United States Court of Appeals

For the Eighth Circuit

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No. 19-3144

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Amber Boyer,

lllllllllllllllllllllPlaintiff - Appellee,

v.

Schneider Electric Holdings, Inc.; Schneider Electric Holdings, Inc. Life and

Accident Plan; Unum Life Insurance Company of America,

lllllllllllllllllllllDefendants - Appellants.

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Appeal from United States District Court 

for the Western District of Missouri - Joplin

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 Submitted: November 18, 2020

Filed: April 5, 2021

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Before COLLOTON, ARNOLD, and KELLY, Circuit Judges.

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COLLOTON, Circuit Judge.

After Eric Boyer died in a single-vehicle crash, his sister Amber sought life and

accidental death benefits under his insurance plan. Unum Life Insurance Company

of America paid Amber life insurance benefits, but denied her claim for accidental

death benefits. Unum concluded that no benefits were allowed because Boyer’s
commission of a crime—speeding and passing vehicles in a no-passing

zone—contributed to the crash. Amber disagreed and sued Unum and two codefendants under the Employee Retirement Income Security Act of 1974 (“ERISA”). 

See 29 U.S.C. § 1132(a)(1)(B). The district court ruled that Unum’s interpretation of

a “crime” exclusion in Boyer’s insurance plan was unreasonable and granted

summary judgment for Amber. We reach a contrary conclusion, and therefore reverse

the judgment.

I.

Boyer died on January 22, 2016, after his vehicle ran off a two-lane road in

Missouri and struck a tree. He was employed by Schneider Electric Holdings, Inc.,

and enrolled in Schneider’s Life and Accident Plan. The Plan is funded by an

insurance policy issued by Unum, which also serves as claims administrator with

discretionary authority to make benefit determinations. Amber is the sole beneficiary

of Boyer’s insurance plan. Schneider, on Amber’s behalf, filed a claim for life and

accidental death benefits under the Plan.

The Plan insures against an “accidental bodily injury” resulting in death. It

defines “accidental bodily injury” as “bodily harm caused solely by accidental means

and not contributed to by any other cause.” An exclusion from coverage is at issue

here. The Plan does not cover accidental losses “caused by, contributed to by, or

resulting from . . . an attempt to commit or commission of a crime.”

Before reaching its decision to deny accidental death benefits, Unum reviewed

Boyer’s death certificate, a police report from the crash scene, an autopsy report, and

a toxicology report. In its denial letter, Unum explained that the police report showed

that Boyer was passing vehicles in a no-passing zone and driving approximately 80

miles per hour in a 35 mile-per-hour zone. Unum observed that improper passing and

speeding are misdemeanors punishable by jail time in Missouri, and concluded that

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Amber could not recover accidental death benefits because the loss occurred during

Boyer’s commission of a crime.

Amber filed an appeal with the claims administrator. Elaborating on its earlier

denial, Unum explained that speeding and improper passing are crimes under

Missouri law and “under the dictionary definition of ‘crime.’” Even if the crimes

were classified as violations or infractions under Missouri law, the decision added,

“they would still be crimes” under Unum’s interpretation of the Plan. The

administrator concluded that because Boyer’s death was “caused by, contributed to

by, and/or resulted from an attempt to commit or commission of a crime,” Amber was

not entitled to accidental death benefits.

Amber sued, and the district court concluded that Unum abused its discretion

in applying the “crime” exclusion, because “its determination was unreasonable and

not supported by substantial evidence.” Unum and its co-defendants appeal, and we

review the district court’s ruling de novo. Engle v. Land O’Lakes, Inc., 936 F.3d 853,

855 (8th Cir. 2019).

II.

The Plan grants Unum discretion to determine eligibility for benefits, resolve

factual disputes, and interpret its provisions, so we review Unum’s denial of benefits

for abuse of discretion. We uphold an administrator’s interpretation of a plan if it is

reasonable. Mitchell v. Blue Cross Blue Shield of N.D., 953 F.3d 529, 537 (8th Cir.

