Levi Goldfarb, et al. v. Reliance Standard Life Insurance Company
AdministrativeLaw Arbitration ERISA
Whether an accidental death insurance policy subject to ERISA should determine the existence of an 'accident' by common law presumption or a 'reasonable mountain climber' standard, and whether an undefined policy term should be construed against the insurer
I. The insured under a policy insuring against accidental death, which was subject to the Employee Retirement Income Security Act of 1974 (“ERISA”) and did not exclude mountain climbing, died of an unknown cause while ascending a peak in Pakistan. Should the existence of an “accident” be determined by (a) the usage of the common law presumption in favor of an accident or (b) an inquiry into whether the insured failed to conduct himself as a “reasonable mountain climber”? II. A policy insuring against accidental death, which was subject to ERISA, did not define either “accident” or “accidental”. Should the policy be (a) deemed ambiguous and, therefore, (b) construed strictly against the insurer and in favor of the beneficiaries? Each of the foregoing questions is the subject of a circuit split. ii RELATED CASES Levi Goldfarb and Benjamin Goldfarb v. Reliance Standard Life Insurance Company , 0:22-cv-60804-FAM, U.S. District Court for the Southern District of Florida. Judgment entered January 1, 2023. Levi Goldfarb and Benjamin Goldfarb v. Reliance Standard Life Insurance Company , No. 23-10309, U.S. Court of Appeals for the Eleventh Circuit. Judgment entered July 2, 2024. Rehearing en banc denied August 13, 2024.