Court Opinion

ID: 9495028
Source: CourtListenerOpinion
Date Created: 2023-08-05 15:52:59.879473+00
Date Added: 2024-06-11T17:56:46.664077
License: Public Domain

LEAVY, Senior Circuit Judge,
concurring in part and dissenting in part.
I concur in the majority’s conclusion in Part IV(A) that Mr. Padfield’s death was not a “suicide” within the meaning of the policy. However, I disagree with the majority’s conclusion in Part IV(B) that the injuries resulting in Mr. Padfield’s death were not “intentionally self-inflicted.” I would hold, as a matter of law, that Mr. Padfield’s act of tying a necktie around his neck with the intent to restrict the flow of oxygen to his brain was an intentionally self-inflicted injury which resulted in his death. The policy excludes coverage for such a loss.
A. The Policy Terms
The policy provides coverage as follows: “If Injury to the Insured Person results in death within 365 days of the date of the accident that caused the Injury, the Company will pay 100% of the Principal Sum.” The policy defines “injury” as “bodily injury caused by an accident.” The policy excludes coverage for “any loss caused in whole or in part by, or resulting in whole or in part from the following:”... “any intentionally self-inflicted injury or any attempt at intentionally self-inflicted injury.”
An intentionally self-inflicted injury has three elements: (1) an act upon oneself; (2) done with intent to injure; and (3) an injury. If the act is done with intent to kill (not injure) one’s self, this'is suicide, and the policy excludes coverage for such a loss. The majority states that “this case hinges on whether the physical consequences that Mr. Padfield intended were injuries,” and concludes that “the intended physical consequences led to unintended injuries.” The policy language does not speak in terms of “intended physical consequences” or “unintended injuries.” When interpreting terms in ERISA insurance policies, we adopt a reasonable inter*1131pretation of the policy language and avoid torturing or twisting the language of the policy. See Evans v. Safeco Life Ins. Co., 916 F.2d 1437, 1441 (9th Cir.1990). The only inquiry we should be making under the terms of the .policy is whether Mr. Padfield’s injuries, which resulted in his death, are intentionally self-inflicted.
The majority concludes Mr. Padfield intended to tighten the necktie, but did not intend to injure the tissue in his neck, leave a visible mark, or cut off his blood flow for a sustained period, which were “fatal mistakes.” For such a proposition, the majority relies upon Santaella v. Metro. Life Ins. Co., 123 F.3d 456 (7th Cir.1997) where the court held the .insured’s death from the voluntary ingestion of pro-poxyphene (commonly known as Darvon) was not an intentionally self-inflicted injury. Santaella, 123 F.3d at 465. In Santa-ella, there was nothing in the record to indicate that the insured intended to inflict injury upon herself by ingesting the legal, prescription painkiller. While the record in Santaella revealed that the insured had abused drugs five years before and had a damaged spleen, there was nothing in the record indicating that, in the incident which resulted in her death, the insured intended to injure herself. The insured had taken a relatively low level of the prescription drug for a fatal dosage, and the pathologist noted that a person could develop increasing levels of tolerance for the prescription and thus could take mistakenly a lethal dose of the drug.1 Santaella, 123 F.3d at 464.
By contrast, in the present case, Mr. Padfield intended to restrict the flow of oxygen to his brain by self-asphyxiation with a necktie. This intentional act inflicted an injury from which Mr. Padfield never recovered. Whether such an intentional act leaves ligature marks on the deceased’s body is of little or no significance. Mr. Padfield’s intentional act of injuring his brain rendered it incapable of functioning. His intentional act caused injury to a live organ. This injury to his brain rendered it incapable of saving him from death. This is an intentionally self-inflicted injury which resulted in death. Such a loss is not covered under the terms of the policy.
B. The Decision is Contrary to ERISA Case Law
None of the ERISA cases concerning policy coverage for death from autoerotic asphyxiation support the majority’s position. There are, to date, seven ERISA cases which concern policy coverage for a death from autoerotic asphyxiation. In four recent cases, which are factually and procedurally similar to the present case, death resulting from autoerotic asphyxiation was excluded from coverage because the policy contained a self-inflicted injury exclusion: Critchlow v. First UNUM Life Ins. Co., 198 F.Supp.2d 318 (W.D.N.Y.2002); Cronin v. Zurich American Ins. Co., 189 F.Supp.2d 29 (S.D.N.Y. Feb.19, 2002); Hamilton v. AIG Life Insurance Company, 182 F.Supp.2d 39 (D.D.C.2002); Fawcett v. Metro. Life Ins. Co., 2000 WL 979994 (S.D.Ohio June 28, 2000). In these four cases, the policy at issue contained both a policy exclusion for suicide and a policy exclusion for intentionally self-inflicted injuries, which are virtually identi*1132cal to the summary plan exclusions in this case.
