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February 27, 2003


The opinion of the court was delivered by: Jenkins, District Judge.



Before the Court are defendant Life Insurance Co. of North America's Motion For Summary Judgment, defendant J.C. Penney Life Insurance Co.'s Motion For Summary Judgment, defendant Union Labor Life Insurance Co.'s Motion For Summary Judgment, and plaintiff Kay Parra's Cross Motion For Summary Judgment. All of these motions are based on the same set of facts and concern defendants' denial of accidental death benefits to plaintiff as a result of her husband's death. Plaintiff maintains that a traffic accident triggered her husband's death, while defendants maintain that his death was caused by the host of serious physical ailments he was suffering at the time, and that the policies under which plaintiff is seeking benefits have exclusions for death resulting from sickness or disease. Because plaintiff has presented no competent evidence to support her contention that the accident precipitated her husband's demise, the motions for summary judgment brought by the various defendants are GRANTED, and plaintiffs motion for summary judgment is DENIED.


1) The Death Of Henry Parra

On September 29, 2000, at around 4:00 a.m., Henry Parra died in his wife's arms at their family home. At the time of his death, Mr. Parra was suffering a number of serious ailments, including end-stage cirrhosis of the liver, advanced diabetes, advanced coronary artery disease, hypertension, and Hepatitis B. In addition, Mr. Parra had also been treated for prostate cancer, a stroke, and had undergone numerous surgeries, including open-heart surgery, operations to install and/or repair shunts in his liver, and urologic and abdominal surgery. Despite these complications, Mr. Parra appeared to be doing well in August and September of 2000, traveling with his family and even conducting a family Bar-B-Que on September 24, 2000.

On September 25, 2000, however, Mr. Parra was driving to Oakland when he was involved in a traffic accident. His SUV was hit from behind by a pickup truck, causir g minor damage. Soon after the accident, Mr. Parra phoned his wife, reporting that he did not feel well, that he had a headache, blurred vision, and dizziness, and that he could not drive home. Kay Parra, his wife and the plaintiff in this action ("Plaintiff"), then drove to Mr. Parra's location with her son, where they found Mr. Parra vomiting and complaining of a headache. Plaintiff then drove her husband home, where he went to bed.

The next day, plaintiff phoned one of Mr. Parra's treating physicians, Dr. Ralph Camacho, to tell him about the accident and about her husband's condition. Dr. Camacho suggested Mr. Parra go to the emergency room, but Mr. Parra, who had expressed his antipathy toward hospitals, refused to go and remained at home. Over the next two days, Mr. Parra became increasingly lethargic, and on September 28, 2000, he remained in bed, possibly slipping into a coma. When her husband began vomiting in his sleep, plaintiff again called Dr. Camacho's office. Over the phone, the doctor listened to Mr. Parra's breathing, which plaintiff said had changed over the course of the day. Dr. Camacho prescribed medication to control the nausea and suggested that a hospice service come to the house, but plaintiff declined. Early the next morning, Mr. Parra died.

Soon thereafter, the family reported Mr. Parra's death to the police, who arrived at the house with paramedics and staff from the coroner's office. After determining that no crime was involved, the police turned Mr. Parra's body over to the coroner's office. Importantly, the police reported that Mr. Parra had been attended by a physician within the last 20 days. In such cases, the death is treated as an "attended death," and no further investigation is called for. When examining the body, the police also noted that there were no signs of bruising or any other evidence of trauma on Mr. Parra. When the body was taken by the coroner's office personnel, plaintiff was given a piece of paper with "Coroner's Hold" written across the top, causing her to believe that her husband's body would have an autopsy performed on it. (See Declaration Of Carolyn A. Knox In Support Of Defendant Life Insurance Company of North America's Motion For Summary Judgment ("Knox Decl."), Ex. B at LINA01165.) No autopsy was performed, however, and Mr. Parra was cremated without any medical examination.

The death certificate described Mr. Parra's death as "immediate cause — cardiac arrest due to cirrhosis of liver," with "other significant conditions contributing to death" listed as "diabetes, congestive heart failure." (Knox Decl., Ex. C at LINA00213.) It was signed by Dr. Camacho, Mr. Parra's primary doctor.

The police report, coroner investigator report, paramedic's report, and original death certificate all indicate nothing about the September 25, 2000 accident. According to defendant J.C. Penney Insurance Co., had the accident been reported to the officials at the scene, it would have triggered an autopsy by the Coroner's Office. (See Declaration Of Cynthia D. McGaughey In Support Of Defendant J.C. Penney Life Insurance Company's Motion For Summary Judgment ("McGaughey Decl.,"), Ex. G at JCP 71 (notes of McGaughey's telephone conversation with the Alameda County Coroner's Office).)*fn2 However, no report of the September 25, 2000 accident was made to any of the paramedics, police officers, or coroner's officer personnel at the scene of Mr. Parra's death, so Mr. Parra was cremated without having undergone any post-mortem examination, other than that performed by the police officers at the house. Once again, that examination revealed no evidence of any bruising or other trauma to Mr. Parra's body.

2) Mr. Parra's Insurance Policies

Mr. Parra was a subscriber to several insurance policies that provided benefits in the event of an accident resulting in injury or death. These were provided by defendants Insurance Company of North America ("INA"), J.C. Penney Life Insurance Company, ("J.C.Penny"), and Union Labor Life Insurance Company ("Union"). Each policy awards survivor benefits when the policyholder is killed as a result of an accident: INA — $250,000, J.C. Penney — $100,000, and Union — $200,000, plus a $25,000 "special hazard benefit" for motor vehicles. (Knox Decl., Ex. B at LINA00003; McGaughey Decl., Ex B at 2; Declaration Of Linda Newkirk In Support Of Defendant Union Labor Life Insurance Company's Motion For Summary Judgment ("Newkirk Decl."), Ex. A at UL 00150.) Each policy also contains critical exclusions from coverage, stating that no benefits shall be paid for deaths caused by disease or illness. (See Knox Decl., Ex. B at LINA00001; McGaughey Decl., Ex. B at 5; Newkirk Decl., Ex A at UL 00151.)

After plaintiff applied for payment of death benefits under the policies, defendants denied coverage, claiming that Mr. Parra's death was caused by his various illnesses, not the traffic accident. Plaintiff appealed the denials, both within the insurance companies' internal procedures and through the ...

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