Calvin Fisher v. Aetna Life Insurance Company

MEMORANDUM

Appellants Calvin and Penny Fisher (“the Fishers”) filed a claim for benefits under their deceased son Jeffery’s life and accidental death insurance policy. Appel-lee Aetna Life Insurance Co. (“Aetna”) initially denied their claim on the basis that Jeffery did not become eligible for benefits until the day after his death. The Fishers appealed to the district court, and once it was determined that Aetna had applied an outdated 1999 eligibility provision, the district court remanded to the plan administrator for a coverage determination. The Fishers appealed the district court’s remand order to this court, which dismissed their appeal for lack of jurisdiction. On remand, Aetna denied accidental death benefits because Jeffery was intoxicated while operating a motor vehicle at the time of his death. The Fishers again appealed to the district court, which affirmed. The Fishers again appealed to this court. This court now has jurisdiction pursuant to 28 U.S.C. § 1291 , and we affirm.

Once the district court determined that Aetna had applied an outdated 1999 eligibility provision, it properly remanded to the plan administrator to determine coverage. Aetna had never…