Charles Kleinsteuber v. Metropolitan Life Ins. Co.

── Charles Kleinsteuber v. Metropolitan Life Ins. Co. ── Court: Court of Appeals for the Eighth Circuit Date: May 29, 2026 Category: General United States Court of Appeals For the Eighth Circuit ___________________________ No. 25-2860 ___________________________ Charles M. Kleinsteuber Plaintiff - Appellant v. Metropolitan Life Insurance Company Defendant - Appellee ____________ Appeal from United States District Court for the District of Minnesota ____________ Submitted: March 17, 2026 Filed: May 29, 2026 ____________ Before SHEPHERD, ERICKSON, and GRASZ, Circuit Judges. ____________ GRASZ, Circuit Judge. After Dana Kleinsteuber died, her husband, Charles Kleinsteuber, made a claim for accidental death and dismemberment (AD&D) benefits under an Employee Retirement Income Security Act (ERISA) plan, which was administered and insured by the Metropolitan Life Insurance Company (MetLife). MetLife denied coverage, explaining an exclusion applied because the home dialysis Mrs. Kleinsteuber used to treat her end-stage renal disease (ESRD) caused or contributed to her death. Mr. Kleinsteuber filed this lawsuit pursuant to ERISA, asking the district court 1 to reverse MetLife’s denial. The parties filed cross motions for summary judgment, and the district court entered judgment in MetLife’s favor. Mr. Kleinsteuber appeals, and we affirm. I. Background Mrs. Kleinsteuber began struggling with an eating disorder as a teenager, and she ultimately developed ESRD as a result. She began using home dialysis to treat her ESRD in December 2021. On January 18, 2022, Mrs. Kleinsteuber started a round of home dialysis mid- morning. She spoke with Mr. Kleinsteuber on the phone at 11:25 a.m. and mentioned her dialysis was almost finished. When he arrived home at 11:55 a.m., he found her lying on the ground covered in blood. She was disoriented but said, “I think I may have killed myself,” and “do not let me die.” Mr. Kleinsteuber called 911 at 11:59 a.m. When first responders arrived at 12:23 p.m., they quickly realized that Mrs. Kleinsteuber was still losing blood because she had not closed the chest port she used to administer dialysis. They closed her port, and her blood loss immediately stopped. Around this time, however, Mrs. Kleinsteuber went into cardiac arrest due to her severe blood loss. The first responders attempted various lifesaving measures, but she died at 1:08 p.m. Mr. Kleinsteuber submitted a claim for AD&D benefits under his employer’s ERISA plan, which MetLife administers, after Mrs. Kleinsteuber died. The plan provides AD&D coverage when an enrollee or their spouse “sustain[s] an accidental injury that is the Direct and Sole Cause of a Covered Loss,” including a “[l]oss of life.” But the plan excludes this coverage “for any loss caused or contributed to by . . . physical or mental illness or infirmity, or the diagnosis or treatment of such 1 The Honorable John R. Tunheim, United States District Judge for the District of Minnesota. -2- illness or infirmity.” It also grants MetLife “discretionary authority to interpret [its] terms . . . and to determine eligibility for and entitlement to [p]lan benefits in accordance with the terms of the [p]lan.” MetLife initially declined to review Mr. Kleinsteuber’s claim because Mrs. Kleinsteuber’s death certificate states she died from her ESRD and “natural causes.” MetLife agreed to review the claim at Mr. Kleinsteuber’s insistence, however, and determined that AD&D benefits were not payable. It sen