Reversal of Claim Denial Due to Intoxication Exclusion
Jan 05, 2018OUTCOME: The company reversed the denial and paid the full death benefit with interest and an additional benefit for child care expenses.
Erik represented a woman who had filed an accidental death claim after her husband was killed in a motor vehicle accident. The insurance company initially denied her claim for death benefits, because t ... he toxicology and autopsy results revealed that her husband had an illegal blood alcohol content (BAC) at the time of the crash. The policy contained an intoxication exclusion, which denies payment of the death benefit when the insured’s intoxication contributed to the accident. Erik argued that the alleged fact of intoxication did not warrant denial under the accidental death and dismemberment policy. The company reversed the denial and paid the full death benefit with interest and an additional benefit for child care expenses.