2020). We have identified a number of factors that bear on the question of

reasonableness: (1) whether the interpretation is consistent with the goals of the plan,

(2) whether the interpretation renders any language in the plan meaningless or

internally inconsistent, (3) whether the interpretation conflicts with substantive or

procedural requirements of the ERISA statute, (4) whether the administrator has

interpreted the words at issue consistently, and (5) whether the interpretation is

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contrary to the clear language of the plan. Finley v. Special Agents Mut. Benefit

Ass’n, Inc., 957 F.2d 617, 621 (8th Cir. 1992).

By contrast, when an administrator evaluates facts to determine the plan’s

application to a particular case, we review whether the administrator’s decision was

supported by “substantial evidence.” Mitchell, 953 F.3d at 537. Substantial evidence

need not amount to a preponderance, but it must be sufficient to satisfy a reasonable

mind of the conclusion. See King v. Hartford Life & Accident Ins. Co., 414 F.3d 994,

999 (8th Cir. 2005) (en banc).

Although Unum plays the dual role of evaluating claims and paying benefits,

any conflict of interest does not alter the abuse-of-discretion standard of review. 

Metro. Life Ins. Co. v. Glenn, 554 U.S. 105, 115-16 (2008). A conflict of interest

may be a factor in the review—a tie, for example, might be resolved against a

conflicted administrator, id. at 117—but on this record, the circumstance does not

warrant great weight. On the question of potential bias, Unum explained that the

company does not permit outcomes on claims decisions to influence the company’s

evaluation and compensation of those who make the decisions, and Amber pointed

to no contrary evidence.

A.

Amber challenged the factual premise of the administrator’s decision, and the

district court concluded that Unum lacked “any substantial evidence in support” of

its determination. The court concluded that Unum acted without “any evidence”

about the posted speed limit or Boyer’s speed, and without evidence that speeding

and improper passing contributed to Boyer’s death.

We have examined the record and conclude that the administrator’s decision

was supported by substantial evidence. Unum relied largely on a police report that

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included a diagram of the collision and five witness statements. All five witnesses

observed Boyer’s westbound vehicle weaving into the eastbound lane of traffic and

attempting to pass several westbound vehicles in a no-passing zone. The

investigating officer noted that the posted speed limit was 35 miles per hour, and that

the road was clearly marked as a “no passing zone” with double solid yellow lines in

the center.

One witness, an off-duty police sergeant, saw Boyer driving approximately 80

miles per hour as he approached the witness from behind. The administrator noted

that the sergeant was experienced in assessing speed without radar. Two witnesses

said that Boyer eventually passed their vehicles; one said that Boyer was traveling at

“a high rate of speed.” All five saw Boyer run off the road and strike a tree. One

reported that Boyer’s vehicle “lost control and began to spin out of control before

striking a tree off of the roadway.” The police report on the crash listed Boyer’s

speed above the posted limit and improper passing as “probable contributing

circumstances.” The evidence is sufficient to support a reasonable finding that

Boyer’s speeding and improper passing contributed to the crash.

The district court also faulted Unum for failing adequately to consider an

investigator’s report noting icy roads and the medical examiner’s determination that

the manner of Boyer’s death was an “accident.” Unum, however, did address

Amber’s contention that slush and ice on the road caused Boyer’s car to spin out of

control. The administrator concluded that her contention was “inconsistent with the

statements of multiple eyewitnesses” who observed Boyer driving at a high rate of

speed and attempting to pass. Road conditions do not undermine the administrator’s

conclusion that Boyer’s illegal conduct at least “contributed to” the loss. The medical

examiner’s characterization of the crash as an “accident” does not conflict with the

decision. The crime exclusion applies to “accidental losses.”

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B.

