Accidental death during act of autoerotic hypoxia. No evidence of intended suicide. Here is the standard in Texas state courts:
The beneficiaries here had the burden to establish that Mr. Tommie's death was due to an accident. Their evidence revealed that his death was by violent and external means, thus raising a presumption that the death was accidental. Republic Nat. Life Ins. Co. v. Heyward, 536 S.W.2d 549 (Tex.1976); International Travelers Association v. Marshall, 131 Tex. 258, 114 S.W.2d 851 (1938); Freeman v. Crown Life Ins. Co., supra. They also produced other evidence that the death was an accident when tested by the rules announced in Freeman. Dr. Norton testified that she encountered from time to time in her medical practice the same type of auto-erotic activity as Mr. Tommie was engaged in, and that while some forty deaths per year were reported in the United States as a result of such activity, death is not the normal expected result of that behavior, but would be considered unusual or unexpected. Dr. Montgomery also agreed that death in those circumstances would not be reasonably expected. Dr. Norton further testified that it was likely that Mr. Tommie had engaged in the practice for several years, considering his age and the fact that such behavior generally begins in young men during pubescence or shortly thereafter. From that testimony and all the other evidence, it can reasonably be concluded that, although the type of activity in which Mr. Tommie was engaged was foolish and fraught with substantial risk of injury or death, it was not of such a nature that the insured should have reasonably known that it would probably result in his death. The finding of the jury that the death was accidental was supported by sufficient evidence and was not so against the great weight of the evidence as to be manifestly wrong.
Connecticut General Life Ins. Co. v. Tommie, 619 S.W.2d 199, 202-203 (Tex.Civ.App. --- Texarkana, writ refused n.r.e.).
Fifth Circuit, however, says it is not an abuse of discretion for ERISA administrator to deny claim based on the same facts.
Estate of Bradley Thompson v. Sun Life Assurance Company of Canada No. 09-10036 Summary Calendar
http://www.ca5.uscourts.gov/opinions/unpub/09/09-10036.0.wpd.pdf