer v. D ul uth Bl dg. Tr ade s We l f areFu nd, 29 9 F. 3d 686, 68 9 ( 8th Ci r. 200 2) ( “w here a pla n’s deci si on to de ny b en efi ts i s ba se d o n i ts c o ns truct i o n o fe xi st i ng law , th e p lan ’s in te rp re ta tio n of a c on tr ollin g p rin c ip le o fl a w i s r e v i e we d deno vo ”); P enn v. H ow e- B aker E ngrs. , Inc. , 89 8 F
. 2d 10 96 , 1 10 0 ( 5th Ci r . 1 99 0) ( “in c o nt r as t to the g r ea t defer en ce we g r an t th e C o m m i tt ee ’ s i nt er pr et at i o ns o fth e P l a n, wh i c h i nv o l v e c o n t r a c ti n t e r p r e t a t i o n, we ac co r d no de fer en ce t o the Co m m i tt ee ’ s co nc l usi o ns as to th e con troll ing law , w hich i nv olve s t a t ut ory i nt erp retation” ). I t i s undis pu ted thatthe Pl an gi ves Zuri ch discreti on to const rue pol i cy te rm s a nd to deter m i ne el i gibi l i ty f or benefi ts. There f or e, the properst andard of r evi ew d epe nds o n the b as i s f o rZur i ch ’ s den i alo fM r s. S el l er s’s cl ai m . A s noted abo ve, Zuri ch bas ed i ts denia lo fbene fi ts d ec isio n on its co n st ru c t i o n of th e P lan te rm “a c c id en t.” T ha t j us tification is su bj ect to revi e w un d er an arbitraryN o. 10

- 1448 7

a n d c a p r i c i o u s s t a n d a r d

. In d e n y i n gMr s . S e l l e r s ’ s c l a i m, Z u rich al so rej ecte d her posi ti on that Sen k ier c o mpe l l ed th e c on c lu sio n t h atM r. Selle rs ’s d ea th w as ac c id en ta l. W e review Zu rich’s read ing of Sen k ier de novo

. W e begin w ith Zu rich’s con clusion that the w ire bre ak w as not an acc i dent un d er the pol i cy because M r. S el l er s’ s doct orexpecte d i t to occur. The questi on before us is w he th er Zu rich’s i nt erp reta t io n o f th e term “a c c id en t,” as u se d in t h e P lan , ha s “ ra tio n al s u p p o rtin the r ec ord. ” Da v i s v . Un u m L i f eIn s . C o . o

f A m. , 44 4 F
. 3d 569, 57 6 ( 7th Ci r. 200 6). Because the Pl an i s g ove rned by ER I SA, federa lco m m on l aw princi ple s o fco ntra ct in te rp re ta tio n ap p ly. Swab ac k v. Am e r i ca n In f or m at i on Tec hnol ogi e s Corp ., 103 F. 3d 535, 54 0 ( 7th Ci r. 19 96)
. Those pri nc i pl e s r e qu i r e tha t Pl a n t e r ms b e i nt e r pr e t e d i n “an ord inary an d pop ular s e n s e, as [they] w ou ld [be un d erst oo d by ] a p er so n o f a ve ra ge in te llige n c e a n d ex p er ien c e.” C a nn o n v . WittekC o . Intern
. , 60 F. 3d 1282, 12 8 4 ( 7 t h Cir. 19 95 )
. Co ns i st en t wi ththa t r ul e, w e ha ve s ta te d tha t th e const ructi on o fthe ter m “a cci dent” sho uld be leftto “com m on u n d er st an d i ng as r eve al ed i n com m on speech. ” Sen k ier, 948 F.2d at10 52
. See a lso Cozzi ev. M e t r opo li t an Li

f eIns . Co. , 1 4 0 F
. 3 d 1 1 0 4 , 1 1 1 0 ( 7 th Ci r . 1 9 9 8) ( a r esul t i s acci dentalwh er e “ the insured di d not be l i eve th at the re sul t would o ccur, ” a nd that“e sti m ati on ca n be c onsi dered r eas onabl e”) ( ci ti ng Wi ck m a n v. Nor t hwe s t e r n Nat ’ l In s . Co
. , 908 F.2d 107 7, 108 8 (1st Cir. 1990)); San t ae l l a v. M e t r opolitan L if eIns . Co. , 12 3 F
. 3d 456, 46 2- 63 (7t h C ir. 19 9 7 ) ( ind et er m in in g w h et h er a c er ta in re sul t i s a ccidental