The district court also accepted Amber’s contention that Unum’s interpretation

of the “crime” exclusion was unreasonable. Unum disputes that conclusion, and

argues that the district court erred in setting aside its decision on benefits. “[W]here

plan fiduciaries have offered a ‘reasonable interpretation’ of disputed provisions,

courts may not replace [it] with an interpretation of their own—and therefore cannot

disturb as an ‘abuse of discretion’ the challenged benefits determination.” King, 414

F.3d at 999 (quoting de Nobel v. Vitro Corp., 885 F.2d 1180, 1188 (4th Cir. 1989)). 

“An interpretation of a term is reasonable if the interpretation conforms with ordinary

meaning, which can be derived from ‘the dictionary definition of the word and the

context in which it is used.’” Kutten v. Sun Life Assurance Co. of Can., 759 F.3d 942,

945 (8th Cir. 2014) (quoting Hutchins v. Champion Int’l Corp., 110 F.3d 1341, 1344

(8th Cir. 1997)).

Unum articulated two reasons why the Plan’s crime exclusion applied to

Boyer’s conduct. First, speeding and improper passing are misdemeanors under

Missouri law and are punishable by jail time. Mo. Rev. Stat. §§ 304.010, 304.016,

558.011. As such, Unum concluded, “[s]peeding and violation of passing regulations

are crimes under Missouri law.” Second, speeding and improper passing are “crimes

under the dictionary definition of ‘crime.’”

Amber maintains that Unum’s interpretation is contrary to the clear language

of the Plan, which excludes coverage for accidental losses “contributed to

by . . . commission of a crime.” Common dictionaries, however, support the

reasonableness of Unum’s conclusion. Crime is “[a]n act that the law makes

punishable.” Black’s Law Dictionary 451 (10th ed. 2014). A misdemeanor is “[a]

crime that is less serious than a felony.” Black’s Law Dictionary 1150 (10th ed.

2014) (emphasis added). Lay dictionaries are in accord as to the meaning of “crime.” 

See American Heritage Dictionary of the English Language 430 (5th ed. 2016) (“[a]n

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act committed in violation of law where the consequence of conviction by a court is

punishment, especially where the punishment is a serious one such as

imprisonment”); Webster’s Third New International Dictionary 536 (2002) (“the

commission of an act that is forbidden . . . by a public law of a sovereign state to the

injury of the public welfare and that makes the offender liable to punishment by that

law in a proceeding brought against him by the state”).

Boyer’s conduct constituted a crime under Missouri law. Boyer was driving

more than twice the legal speed limit and passing vehicles in a no-passing zone on a

two-lane road in icy road conditions. This was not a de minimis non-criminal

“infraction” for exceeding the speed limit by five miles per hour or fewer. Cf. Mo.

Rev. Stat. §§ 304.009.1, 556.021.1. An administrator is not bound to incorporate a

particular State’s criminal law in fashioning its own definition of crime, for that

approach could lead to benefits varying by jurisdiction. But Missouri’s classification

of improper passing and speeding as misdemeanor offenses reinforces the

reasonableness of Unum’s determination. Amber has not established that Missouri

law is an outlier on the question whether Boyer was committing a crime at the time

of the crash.

The district court expressed concern that the term “crime” does not encompass

“traffic violations,” and that Unum’s interpretation would allow the administrator to

deny coverage if an insured suffered an accident while driving one mile per hour over

a speed limit. Unum’s decision here, however, did not dictate that every violation of

law in the area of “traffic” must be treated the same. Boyer’s conduct of high-speed

motoring and improper passing was akin to reckless driving, and Unum reasonably

determined that he was committing a “crime.” If an administrator were to extend the

meaning of “crime” to cover driving 56 miles per hour in a 55-mile-per-hour zone,

then there will be time enough to consider the reasonableness of that position. It is

not implicated here.

