Heimer v. Companion Life Ins. Co., No. 16-2274 (COLE, Stranch, McKeague).

Heimer v. Companion Life Ins. Co., No. 16-2274 (COLE, Stranch, McKeague).

The plaintiff was injured while playing a game of “chicken” on a motorbike with his friends in a Michigan field. The intoxicated plaintiff and one of his friends rode their bikes at one another, but neither swerved and they struck each other head-on. Thereafter, the plaintiff submitted a medical claim to his insurance provider. The insurance company denied the claim, citing a plan exclusion that disclaimed coverage for injuries resulting from the “illegal use of alcohol.” After exhausting his administrative remedies, the plaintiff filed suit in court, eventually landing in federal district court. The district court ruled in the plaintiff’s favor, holding that that plan provision only included the illegal consumption of alcohol, and not the plaintiff’s illegal post-consumption conduct of operating a motorbike under the influence of alcohol.

The Sixth Circuit affirmed the decision. The majority found that the provision was unambiguous, and relied on several dictionary definitions in holding that, in everyday English, “illegal use of alcohol” means “the illegal act of consuming alcohol.” Judge McKeague concurred in the judgement, but dissented from the conclusion that the provision was unambiguous, warning that that determination says more than needs to be said and may establish bad precedent unnecessarily. The Court was unanimous in holding that, even if the contract language were ambiguous, any ambiguities must be construed strictly against the drafter, in this case the insurance company.