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February 10, 2021
Judge Charles Eskridge of the Southern District of Texas ruled Tuesday that the employee health plan of an individual who unintentionally shot themselves while at work is not governed by the Employee Retirement and Income Security Act (ERISA), effectually remanding the matter to state court.
The plaintiff, who is the sole owner and employee of an automobile repair shop, said in the original complaint that they kept a gun at the business for protection. After the accidental self-inflicted injury resulting from “attempting to remove a stuck bullet,” the judge explained, the plaintiff filed a claim with the defendant, Life Insurance Company of North America, for medical and disability benefits. Defendant Matt Reiter, an employee of third-party work-related injury claims administrator Salus Claims Management, denied the plaintiff’s claim, “asserting that using or cleaning a gun wasn’t within the covered scope of employment,” and then