In Critchlow, the court, reviewing de novo, concluded that the decedent’s death was an “intentionally self-inflicted injury.” Critchlow, 198 F.Supp.2d at 327-28. The court reasoned:
In support of her position, plaintiff points to evidence that decedent himself had engaged in this practice on more than once occasion prior to February 26, 1999. This evidence indicates that it is possible to engage in autoerotic asphyxiation without dying, or even without losing consciousness. From that evidence, plaintiff argues that such activity need not cause injury to the person engaged in it. That one may survive autoerotic asphyxiation without suffering any major injury is not dispositive, however. The fact remains that autoerotic asphyxiation, as practiced by decedent, requires not just a slight amount of pressure, or a negligible reduction of the flow of oxygen, but a significant deprivation of oxygen to the brain — in other words, strangulation. Any definition of “injury” that excludes strangulation— whether fatal or not — is simply unreasonable.
198 F.Supp.2d at 326-27.
In Cronin, the court, reviewing de novo, held that the purposefully self-inflicted injury exclusion encompassed the act of au-toerotic asphyxiation. Cronin, 189 F.Supp.2d at 39. The court reasoned:
Although Cronin may not have intended to cause permanent injury, his intention to restrict the flow of blood and oxygen to his brain in order to impair his mental processes was a “hurt” to his physical and mental being, and risked death. Causing oneself “hurt” or “harm” is an injury to one’s own body whether inflicted in the search for delight or in the search for pain; both expose the practitioner to a substantially increased risk of accidental death. Cronin may have intended that the “mischief’ he caused himself could be reversed by timely intervention, but his “hurt” so affected his state of being as to become irreversible. Under the plain language of the policy exclusion, Cronin’s death was “caused by, contributed to, or resulted from a purposely self-inflicted injury.”
189 F.Supp.2d at 40.
In Hamilton and Fawcett, the plan administrator concluded that the insured’s death resulting from autoerotic asphyxiation was an “intentionally self-inflicted injury” that resulted in death, thus precluding coverage. The Fawcett court stated:
In the foregoing examples, death was unintended and, therefore, accidental. Similarly, in the present case, Mr. Faw-cett derived some sexual satisfaction from intentionally restricting the flow of oxygen to his brain, and he intended to live to enjoy it. His death was likewise unintended, and hence, accidental. Nevertheless, the action that he took to achieve the benefit was an intentionally self-inflicted injury that resulted in his death, despite his intentions to the contrary. Accordingly, the terms “accidental death” and “intentionally self-inflicted injury” are not mutually exclusive. This reasoning is best illustrated through [the] following syllogism:
1) Mr. Fawcett’s death was caused by the intentional restriction of oxygen to his brain.
2) To restrict the flow of oxygen to the brain is to inflict injury upon oneself.
3) Therefore, Mr. Fawcett’s death was caused by an intentionally self-inflicted injury.
2000 WL 979994, *6 (emphasis in original).
Both the Fawcett court and the Hamilton court were reviewing the plan adminis*1133trator’s denial of coverage under the abuse of discretion standard, and, in this case, like the Critchlow and Cronin cases, we are reviewing the denial of coverage de novo. The facts and reasoning in these four ERISA cases are directly applicable to this case, and, upon our de novo review, the result should be the same. To. intentionally restrict the flow of oxygen to the brain by self-asphyxiation, even without intent to be fatal, is to inflict, intentionally, injury upon oneself.
Three additional ERISA cases analyze accidental insurance coverage for death from autoerotic asphyxiation and state, in dicta, that coverage would have been denied had the policy contained an exclusion for intentionally self-inflicted injuries. In those cases, Todd v. AIG Life Ins. Co., 47 F.3d 1448 (5th Cir.1995); Bennett v. Am. Int'l Life Assurance Co. of N.Y., 956 F.Supp. 201 (N.D.N.Y.1997); and Parker v. Danaher Corp., 851 F.Supp. 1287 (W.D.Ark.1994), the insurance policies contained coverage for deaths by accident, with an exclusion of coverage for suicide, but contained no exclusion of coverage for intentionally self-inflicted injuries.2
C. The non-ERISA case law does not support the majority’s holding
The majority fails to explain adequately why it rejects federal ERISA cases involving death from aütoerotic asphyxiation, and instead follows two lone non-ERISA cases which apply state law. The majority overstates this case law support when it says that two courts applying state law “have held” that autoerotic asphyxiation is not an intentionally self-inflicted injury. In the two non-ERISA cases relied upon by the majority, the courts left it to a jury to decide whether autoerotic asphyxiation is an intentionally self-inflicted injury. In the present case, the majority goes beyond any reported case by holding that, as a matter of law, autoerotic asphyxiation is not an intentionally self-inflicted injury.
