Berryman v. Niceta

**What happened:** A worker's family sued MetLife after the insurance company denied Personal Accident Insurance benefits following the worker's death. The worker died in a car accident while driving drunk, and his family believed they were entitled to insurance payments under his employee benefit plan. MetLife refused to pay, arguing that the death wasn't truly "accidental" because it resulted from extremely reckless drunk driving behavior. **What the court decided:** The appeals court sided with MetLife and overturned a lower court's earlier decision. The court ruled that MetLife acted reasonably when it denied the insurance claim. The judges determined that when someone dies due to grossly negligent drunk driving, this doesn't qualify as an "accident" under employee insurance plans governed by federal employment law (ERISA). The insurance company was within its rights to refuse payment. **Why this matters for workers:** This ruling clarifies that employee accident insurance benefits may not cover deaths or injuries that result from extremely reckless behavior, even if the person didn't intend to cause harm. Workers should carefully review their insurance policies to understand what types of incidents are excluded from coverage, particularly those involving gross negligence or illegal activities.