Melvin
v. Yale Industrial Products, Inc.,
197 F.3d 944 (8th Cir. 1999)-Melvin,
a self-employed farmer and crop-duster, sustained injuries after crashing his
small plane while spraying chemicals on his son’s field. His health insurance
provider denied coverage on the basis that Melvin’s physical damages fell
outside the plan’s definition of “injury” as “non-occupational.”
This court affirmed the district court’s summary judgment against
Melvin.
This
court reviewed de novo, since the ERISA plan did not give the administrator
discretionary authority to construe the plan’s terms.
Melvin argued that because the crash occurred while Melvin was dusting
his son’s field gratuitously (to use up extra chemicals at the end of the
day), he was not practicing his occupation at the time of the crash. Giving the
term “occupational” its “common and ordinary meaning,” this court denied
that the term was ambiguous.
The court pointed out that doctors and lawyers who work pro bono would be
still commonly understood to be practicing their occupation.