The majority relies upon American Bankers Ins. Co. of Florida v. Gilberts, 181 F.3d 931 (8th Cir.1999), where the court, applying Minnesota law, reversed the district court’s grant of summary judgment for the insurance company and remanded for trial on the issue of whether the intended act of the temporary change in blood flow by self-asphyxiation constitutes a bodily injury. American Bankers, *1134181 F.3d at 933. The court did not hold that autoerotic asphyxiation is not an intentionally self-inflicted injury. The court noted that the two parties’ expert witnesses were split on the question of whether the change in blood flow is an injury. The court stated that there was “essentially no evidence advanced for purposes of summary judgment (but there may be at trial) that an individual’s body is any different after the performance of partial asphyxia in this manner than it was before ...” Id.
The majority also relies upon Connecticut Gen. Life Ins. Co. v. Tommie, 619 S.W.2d 199 (Tex.Civ.App.1981), which was in a much different procedural posture than this case. The Texas intermediate appellate court was reviewing a jury’s finding that the decedent’s death resulting from autoerotic asphyxiation was neither the result of a suicide nor the result of a self-inflicted injury. The Texas court concluded that if there was “any probative evidence to support that finding, we must uphold the verdict in that respect.” Tommie, 619 S.W.2d at 203. The court noted that Mr. Tommie placed a pad between the rope and his neck and there was “no evidence that the rope inflicted any external injury to his body.” Id. The procedural posture of the instant case makes it readily distinguishable from Tommie.
If one looks to cases applying state law rather than ERISA cases, there are two cases which hold that, as a matter of law, an insured’s death from autoerotic asphyxiation was not a covered loss because the policy excluded death from “intentionally self-inflicted injury.” In Sims v. Monumental Gen. Ins. Co., 960 F.2d 478, 480 (5th Cir.1992), the Fifth Circuit, applying Louisiana law, stated that the only question was whether partial strangulation was an “injury.” The court cited the undisputed expert opinion that partial strangulation deprived the brain of valuable oxygen, and the court concluded that partial strangulation is an injury in and of itself. Sims, 960 F.2d at 480. See also Sigler v. Mutual Benefit Life Ins. Co., 663 F.2d 49, 50 (8th Cir.1981) (Applying Iowa law, death from autoerotic asphyxiation was not a covered loss as a matter of law because the policy excluded coverage for “intentionally, self-inflicted injury of any kind.”).
CONCLUSION
Because the majority’s holding is not supported by the policy language, is contrary to ERISA case law, and is not supported by the holdings in non-ERISA case law, I would affirm the district court’s grant of summary judgment in favor of AIG.
I respectfully dissent.

. Accidental deaths resulting from autoerotic asphyxiation are factually and analytically distinguishable from accidental deaths resulting from drugs. In our society, people regularly ingest prescription and nonprescription drugs with widely disparate results. Some accidental death insurance policies specifically exclude coverage for the taking of drugs or asphyxiation from the inhaling of gas, when done on a voluntary basis, but the exclusion does not apply to drugs that are taken on the advice of a physician. See Schadler v. Anthem Life Insurance Company, 147 F.3d 388, 392 (5th Cir.1998).

. The Fifth Circuit in Todd stated:
We add this postscript to this part of the case. It may be that all this writing is necessary to affirm this part of the judgment for appellee, but it is doubtful that it should have any longlasting significance for deciding cases like this. The life insurance companies have ample ways to avoid judgments like this one.
47 F.3d at 1457.
The Bennett court cited Sims v. Monumental General Ins. Co., 960 F.2d 478, 480 (5th Cir.1992), which held that partial strangulation is an injury in and of itself and the policy excluded death resulting from an intentionally self-inflicted injury. The Bennett court stated that "because there is not self-inflicted injury exclusion in the instant policy, and because the Sims court never reached the issue of accidental death, its reasoning is of little value here.” Bennett, 956 F.Supp. at 207. The Bennett court also cited the Todd court's postscript: "The life insurance companies have ample ways to avoid judgments like this one.” 956 F.Supp. at 210.
The court in Parker stated that the insured would not be covered had the policy contained an exclusionary clause for injury resulting from an intentionally self-inflicted injury. The court stated:
We hasten to say that we are not faced in this case with an exclusionary clause for injury resulting directly or indirectly from an intentionally self-inflicted injury. The [foreseeability] standard advanced by the defendants merges in the court’s view the policy definition of injury with typical policy language, not present herein, excluding loss caused by intentionally self-inflicted injury.
851 F.Supp. at 1295.