Neither "Intentionally Self-Inflicted Injury" Nor "Suicide" Exclusions
Are Applicable To Beneficiary's ERISA Claim For Life Insurance Benefits For
Participant's Death From Autoerotic Asphyxiation On the evening of February 9,
1999, Gerald Alan Padfield told his wife he was going to the cleaners and drove
away from his home in the family's van. He never returned. Three days later, a
California Highway Patrol trooper noticed the van parked on an empty street next
to a vacant lot. When he approached the van, he discovered Mr. Padfield dead on
the back-seat floor. According to the coroner's report, Mr. Padfield was found
sitting in an upright position behind the front passenger seat with his back
against the sliding door. He was naked from the waist down. One end of a necktie
was tied around his neck. The other end was tied to the sliding door hinge,
which was located directly above him. The two back seats were folded down, and
on top of them were numerous sexual devices and a
backpack. Inside the backpack were pornographic materials and a small bottle
containing a liquid later identified as Chlorohexanol, an industrial solvent.
Another bottle of the liquid was nearby. Post-mortem tests found the
industrial solvent in Mr. Padfield's blood. The coroner reported that he found
no trauma other than a deep ligature mark around the neck. The report stated
that the death appeared to be the "accidental" result of autoerotic
asphyxiation. The death certificate listed the cause of death as "hanging." Mr.
Padfield's wife, who had filed a missing person report when her husband had
failed to return from the cleaners, said that there were no personal problems at
home and that "everything appeared to be fine." When notified of the
circumstances surrounding her husband's death, she told officers that she knew
of her husband's sexual devices but thought he had quit using them. Mrs.
Padfield was the beneficiary of an ERISA-governed accidental death insurance
policy
that covered Mr. Padfield. Appellee AIG Life Insurance Company (AIG) issued the
policy as part of an employee benefits plan with Raytheon Systems Company, where
Mr. Padfield worked. Mrs. Padfield claimed benefits under the policy, listing
the cause of death as "accidental death by hanging." The policy provides for an
"accidental death benefit" to be paid "[i]f Injury to the Insured Person results
in death within 365 days of the date of the accident that caused the Injury."
"Injury" under the policy is defined as "bodily injury caused by an accident
while this Policy is in force as to the person whose injury is the basis of the
claim and resulting directly and independently of all other causes in a covered
loss." The policy also contains the following exclusion: This Policy does not
cover any loss caused in whole or in part by, or resulting in whole or in part
from, ... suicide or any attempt at suicide or intentionally self-inflicted
injury or any attempt at intentionally
self-inflicted injury. AIG invoked this exclusion and rejected the claim.
After pursuing an unsuccessful administrative appeal, Mrs. Padfield filed a
complaint in the district court under ERISA, seeking benefits under the policy.
Both parties filed motions for summary judgment. The district court granted
AIG's motion and denied Mrs. Padfield's motion. It held that Mr. Padfield's
death by autoerotic asphyxiation fell outside the policy exclusion for suicide,
but fell within the exclusion for death resulting from "intentionally self-
inflicted injury." Mrs. Padfield appealed both the denial of her motion and the
granting of AIG's motion. The 9th Circuit reversed. Autoerotic asphyxiation is
the practice of limiting the flow of oxygen to the brain during masturbation in
an attempt to heighten sexual pleasure. The undisputed evidence indicates that
Mr. Padfield engaged in the most common form of this behavior, in which the
reduction in oxygen is achieved with the application of
pressure to the veins carrying blood out of the head. This method requires
minimal pressure on the neck. It essentially keeps blood from leaving the brain,
which continues to use oxygen until the oxygen in the blood is depleted enough
to give the desired euphoric effect. The asphyxial state stimulates nerve
centers in the brain, and produces a state of hypercapnia (an increase in carbon
dioxide in the blood) and a concomitant state of hypoxia (a decrease in oxygen
in the blood), all of which result in an increased intensity of sexual
gratification. Industrial solvents like the one found near Mr. Padfield are also
used to contribute to, or bring about, the same effect. Autoerotic
