By | July 17, 2014

In Hester v. Life Insurance Company of North America, a recent case out of the Eastern District of Kentucky, the widow of a deceased employee of CSX attempted to bring an ERISA action, alleging that LINA wrongfully denied her claim for death benefits nearly eleven years earlier. Finding plaintiff’s civil action to be untimely, the Kentucky court entered judgment in favor of LINA.

Plaintiff’s husband, Mr. Hester, was an employee of CSX and during his employment with the company obtained a $200,000 Accidental death benefit on his life under the company’s group AD&D Policy.
On July 16, 2002 Mr. Hester died of a self-inflicted gunshot wound to the chest in the garage of the family home. Accordingly, the State of Kentucky Certificate of Death listed the manner of death as “Suicide.” On August 7, 2002, Ms. Hester filed a claim for benefits with LINA.

LINA informed Ms. Hester that suicide was an exclusion under the policy and after giving Ms. Hester additional time to submit additional information that would indicate Mr. Hester’s death was an accident which Ms. Hester failed to do, LINA denied the claim.

The policy under which Ms. Hester was claiming benefits provided that no legal action to get policy benefits could be brought “more than 3 years after written proof has been furnished as required by the policy.”

Undoubtedly stricken by grief, Ms. Hester failed to respond to LINA’s denial and failed to institute a civil action until nearly eleven years later, well beyond the policy’s 3 year limitation. In an attempt to maintain the action Ms. Hester urged the court to apply KRS 413.090(2)’s fifteen year limitations period upon a recognizance, bond or written contract, contending that the policy’s three year window is unreasonable.

Ms. Hester’s argument was unsuccessful. Instead, the court, citing previous case law, concluded that the applicable statute of limitations is five years under KRS 413.120.

Which statute of limitations applies in ERISA actions is a commonly litigated issue in Kentucky. The court deferred to the 6th Circuit’s decision in Redmon v. Sud-Chemie Inc. in concluding the five year statute of limitations applies. To avoid digging further into the differences between previous case law in which Kentucky courts have found the five year limitation to apply and the case under review, the court went on to explain that even if Ms. Hester’s claim was not time barred the court finds that LINA’S decision was correct based on the administrative record since the weight of the evidence supports the finding that Mr. Hester’s death resulted from an “intentionally self-inflicted” injury, benefits for which are specifically excluded by the policy.

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