36 F.4th 678
6th Cir.2022Background
- Daniel Tymoc died in a single-car crash after driving between 80–100 mph and attempting risky passes; his death followed conduct the parties agree was speeding and reckless driving.
- Tymoc’s employer-provided Unum life policy included a $100,000 accidental death benefit but excluded losses "caused by, contributed to by, or resulting from . . . an attempt to commit or commission of a crime."
- Unum paid basic life benefits but denied the accidental death benefit under the policy’s crime exclusion; beneficiary Judy Fulkerson sued under ERISA to recover the denied benefit.
- The district court sided with Fulkerson and awarded the accidental death benefit; Unum appealed.
- The Sixth Circuit reviewed de novo, applied federal common-law contract interpretation, and asked whether ‘‘crime’’ plainly includes reckless driving.
- The Sixth Circuit held the plain, ordinary meaning of "crime" includes reckless driving and reversed the district court as to the crime-exclusion issue.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether reckless driving is a "crime" under the policy's exclusion | Fulkerson: "Crime" is ambiguous and should be read narrowly (serious offenses/felonies); construing ambiguity against insurer yields coverage | Unum: "Crime" in ordinary meaning covers illegal acts punishable by government, including reckless driving | Reckless driving falls within the plain, ordinary meaning of "crime," so the exclusion applies |
| Whether the term "crime" is ambiguous such that contra proferentem should apply | Fulkerson: ordinary person may view traffic offenses as non-criminal; ambiguity requires construing against drafter | Unum: "Crime" covers a wide spectrum (felonies and misdemeanors); policy text and state laws show recklessness is punishable crime | Court: term is unambiguous here; reckless driving is a punishable offense and not ambiguous for ERISA plain-meaning analysis |
Key Cases Cited
- Boyer v. Schneider Electric Holdings, Inc., 993 F.3d 578 (8th Cir. 2021) (upholding crime exclusion where insured’s high-speed improper passing/reckless driving led to death)
- Clemons v. Norton Healthcare Inc. Ret. Plan, 890 F.3d 254 (6th Cir. 2018) (addresses standards of review in ERISA cases)
- Perez v. Aetna Life Ins. Co., 150 F.3d 550 (6th Cir. 1998) (federal common-law rules apply to ERISA plan interpretation)
- Williams v. Int’l Paper Co., 227 F.3d 706 (6th Cir. 2000) (interpret ERISA plan provisions by plain meaning in ordinary and popular sense)
- Kovach v. Zurich Am. Ins. Co., 587 F.3d 323 (6th Cir. 2009) (use dictionaries to determine plain meaning in contract interpretation)
- Shelby Cnty. Health Care Corp. v. Majestic Star Casino, LLC Group Health Benefit Plan, 581 F.3d 355 (6th Cir. 2009) (distinguishes "illegal act" ambiguity from narrower "crime"/"criminal act")
- American Family Life Assurance Co. v. Bilyeu, 921 F.2d 87 (6th Cir. 1990) (prior panel found "crime" ambiguous under state law; court here distinguishes that precedent)
- Carroll v. United States, 267 U.S. 132 (1925) (historical discussion of felony–misdemeanor distinction)