the toxicology results became available, Dr. Singh completed an addendum to the Autopsy Report (the "Addendum Report"). The Addendum Report states that, on 25 July 1990, the death certificate was amended to read: "CAUSE OF DEATH: Acute Drug Reaction" and "MANNER OF DEATH: accident." Joint 12G Statement, P 16; Ex. J-6.
On 12 June 1990, AT&T notified MetLife that J. Mclain died on 10 June 1990 and that his last day of work was Friday, 8 June 1990. Joint 12G Statement, P 17; Ex. J-8(a). Prior to receipt of McLain's claim for Accidental Death and Dismemberment benefits, MetLife approved a request by AT&T that an advance payment of basic life insurance benefits in the amount of $ 10,000 be made to McLain, as against the payable basic life insurance benefit of $ 35,000. On 14 June 1990, MetLife made the advance payment to McLain. Joint 12G Statement, P 18; Ex. J-8(b).
McLain submitted a claim, dated 21 June 1990, for basic life insurance benefits and Accidental Death and Dismemberment benefits under the AT&T Plan. A copy of the initial Death Certificate, indicating that an investigation was pending, was attached to the claim. Joint 12G Statement, P 19. On 2 August 1990, Mclain submitted Dr. Singh's Addendum Report to MetLife. Id.; Ex. J-8(c).
On 7 August 1990, MetLife reviewed McLain's claim and approved payment of the remaining balance of $ 25,000 in basic life insurance benefits. Payment was made on 7 August 1990. Joint 12G Statement, P 20; Ex. J-8(d). However, after review of J. Mclain's Autopsy Report, Toxicology Report and Death Certificate, MetLife denied McLain's claim for Accidental Death and Dismemberment benefits. Joint 12G Statement, P 21. By letter, dated 3 October 1990, MetLife informed McLain of its determination that J. McLain's death was not accidental under the terms of the AT&T Plan. In addition, his death was excluded under the Plan's "purposely self-inflicted injury" exclusion. Id.; Ex. J-8(e).
In October 1990, McLain requested a review of the claim denial. McLain stated in her letter that J. McLain's death was accidental based upon the Autopsy Report and that he did not intend "to inflict self-injury at the time of [his] death." Joint 12G Statement, P 22. No additional information was submitted in support of McLain's claim appeal. Id.; Ex. J-8(f).
In response to McLain's appeal, MetLife, again, reviewed McLain's claim for Accidental Death and Dismemberment benefits under the AT&T Plan. MetLife determined J. McLain's death did not constitute an accidental injury under the AT&T Plan, as his death resulted from an intentionally self-inflicted injury, as a consequence of his use of cocaine. Therefore, on 16 November 1990, MetLife wrote McLain and informed her the initial denial of her claim would be upheld. Joint 12G Statement, P 23; Ex. J-8(g). McLain commenced the present action on 7 October 1992.
A. Standard of Review for Summary Judgment
To prevail on a motion for summary judgment, the moving party must establish "there is no genuine issue as to any material fact and that [it] is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(c). The present task is to determine whether disputed issues of fact exist, but a district court may not resolve factual disputes in a motion for summary judgment. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249-50, 91 L. Ed. 2d 202, 106 S. Ct. 2505 (1986); see also Desvi, Inc. v. Continental Ins. Co., 968 F.2d 307, 308 (3d Cir. 1992) ("The threshold inquiry is whether there are 'genuine factual issues that properly can be resolved only by a finder of fact because they may reasonably be resolved in favor of either party.'" (citations omitted); Gray v. York Newspapers, Inc., 957 F.2d 1070, 1078 (3d Cir. 1992) ("We apply the test (1) Is there no genuine issue of material fact and (2) is one party entitled to judgment as a matter of law?") (quotations omitted); Hackman v. Valley Fair, 932 F.2d 239, 241 (3d Cir. 1991) ("Summary judgment is inappropriate when a conflict on a material fact is present in the record."); Nathanson v. Medical College of Pennsylvania, 926 F.2d 1368, 1380 (3d Cir. 1991) (Summary judgment may not be granted "if there is a disagreement over what inferences can be reasonably drawn from the facts even if the facts are undisputed.").
All evidence submitted must be viewed in a light most favorable to the party opposing the motion. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587, 89 L. Ed. 2d 538, 106 S. Ct. 1348 (1986); Williams v. New Castle County, 970 F.2d 1260, 1264 (3d Cir. 1992); Boyle v. Governor's Veterans Outreach & Assistance Center, 925 F.2d 71, 75 (3d Cir. 1991); Weldon v. Kraft, Inc., 896 F.2d 793, 797 (3d Cir. 1990); Todaro v. Bowman, 872 F.2d 43, 46 (3d Cir. 1989). "'Any 'unexplained gaps' in materials submitted by the moving party, if pertinent to material issues of fact, justify denial of a motion for summary judgment.'" Ingersoll-Rand Fin. Corp. v. Anderson, 921 F.2d 497, 502 (3d Cir. 1990) (quoting O'Donnell v. United States, 891 F.2d 1079, 1082 (3d Cir. 1989)).
Although the summary judgment hurdle is a difficult one to overcome, it is by no means insurmountable. As the Supreme Court has stated, once the party seeking summary judgment has pointed out to the court the absence of a genuine issue of material fact,
its opponent must do more than simply show that there is some metaphysical doubt as to the material facts. In the language of the Rule, the nonmoving party must come forward with 'specific facts showing that there is a genuine issue for trial.' Where the record taken as a whole could not lead a rational trier of fact to find for the non-moving party, there is no 'genuine issue for trial.'