— m ea ni ngune xpe ct ed o runint en -8 N o. 10

- 1448 ti onal

— w e co nsi der the r esul t from the poi nt o fvi ew o f a reason able pe rson i n th e insu red ’s position). I n l igh t ofthes e pr i nci ple s, we concl ud e that Z u ri ch’s deci si on that the wir e br eakwas not an acci dent beca use it w as expected w as not re aso nabl e. Zuri ch i n te rp reted the ter m “a cci dent” as an e vent that Dr. S chult z, a m edi calpro fess i onal, wo u ld c onsi der t o be “ un ex p ecte d” or“for tui tous. ” Zuri ch’s co nstr ucti on o f“ a c c i d e n t ” a s “ u n e x p e c t e d ” i s n o tth e p r o b l e m; we ha ve f o und com p ar ab l e i nt er pr et at i o ns t o b e r ea so nab le. See C ozz ie, 140 F.3d at 110 9 (find in g i ns ure r’s int erpr e t a t i o n o f the t e r m “ a c c i de nt ” a s a n e v e nt tha ti s no t “reason ably foreseeable” to b e rea son able). I t is Z urich ’s a pp l i c a t i o n o ftha tde fi ni t i on

— fro m the poi nt o fvi ew o f a doct or, r athert h an “a per son ofave ra ge i ntel l i gence and experi ence” i n M r. S el l er s’ s s hoes

— th atw as a r b itr ar y. See S e n k ier, 9 48 F
. 2d at1 05 4 ( th e pr o peri nquir y i s whether “the aver age p er son w oul d say that th e dec ede ntha d di ed i n an ac ci den t” o rno t)
. By f ai l i ng to int er p re t t h e P lan as w ou ld a p er so n o fav er ag e in te ll i g en ce a nd e xpe r i en ce , Zur i cha ct ed arbi tr ar i l y a nd c ap ric iou sly

. See Sw aback, 1 03 F
. 3d at 540- 42 ( fi ndi ng th atERI S A p lan admi ni st r at o ra ct ed arbi tr ar i l y a nd capri ci ousl y where i t devia te d fr om the pla n l anguage as itw ou ld be u n d er st oo d by a p er so n of av er ag e in te llige n c e a n d ex p e r i e n c e); D ab e r t i n v . H CR M anorCare, Inc ., 373 F. 3d 822, 82 9 ( 7th Ci r. 20 04) ( ER I SA p l an adm i ni str ator ’s de fi ni ti o n o fpl ant er m “ defi ed co m m o n s en se a nd w as not i n acco rd with the o rdi naryand popular m ea ni ngo fthe t er m , a nd theref o r e was a rbi tr ary a nd cap rici ou s”).N o. 10

- 1448 9

I n de nyi ng Mrs
. Se l l er s ’ s cl ai m , Z ur i c h bothrel i ed o n S enkier 1 and concl ud ed that the wire breakage w as not an ac ci dental inj ury b ecaus e i t was an ex pected com pl ic ati on of m edical trea tm en t. H ow ev er, it is not clea r tha t Z u rich p rev iou sly l i nke d the two, ar gui ng, as i tdoe s no w, thatthe wir e bre aka ge w as n o t an acci dent because itw as an inj ury d ue to m edical tr eatm ent, w hich cannot be an ac ci dent und er S enkier

. To the ext ent thatZ uric h is rai si ng this argum ent f or t h e firstti m e, we ne ver the l es s wil l addr es s i t
. “Th e m at t erofwhatque s tions m ay b e tak en up an d resolv ed f or the fi r st t i m e on ap p eal is on e left p rim arily to the d iscretion of the co u rts o f a p p eals, to be exer ci se d on the f act s ofi nd ividual cas es . ” S in g let o n v . Wu lff, 4 2 8 U .S. 1 0 6 , 12 1 (19 7 6 ); seeal so S p ro st y v . B u chler, 79 F. 3d 63 5, 64 5- 46 ( 7th Ci r. 19 96 )
. W e c onc l ude thate nt er t ai ni ng Z u rich ’ s arg u m en t is ap p ro p riate for a nu m b er o f rea son s. Fi rs t, M rs . Se l l er s ha s r el i ed o n S enkierthr oug ho u t th is cas e, inclu d ing in h er op en ing b rief o n ap p eal. Th erefor e, that S enkier w ould be an is sue befor e thi s Co urt com es as no su rp ri se . Second, the is sue has been full y briefed, a s M rs . Sel le rs had a n o p p o rt u n ity to ad d re s s Z u ri ch ’s in te rp re ta tio n o f S enkier i n h err epl y br i ef

. Thi rd, be c aus e w e are r evi ewi ng the i s s ue de nov o, i t i s ir rel evant th a t w e have no dist ri ctcourt or Plan adm ini st rat or decis ion t o w hich to defer. U nfo rtunatel y forM rs . S el l ers’ s pos i ti on, we never thel es s ar e co m pel l ed to a ffi r m b y o urho l di ngin Sen k ier
. Zuri ch ar gues th at the w i re br eak age was a c om pli cati on of th e origina l kn ee su rgery, an d th us , u n d e r Sen k ier, ca nno t be de emed a n a cc i den t. In Sen k ier, the i nsured 1 was admi tt ed to th e ho spi ta l be ca us e of c o m pl i ca ti o ns ass oci ate d w ith C ro hn’s dise ase . 94 8 F
. 2d at 1051
. “A cath et erwas i nser ted i n a v ei n benea th [ the insured’ s]10 N o. 10

- 1448 cl av i cl e f o rthe pur po se o fa dm i ni st er i ngno ur i sh m en t i ntra venously, ” w hi ch i s a st andard tr eat m ent for C ro h n ’s. Id. T he i ns ur e d d i e d w h e n th e c a th e t e rb e c a me d et ac h ed an d p u n c tu re d h er h ea rt, a n o c c u rre n c e t h atis consi dered a sta nd ar d com pli cati on o fthe tr eat m ent. Id. at 1051 , 10 53. W e co ncl ud ed that the insured’ s d eath w as not cove re d by herERIS A

- gov er ned A D& D poli cy, hol ding that “a pol i cy ofaccident i nsurance does not re ach .