asphyxiation can result in death, as it did in this case. Because of equipment
malfunction, errors in the placement of the noose or ligature, or other
mistakes, accidental deaths sometimes occur. Data from the United States,
England, Australia, and Canada indicate that one to two hypoxyphilia--caused
deaths per million population are detected and reported each year. But the use
of asphyxia to heighten sexual arousal more often than not has a nonfatal
outcome. Autoerotic asphyxiation is a repetitive pattern of behavior that
individuals engage in over a period of years, and generally the intent of the
individuals performing this act is not death. When performed successfully, the
act results only in a temporary decrease in oxygen levels that causes
light-headedness, and usually does not leave visible marks on the neck. The
policy exclusion at issue in this case contains two separate exclusions--one for
"suicide or any attempt at suicide" and one for "loss caused in whole or in part
by, or resulting in whole or in part from ... intentionally self-inflicted
injury or any attempt at intentionally self-inflicted injury." The 9th Circuit
considered each of these exclusions, and found neither to be applicable on the
facts of this case: The undisputed evidence in this case
requires us to conclude that Mr. Padfield's death was "accidental," and was
thus not a "suicide" within the meaning of the policy. Autoerotic asphyxiation
practitioners expect to survive the experience, and there is nothing to suggest
that Mr. Padfield subjectively expected otherwise. Though the record is limited,
it appears that Mr. Padfield had a history of engaging in this autoerotic
behavior and surviving it. Moreover, there is no evidence that he was distraught
or experiencing any personal problems. Because death by autoerotic asphyxiation
is statistically rare, his expectation of survival certainly was reasonable.
Even if we could not determine Mr. Padfield's subjective expectations, the same
conclusion would be warranted under a purely objective analysis because death is
not the "substantially certain" result of autoerotic asphyxiation. . . Given the
uniform medical and behavioral science evidence indicating that autoerotic
activity ordinarily has a nonfatal outcome, "the
likelihood of death from autoerotic activity falls far short of what would be
required to negate coverage" under an accidental death policy. Examining the
suicide exclusion in its "ordinary and popular sense as would a person of
average intelligence and experience," it is clear that the provision does not
preclude recovery of benefits. Mr. Padfield "was merely involved in an act
designed to enhance his sexual gratification," and we believe that "in the
common understanding ..., [his] death would be regarded as accidental." Every
court to have considered autoerotic asphyxiation under the federal common law of
ERISA has concluded that it is not excluded from coverage by a suicide
exclusion. The district court did not err in so holding. AIG also argues that
Mrs. Padfield may not receive benefits under the policy because Mr. Padfield's
death was the result of an "intentionally self-inflicted injury." The district
court held for AIG on this ground. We disagree. AIG emphasizes that
Mr. Padfield voluntarily engaged in a risky activity. This is true, but
voluntary risky acts resulting in injury are not necessarily acts that result in
"intentionally self-inflicted injury." Mr. Padfield voluntarily engaged in
actions that led to a fatal injury, but his reasonable expectation was that this
behavior would not have resulted in "injury" as that word is commonly defined.
Given both the usual pattern of autoerotic asphyxiation and the statements by
Mrs. Padfield, the undisputed facts in this case show that Mr. Padfield, having
performed the act in the past without inflicting any injury, had a reasonable
expectation that he would be able to do so again. Thus . . . Mr. Padfield "did
not die from an intentionally self-inflicted injury." Rather, he made a "fatal
mistake." "Generally, insureds purchase accident insurance for the very purpose
of obtaining protection from their own miscalculations and misjudgments."





Padfield v. AIG Life Insurance Read the case The 9th Circuit Court of
Appeals' jurisdiction includes California, Oregon, Washington, Arizona, Montana,
Idaho, Nevada, Alaska and Hawaii. This abstract was provided by LawMemo.Com,
publisher of the popular Employment Law Memo email service. Editor Ross Runkel
can be reached at Ross@... or 1-877-399-8028.-->(You must have Adobe
Acrobat Reader installed on your computer to properly view this case)-->

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