Fonda Wicks v. Metropolitan Life Insurance Company

The 5th Court of Appeals determined, and we agree, that “Wicks was required to show that Mr. Wicks “sustain[ed] an accidental injury that [was] the Direct and Sole Cause of a Covered Loss.” The questions presented to this court are: Whether considering the Accidental Death and Dismemberment Plan, and the facts, Petitioner Wicks is entitled to benefits? Whether the Fifth Court of Appeals failed to apply the contra proferentum and/or a strict interpretation of the entire plan to give meaning to the Covering Clause, the Medical Treatment Exception, the Drug Exception, and the role of the Direct and Sole Clause? Whether the Fifth Court blanket rule that obesity is legal cause of death even if unrelated to the death while undergoing medical procedure materially deviates from the terms of the Plan? Whether “Accidental Injury” as an essential term needing interpretation and whether the Anoxic Brain Injury is the subject “Accidental Injury” or is the Death of Mr. Wicks the Accidental Injury?