general work-related stress) has no correlation with sudden cardiac death.
II. CONCLUSIONS OF LAW
A. Standard of Review under ERISA
Under ERISA, "a denial of benefits challenged under § 1132(a)(1)(B) is to be reviewed under a de novo standard unless the benefit plan gives the administrator or fiduciary discretionary authority to determine eligibility for benefits or to construe the terms of the plan." Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115, 103 L. Ed. 2d 80, 109 S. Ct. 948 (1989); see also Schultz v. Metropolitan Life Ins. Co., 872 F.2d 676, 678 (5th Cir. 1989).
Here, this Court previously ruled on Defendants' Motion to Dismiss that the Court will perform a de novo review of Hartford Life's denial of benefits. See Howard v. Nat'l Ed. Ass'n of N.Y., 911 F. Supp. 48 (N.D.N.Y. 1995). Accordingly, the following is the Court's de novo review of Hartford Life's decision to deny benefits.
B. Interpretation of ERISA Regulated Insurance Policies
The instant dispute essentially presents only one issue: whether Richard Howard's death was an "accident" within the meaning of the Policy issued by Hartford Life.
The benefit provisions of an ERISA regulated insurance program must be interpreted under principles of federal substantive law. Congress, in adopting ERISA, expected that "a federal common law of rights and obligations under ERISA-regulated plans would develop." Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 56, 95 L. Ed. 2d 39, 107 S. Ct. 1549 (1987); see also Firestone, 489 U.S. at 110. In ascertaining the applicable federal common law, a court may "'draw guidance from analogous state law.'" Brandon v. Travelers Ins. Co., 18 F.3d 1321, 1325 (5th Cir. 1994) (quoting McMillan v. Parrott, 913 F.2d 310, 311 (6th Cir. 1990)). However, "in so doing, [a court] may use state common law as a basis for new federal common law . . . only to the extent that state law is not inconsistent with congressional policy concerns." Thomason v. Aetna Life Ins. Co., 9 F.3d 645, 647 (7th Cir. 1993); see also Heasley v. Belden & Blake Corp., 2 F.3d 1249, 1257 n.8 (3d Cir. 1993); Jamail, Inc. v. Carpenters Dist. Council of Houston Pension & Welfare Trusts, 954 F.2d 299, 304 (5th Cir. 1992).
Applying the basic tenets of contract interpretation, the first place to look for a definition is in the terms of the policy contract itself. See Pilot Life, 481 U.S. at 56-57. These terms must be given their plain meanings, meanings that comport with the interpretations given by the average person. See, e.g., Wickman v. Northwestern Nat. Ins. Co., 908 F.2d 1077, 1084 (1st Cir. 1990); Hoffman v. Life Insurance Co., 669 P.2d 410, 416 (Utah 1983); Knight v. Metropolitan Life Ins. Co., 103 Ariz. 100, 437 P.2d 416 (Ariz. 1968). "Courts have also held, nearly unanimously, 'that insurance contracts must be liberally construed in favor of a policyholder or beneficiary . . . and strictly construed against the insurer in order to afford the protection which the insured was endeavoring to secure when he applied for the insurance.'" Wickman, 908 F.2d at 1084 (quoting 13 Appleman, Insurance Law and Practice § 7401 at 197 (1976)); see also Howard v. Federal Crop Ins. Corp., 540 F.2d 695 (4th Cir. 1976).
Turning to the policy in question, Hartford Life is obligated to pay benefits for "accidental bodily injury . . . [if] a loss results directly from such injury, independent of all other causes." (Ex. DH 119) (emphasis added). The instant policy also contains various exclusions from coverage, including loss due to "sickness" or "disease." (Ex. DH 119). Unfortunately, the Policy does not define the term "accidental." Thus, the Court must seek guidance from alternative sources.
In a case similar to the present one, this Court was forced to decide whether death by autoerotic asphyxiation was an "accident " under the terms of an ERISA benefit plan. See Bennett v. American Int'l Life Assurance Co., 956 F. Supp. 201 (N.D.N.Y. 1997). In Bennett, we quoted from Justice Cardozo's dissent in Landress v. Phoenix Mutual Life Ins. Co., 291 U.S. 491, 78 L. Ed. 934, 54 S. Ct. 461 (1934), wherein he stated:
"Probably it is true to say that in the strictest sense and dealing with the region of physical nature there is no such thing as an accident." Halsburg, L.C. in Brintons v. Turvey, L.R. . . . . On the other hand, the average man is convinced that there is, and so certainly is the man who takes out a policy of accident insurance. It is his reading of the policy that is to be accepted as our guide, with the help of the established rule that ambiguities and uncertainties are to be resolved against the company. . . . When a man has died in such a way that his death is spoken of as an accident, he has died because of an accident, and hence by accidental means.