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MCLEAN v. CONTINENTAL CAS. CO.

January 27, 1997

CATHERINE MCLEAN, Plaintiff, against CONTINENTAL CASUALTY COMPANY and THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, Defendants.


The opinion of the court was delivered by: BAER

 Hon. Harold Baer, Jr., District Judge:

 I. Introduction

 Plaintiff, Catherine McLean, filed an amended complaint seeking to recover accidental death benefits allegedly due from The Prudential Insurance Company of America ("Prudential") and Continental Casualty Company ("Continental"). Plaintiff claims that her husband was covered under the Defendants' insurance plans. She contends that the accidental injury clause in Prudential's policy was applicable to her husband who contracted meningococcal meningitis and died. Each of the defendants denied coverage for different reasons. Plaintiff also claims that defendants breached their fiduciary duties in denying her claims.

 Defendant Prudential *fn1" moved this Court to dismiss Plaintiff's amended complaint for failure to state a claim pursuant to Rule 12(b)(6) or, in the alternative, for summary judgment under Rule 56(e), arguing (1) that plaintiff's husband's death was not the direct result of an accidental bodily injury as required by the policy and (2) that Defendant owes no fiduciary duty to Plaintiff. By Order dated October 25, 1996, I denied Defendant's motion with leave to renew after the close of discovery.

 Defendant Prudential now renews its motion. In addition to the arguments that Prudential originally made, it also now argues that dismissal is proper because Mr. McLean's death was excluded by its policy. For the reasons stated below, the defendant's motion for summary judgment is GRANTED.

 From 1986 until the date of his death, Theodore McLean was an employee of National Westminster Bank USA ("NatWest"). On the evening of October 23, 1993 after returning home from a business trip to England for NatWest, Mr. McLean began experiencing symptoms such as fever and vomiting. On October 26, 1993 Mr. McLean died of septicemia, or blood poisoning, caused by the microorganism meningococcus. On or about December 9, 1993 Prudential paid the term life insurance proceeds of approximately one million dollars to an irrevocable trust of which plaintiff is the sole beneficiary. Furthermore, Prudential approved plaintiff's claim for survivor benefits in the amount of $ 10,000 per month.

 On December 15, 1995, plaintiff, Theodore McLean's widow, submitted a claim to Prudential under the Group Insurance Policy (the "Policy") covering her husband seeking payment of benefits for accidental death and disability. The Policy provides, in pertinent part, that benefits for accidental death will be payable only if

 
[the insured] sustain[s] an accidental bodily injury while a covered person;
 
the loss results directly from that injury and no other cause;
 
[the insured] suffers the loss within 90 days after the accident.

 The Policy states that benefits are not payable if the loss resulted from

 
(2) Sickness, whether the loss results directly or indirectly from ...

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