Key Takeaways from the Case
- Elective surgery that is not necessitated by an accident does not qualify as a cause of accidental death.
- If surgery follows an accident and the death results from complications, it may be considered an accidental death.
- Understanding why surgery was performed is critical in determining whether a death is covered under an accidental death insurance policy.
Case Background: Florida Appellate Court on Accidental Death & Elective Surgery
A Florida appellate court issued a significant ruling in a case involving Beneficial Standard Life Insurance Company and the death of Mr. Forsyth, who was covered under an Accident Only Insurance Policy.
The policy covered death, dismemberment, and hospital care caused by accident—but notably did not define the term “accident.”
Mr. Forsyth underwent elective jaw-wiring surgery for weight loss purposes. The procedure was not required due to an injury or accident. Tragically, he passed away during surgery due to a pulmonary embolism.
Legal Question: Is Death After Elective Surgery Considered an Accident?
The Florida court ruled that Mr. Forsyth’s death did not qualify as an accidental death under the policy because:
- The surgical procedure was elective, not medically necessary due to an injury.
- The embolism and death were foreseeable, even if unanticipated, outcomes of surgery.
The Court’s Reasoning:
"If an operation is not necessitated by an injury resulting from an accident, then death following the operation is not accidental."
However, the court clarified that:
"If an operation is necessitated by an injury resulting from an accident, then a death resulting from surgery may be classified as an accidental death."
This ruling underscores the importance of evaluating what caused the need for surgery—was it an accident, or was it elective?
Why This Ruling Matters
This case establishes a legal principle that can make or break accidental death and dismemberment (AD&D) claims:
- Complications from surgery alone are not enough to qualify a death as accidental.
- What matters is why the surgery was performed—if due to an accidental injury, the outcome could be considered covered.
Many families are shocked to learn that an accidental death insurance claim is denied after a loved one dies during a surgery. Understanding these legal nuances is critical.
Dabdoub Law Firm Knows How to Win These Cases
At Dabdoub Law Firm, we have successfully challenged wrongful denials of accidental death benefits involving post-surgical complications. In multiple cases, we have proven that when surgery is necessitated by an accidental injury, the resulting death is in fact covered under an AD&D policy.
Why Choose Dabdoub Law Firm for Your Insurance Claim?
We are a litigation powerhouse focused exclusively on disability and life insurance claims, including accidental death denials. Our legal team is trusted nationwide to take on the toughest cases and insurance carriers.
We offer:
- Nationwide representation for life and disability insurance claims
- Experience against every major insurance company
- A proven record of federal court victories
- Deep knowledge of ERISA and state insurance laws
- Results: Millions recovered for our clients in denied insurance benefits
Let Our Accidental Death Insurance Lawyers Help You
If you’ve been denied a claim for accidental death insurance benefits—especially after a surgical procedure—you need experienced legal help.
Our firm can help you:
- Analyze the cause of death in light of policy definitions
- Gather medical records and expert opinions
- Appeal a wrongful denial or file a federal lawsuit
- Win the benefits your loved one paid for and your family deserves
Call Today for a Free Consultation
You pay no fees or costs unless we recover benefits. Contact us now to speak with a lawyer who specializes in accidental death insurance claims.