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Amber also defends the district court’s conclusion that defining crime to

include Boyer’s conduct is inconsistent with the goal of the Plan to provide benefits

in the case of an insured’s accidental death. A plan that provides accidental death

benefits, however, need not pursue that goal to the exclusion of all others. See Wald

v. Sw. Bell Corp. Customcare Med. Plan, 83 F.3d 1002, 1007 (8th Cir. 1996). The

Plan at issue does not provide coverage for accidental losses caused or contributed

to by commission of a crime. It thus tempers the goal of providing accidental death

benefits in order to preserve assets for those who do not engage in criminal conduct. 

A plan “need not draw down the assets contributed by the provident many to shift the

cost of self-destructive behavior.” Sisters of the Third Ord. of St. Francis v.

SwedishAmerican Grp. Health Benefit Tr., 901 F.2d 1369, 1372 (7th Cir. 1990). 

Denying benefits to an insured who commits a crime is not inconsistent with the goals

of the Plan.

Amber next argues that Unum’s interpretation of “crime” renders the Plan

meaningless, but that is not so. An exclusion for speeding and improper passing does

not preclude an award of benefits when injury or death results from any number of

occurrences when the insured does not commit a crime. Just in the area of auto

accidents, for example, consider an insured who hits a deer in the highway, misses a

curve on a dimly-lit road, falls asleep at the wheel, or sustains injury when impacted

by a drunk or careless driver.

The district court thought it problematic that Unum’s claims manual says the

“crime” exclusion “was not intended to apply to activities which would generally be

classified as traffic violations.” As the Tenth Circuit observed, however, the manual

“does not purport to be definitive and has substantial play in the joints.” Caldwell v.

Unum Life Ins. Co. of Am., 786 F. App’x 816, 818 (10th Cir. 2019). The manual

emphasizes that “[e]ach claim is unique and should be evaluated on its own merits.” 

On the “crime” exclusion, the guidance also says that the exclusion was intended to

apply to “an activity that would typically be classified as a crime . . . under state or

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federal law.” The document was not available to the insured, so it could not have

affected his reasonable expectations. Even accepting the manual as evidence of

Unum’s intent, it does not remove Boyer’s conduct from the “crime” exclusion. As

discussed, Boyer’s speeding and improper passing each were classified as a crime

under state law, and the manual is reasonably understood to distinguish between

driving offenses like Boyer’s and minor traffic infractions that jurisdictions like

Missouri do not even classify as crimes.

Nor has Amber established that Unum applies the crime exclusion

inconsistently. She adverts to Harrison v. Unum Life Ins. Co. of Am., No. CV-04-21-

PB, 2005 WL 827090 (D.N.H. Apr. 11, 2005), where Unum applied a crime exclusion

to drunk driving that New Hampshire classified as a “violation” rather than a “crime.” 

Id. at *1, 3. Since Unum relied here on the fact that Boyer’s conduct was criminal in

Missouri, Amber perceives an inconsistency. But in both Harrison and here, Unum

relied on the ordinary dictionary meaning of “crime” in applying the exclusion to a

violation of law. Breadth of application does not establish inconsistency.

Amber argues finally that Unum’s interpretation conflicts with the substantive

and procedural requirements of ERISA. Summary plan descriptions must “be written

in a manner calculated to be understood by the average plan participant.” 29 U.S.C.

§ 1022(a). They also must contain information about “circumstances which may

result in disqualification, ineligibility, or denial or loss of benefits.” Id. § 1022(b). 

Amber observes that Unum’s summary does not mention traffic violations, and argues

that it does not place an average participant on fair notice that the crime exclusion

encompasses speeding and improper passing. But there is nothing inherent in the

word “crime” that would lead an average participant to believe that violations of law 

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like Boyer’s are not contemplated, especially where state law criminalizes the

conduct. The administrator’s decision does not conflict with the statute.

* * *

For these reasons, the judgment of the district court is reversed, and the case

is remanded with directions to enter judgment for the defendants.

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