. . i nj uri es re sul ti ng fro m m edi caltr eat m ent. ” Id. at 1051
. N oting tha t a ny m edi calpro cedure i nvol ves “a ri sk that the pr oce du re wil linfl i ct an inj ury, ” we re aso ned that w hi le th at such “ i nj uri es ar e a cci dentali n the sense o f uninte nd ed and i nfr equent[,]
. . . theyar e no t ‘ acci dents’ as the t er m i s use d i n i nsurance pol i c ies fo r acci dental i nj uri es. ” 9 48 F. 2d at 1051

- 52. R ather, w here an ind i vi du al die s a s a r esul t o f“ st an dard com pli cati ons of[ a] sta nd ar d m edi caltr eat m ent[ ] ” fora n i l l ness, thei r death i s the r esu lt ofthe und er l yi ng i l l ness f orwh i ch they w er e re c eiv in g t re at m en t. Id. at10 53. B oth pa rties conte nd that, un d er Sen k ier, w h ere a n i nd i vi du aldi es because o fco m pli cati ons ass oc iate d w i th m edi ca l tr ea tment f o r an ac ci den t, th at ac ci den t is the c au se of d ea th . W e a gr ee . Th e re as on in g s etfort h in Sen k ier ap p lies eq u ally reg ar d les s o f w h et h er an ind ivi du ali s be i ng tr eated fo r an acc i dent oran i l l ness w hen a m edi calm i shap l eads t o i nj ury or d ea th

. In ei ther ca se , the c au se o fthe i nj ur y o rdeath is th e unde r l y i ng re aso n f orthe tr eat m ent. T he pa rties’ d ispu te ce n t e rs on w he th er the w ire break, a s s u m ing for th e m om en t tha t it w as th e un d er-N o. 10

- 1448 11

M r s . S e l l e r s a r gu e s tha tthe wi r e br e a k s ho ul d no tbe c on s i d- 2 e r e d a c o mp l i c a t i o n o fth e o r i g i n a l i nj u r y , b e c a u s e , by t h e t i me the w ir e broke, M r. Sel le rs ’ s knee had full y heale d and the w ir e no l on ge r wa s t r e a t i ngtha ti nj ur y. Butth e wi r e wou l d n oth a ve been im planted in M r. Sel le rs ’ s knee bu t f or the Septem ber 2005 a c c i de n t a l k n e e i nj u r y . T h e r e f o r e , th e wi r e b r e a k i ng

— and the ensui ng s econd surgery

— c ann otlog i c al l y be se par at ed f ro m the i ni t i alope ra t i on. l yi ng r eas on forM r. S elle rs’ s Novem ber20 06 surg er y, con stitut ed an acc iden tal bod il y inj ury. M rs. S e llers co nt e nd s tha ti tdi d. Whi l e we a r e s y mpa the t i c to M r s. S el l er s’ s at te m pt to a vo i d th e h ar shi m pac t o fthe p ol i c y ’ s 3 65 -d ay ba r, Sen k ierr equi re s us to disa gr ee. Th a t the wi r e mi g ht b r e a k wa s a r i s k a s s o c i a t ed w i th the or igin alo perat i on, as ev i denced by the f act that Dr
. S ch ul tz e xpe ct ed i t to b r ea k

. The r efo r e, t o the e xt en t 2 that the b r e a k i ng o f the wi r e wa s a n i nj ur y, i t was a r e su lt ofthe fir st su rgery. U nd er Sen k ier, such “ i nj uri es re sul ti ng fro m m edi calt re atm ent” ar e no t a cci dents as th at t erm i s use d i n A D& D poli ci es. 94 8 F
. 2d at 1051

- 52. Because the wir e br eaki s e xactl y the ty p e o fco m pli cati o n we di sc us se d i n Sen k ier, i t ca nno t b e char acte ri zed as an ac c id en t. The dis cussi on above i nd i cate s that, to t h e e xtent that M r. Sel l er s’ s death can be tr aced to any acci dental inj ury, i t is to the Sept em ber 2005 injury. H ow ever, because thati nj ury predated hi s death by m or e th an 36 5 day s, M r s. S el l er s i s not e nt i tl ed to b en efi ts unde rthe A D& D poli cy.12 N o. 10

- 1448 I I I . Concl usio n Forthe f or ego i ng r easons, we A FFIRM the dist ri ct cour t’ s j ud gm ent.

12- 3- 10