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Widow's claim for benefits under the accidental death and dismemberment insurance policy
Sellers v. Zurich Am. Ins. Co., 10-1448, concerned a challenge to the district court's affirmance of an insurer's denial of a widow's claim for benefits under the accidental death and dismemberment (AD&D) insurance policy, arising from her husband's death shortly after undergoing a surgery to remove a broken wire from his knee that was inserted over a year during a previous surgery for work-related injury.
In affirming the district court's judgment, the court held that, although the insurer acted arbitrarily and capriciously in failing to interpret the Plan as would a person of average intelligence and experience, to the extent that the breaking of the wire was an injury, such injuries resulting from medical treatment are not accidents as that term is used in AD&D policies.
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