MOORE v. RECO EQUIPMENT INC EMPLOYEE WELFARE BENEFIT PLAN et al

Filing 39

MEMORANDUM OPINION AND ORDER adopting 35 Report and Recommendations as supplemented; granting 18 Motion for Summary Judgment; and denying 22 Motion for Summary Judgment, as explained therein. Signed by Chief Judge Joy Flowers Conti on 6/15/17. (mh)

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF PENNSYLVANIA

LINDA L. MOORE, surviving spouse and
beneficiary of Tynan Moore,
Plaintiff,
v.
RECO EQUIPMENT INC EMPLOYEE WELFARE
BENEFIT PLAN, and RELIANCE STANDARD
LIFE INSURANCE COMPANY,
Defendants.

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Civil Action No. 16-1017
Chief Judge Joy Flowers Conti
Chief Magistrate Judge Maureen P.
Kelly

Re: ECF Nos. 18, 22

MEMORANDUM OPINION
Conti, Chief District Judge.
Plaintiff Linda L. Moore (“Moore” or “Plaintiff”), surviving spouse and beneficiary of
Tynan Moore, filed objections (ECF No. 36) to the Report and Recommendation (“R&R”) of the
magistrate judge dated April 3, 2017 (ECF No. 35). Defendants Reco Equipment, Inc. Employee
Welfare Benefit Plan (“Reco”) and Reliance Standard Life Insurance Co. (“Reliance”) oppose
the objections and urge the court to adopt the R&R. The objections are ripe for disposition.
This ERISA case involves Reliance’s decision to deny benefits under Reco’s employee
group accidental death policy after Tynan Moore was found dead of acute alcohol intoxication.
In a thorough, nineteen page R&R, the magistrate judge concluded that an “arbitrary and
capricious” standard of review applied because the policy gave Reliance discretion to determine
eligibility for benefits under the policy; Reliance’s interpretation of the policy term “accidental
bodily injury . . . caused directly and independently of all other causes by accidental means” was
not arbitrary and capricious; substantial evidence in the record supported Reliance’s conclusion
that Tynan Moore was an alcoholic and alcoholism was a contributing cause of his death; and

recommended that summary judgment be granted in favor of defendants.
Plaintiff asserts that the magistrate judge erred in the R&R by: (1) finding that
Reliance’s interpretation of the policy language was reasonable; (2) applying an incorrect “some
evidence” standard in evaluating the factual record; and (3) concluding that alcoholism was
causally related to Tynan Moore’s death. The court will address each contention.
The magistrate judge properly analyzed Reliance’s interpretation of the policy language.
As explained in the R&R, and as conceded by Plaintiff, there is a circuit split about the meaning
of the phrase “directly and independently of all other causes.” Reliance applied the more literal
interpretation adopted by the Sixth and Tenth Circuit Courts of Appeals, rather than the
“substantial contribution” test adopted by the Fourth, Ninth and Eleventh Circuit Courts of
Appeals. In light of the deferential standard of review, Reliance’s adoption of the (slightly)
minority position was not arbitrary and capricious.
The court rejects Plaintiff’s assertion that the magistrate judge applied the wrong standard
of review to the evidentiary record. Although she did use the phrase “at least some evidence” at
page 15 of the R&R, perhaps imprecisely, it is clear from the entire R&R that the magistrate
judge applied the correct “substantial evidence” standard. See R&R at 9 (discussing the
“substantial evidence” standard and citing Courson v. Bert Bell NFL Player Ret. Plan, 214 F.3d
136, 142 (3d Cir. 2000)); R&R at 12 (explaining that to assess Reliance’s reasoning, the court
must consider the question: “was there substantial evidence to support Reliance’s conclusion
that Mr. Moore ‘had a history of long-standing alcoholism’ and that his alcoholism was a cause
of his death?”); R&R at 14 (captioned “Substantial evidence to support Reliance’s conclusions”);
R&R at 17 (concluding that the evidence “considered as a whole, would cause a ‘reasonable
person to agree’ that he was an alcoholic.” (citing Courson)); R&R at 18 (noting that “there was

