While most people are aware that life insurance policies may contain exclusions for suicide or material misrepresentation, fewer understand the impact a felony can have on coverage. Many policies contain clauses that allow insurers to deny payment if the insured dies while committing, or as a result of, a felony. The purpose of these clauses is to prevent individuals from profiting from criminal behavior. However, the way these provisions are enforced can be highly subjective and often unfair.
Common Felonies That Can Lead to a Denied Claim
Insurance companies typically invoke felony exclusions in cases involving serious crimes. These often include:
Murder
Manslaughter
Armed robbery
Burglary
Arson
Kidnapping
Drug trafficking
If the insured was engaged in one of these felonies at the time of death, the insurance company may argue that the death was not accidental or covered and deny the claim.
Example: A man was shot and killed during an attempted armed robbery. His life insurance policy included a clause excluding coverage for deaths that occurred during the commission of a felony. The insurer denied the claim, and the court upheld the denial after determining that the insured was actively participating in the robbery at the time of death.
Lesser Known or Nonviolent Felonies
Although most felony exclusions involve violent crimes, insurers may also attempt to apply them in less obvious cases. Crimes involving fraud, computer misuse, or even repeated minor offenses that escalate to felony status can be cited by insurers when denying a claim.
Example: An insured individual died in a car accident while fleeing from police after committing credit card fraud. Although no violence occurred, the insurer denied the claim by citing the felony exclusion clause. The family contested the denial, arguing that the death was unrelated to the felony itself. After litigation, the court found that the flight from law enforcement constituted part of the felony conduct and upheld the insurer’s decision.
Example: A policyholder was under investigation for large-scale illegal file sharing and died from an unrelated health condition during the investigation. The insurer attempted to deny the claim based on the felony exclusion. Our legal team proved that the death was in no way related to criminal conduct, and the insurer reversed its denial without the need for court intervention.
What Happens If the Insured Dies While Committing a Felony?
If a person dies while actively engaged in the commission of a felony, insurers often argue that they are not obligated to pay the death benefit. This is based on the principle that insurance coverage should not reward criminal behavior. However, the burden is on the insurance company to prove that a felony was committed and that the death was a direct result of the criminal activity.
This determination is not always straightforward. Some cases involve disputed facts or unclear legal definitions, and the conduct of the insured may fall into a gray area.
Example: A man was killed during an altercation at a party. The insurer denied the claim, alleging that the insured instigated a felony assault. However, witness statements revealed that he was defending himself. With this evidence, our attorneys successfully overturned the denial, and the family received the full benefit.
What to Do If a Life Insurance Claim Is Denied Due to a Felony Exclusion
If you have received a denial letter that cites a felony exclusion, it is important to act quickly and understand your rights. Not all denials are valid, and many can be challenged successfully with proper legal support.
Step One: Review the Denial Letter Carefully
Obtain and review the insurer’s written explanation for the denial. Identify the exact felony the insurer claims was involved and the reasoning behind the rejection. This letter is essential for preparing an appeal or legal challenge.
Step Two: Investigate the Circumstances of the Death
Gather as much documentation as possible related to the incident. This may include police reports, witness statements, autopsy results, and criminal records. These materials can help clarify whether the insured’s actions legally qualify as a felony and whether the death was connected to the alleged crime.
Example: A client came to us after her husband’s claim was denied due to an alleged drug offense. The insurer claimed he died while transporting illegal substances. Our investigation revealed that he was unaware of the drugs hidden in his vehicle by a third party. With evidence to support his lack of intent or knowledge, we persuaded the insurer to pay the full claim.
Step Three: Speak with a Life Insurance Attorney
Felony-related exclusions are among the most complex and contested reasons for claim denial. An experienced life insurance lawyer can review the facts, examine the policy language, and evaluate whether the insurer is applying the exclusion fairly and within the bounds of the law. If you need legal help for life insurance disputes in Oklahoma call us.
Attorneys can help by:
Challenging the classification of the event as a felony
Arguing that the death was unrelated to any criminal activity
Asserting that the exclusion is overly vague or unenforceable
Negotiating a settlement or pursuing litigation if necessary