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substantial evidence that Mr. Moore was an alcoholic”). The magistrate judge conducted a
thorough and even-handed investigation of the evidentiary record. The court independently
reviewed the record and finds that there is “substantial evidence” that Tynan Moore was an
alcoholic.1
Finally, Plaintiff challenges the causal connection between Tynan Moore’s alcoholism
and death. Plaintiff contends that the independent medical report prepared by Dr. Thomas Gill
establishes that Tynan Moore’s overdose death was a “separate act” from his alleged alcoholism.
The R&R acknowledged that “Dr. Gill’s report could be read to undermine” the causal
connection. R&R at 18. The magistrate judge, however, explained that it was reasonable for
Reliance to conclude that Tynan Moore’s alcoholism contributed to his death by acute alcohol
intoxication, such that the death did not occur by accident “directly and independently of all
other causes.” Id. The magistrate judge reasoned that alcoholism is a chronic condition and that
the circumstances surrounding Tynan Moore’s death (with an extraordinarily high blood alcohol
content of .502) “support the conclusion that he was still struggling with his addiction at the time
of his death.” R&R at 18. The magistrate judge pointed out that although the self-induced fatal
overdose may have been an unintentional “accident,” it does not mean that it was unrelated to
Tynan Moore’s alcoholism. The court agrees with this analysis.2 See Ablow v. Canada Life

1

Plaintiff is correct that the evidentiary record, on its face, does not establish that Antabuse is a
drug used to treat alcoholism. (ECF No. 36 at 6-7). Antabuse was listed among Tynan Moore’s
prescribed medications. (ECF No. 19-2 at 66). It was appropriate for the magistrate judge to take
judicial notice of the properties of a medication. See Purkey v. Green, 28 F. App’x 736, 742 n.4
(10th Cir. 2001).
2
Although the magistrate judge decided the motions based on the “accident” arguments, she
noted that the same rationale would apply to the policy’s “sickness or disease” exclusion because
Tynan’s Moore’s alcoholism was a disease that contributed to his death. R&R at 19 n.9. The
court agrees with this alternative basis to grant summary judgment in favor of defendants. See
Klei v. Metroplitan Life Ins. Co., No. 91–CV–76942, 1992 WL 695749, at *11 (E.D. Mich. Oct.
30, 1992).
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Assurance Co., No. 3:02-CV-300, 2003 WL 23325805, at *8 (D. Conn. Nov. 19, 2003) (“It is
not necessary that the person ingesting the drugs know that death could result. If the person
ingesting the drug has a general cognizance that the drugs could produce some injury, it is
enough that there is some causal relation between the injury caused and the ultimate loss.”)
(citations omitted). In summary, the court agrees with and adopts the reasoning in the R&R, as
clarified in this opinion.
An appropriate order follows.

BY THE COURT:

/s/ Joy Flowers Conti
JOY FLOWERS CONTI
UNITED STATES DISTRICT JUDGE

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IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF PENNSYLVANIA

LINDA L. MOORE, surviving spouse and
beneficiary of Tynan Moore,
Plaintiff,
v.
RECO EQUIPMENT INC EMPLOYEE WELFARE
BENEFIT PLAN, and RELIANCE STANDARD
LIFE INSURANCE COMPANY,
Defendants.

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Civil Action No. 16-1017
Chief Judge Joy Flowers Conti
Chief Magistrate Judge Maureen P.
Kelly

Re: ECF Nos. 18, 22

ORDER
AND NOW, this 15th day of June, 2017, after plaintiff Linda L. Moore (“Plaintiff”) filed
an action in the above-captioned case, and after cross-motions for summary judgment were filed
by the parties, and after a Report and Recommendation was filed by a magistrate judge giving
the parties until April 17, 2017, to file written objections thereto, and upon consideration of the
objections filed by plaintiff and the responses to the objections submitted by defendants Reco
Equipment, Inc. Employee Welfare Benefit Plan (“Reco”) and Reliance Standard Life Insurance
Co. (“Reliance”) (together, “Defendants”), and upon independent de novo review of the record,
and upon consideration of the Report and Recommendation, which is adopted as the opinion of
this court as supplemented by the accompanying memorandum opinion,
IT IS HEREBY ORDERED that Defendants’ motion for summary judgment (ECF No.
18) is GRANTED and Plaintiff’s motion for summary judgment (ECF No. 22) is DENIED.

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IT IS FURTHER ORDERED that, pursuant to Rule 4(a)(1) of the Federal Rules of
Appellate Procedure, if any party wishes to appeal from this Order a notice of appeal, as
provided in Federal Rule of Appellate Procedure 3, must be filed with the Clerk of Court, United
States District Court, at 700 Grant Street, Room 3110, Pittsburgh, PA 15219, within thirty (30)
days.
BY THE COURT:

/s/ Joy Flowers Conti
JOY FLOWERS CONTI
UNITED STATES DISTRICT JUDGE

cc:

Honorable Maureen P. Kelly
Chief United States Magistrate Judge
All Counsel of Record Via CM-ECF

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