Every year, millions of vacationers flock to the island state of Hawaii. Some go to spend relaxing days lying on the beach. Others seek out days of unparalleled surfing or scuba diving. And then there are the people who seek out the greatest adventures. These are the folks who climb volcanoes, swim with sharks, and dive off the islands highest cliffs into the water below.
What many of us do not think about is how our behavior while on vacation might impact other areas of our lives. For example, some life insurance companies might consider cliff diving into the ocean to be an “inherently dangerous activity” that would nullify coverage. Of course, as attorneys who specialize in the wrongful denial of life insurance claims, we watch these cases closely, whether we’re directly involved or not.
This article explorers one case where vacation activities almost served as the basis for a life insurance claim denial. It is a good example of the ludicrous claim denial justifications that life insurance companies will employ when they are trying to avoid paying out an expensive claim.
A dream vacation
The case involved a young lawyer named Kristin. Kristin had always been a bit of a daredevil. She loved snow skiing, water skiing, bungee jumping, backpacking, and rock climbing. She also loved being outdoors. Therefore, anytime she got to take a vacation from her high pressure law firm job, Kristin would head straight to Hawaii.
She was particularly excited about what would turn out to be her last trip to the islands. In part, her excitement was due to the fact that she was going with a new boyfriend, Tom, and he was willing to explore Hawaii's cliff diving scene with her. Cliff diving was something Kristin had always wanted to do, but she never had anyone who was willing to take the plunge with her, so to speak.
The couple arrived at the island of Kauai and set out for a Cliff diving adventure at a popular jump-off spot located just miles from their hotel. By the time they arrived, there were already several dozen people waiting for their turn to jump. Kristin and Tom were excited as they heard the large splashes a fellow vacationers hitting the water some 45 feet below.
In fact, both Kristin and Tom took a few successful jumps that day. After each jump, they got more excited for the next one. Unfortunately, on the fourth time that Kristin was getting ready for her dive, she slipped as she hit the edge of the cliff. Thus, rather than jumping away from the rockface, she slid straight down. This caused her to hit several rocks on the way down to the water. By the time she reached the ocean, she was unconscious from several blows to her head.
Sadly, Kristin never regained consciousness. She died in a hospital with Tom by her side.
A compound tragedy for the family
Kristen's law firm job had afforded her great benefits, among them a lucrative life insurance policy. At the time she signed up for that policy, she named her mother, Margaret, as the sole beneficiary. Therefore, about a month after Kristen passed away, Margaret put together the necessary paperwork to submit a claim for life insurance benefits. Though she hated the entire process, she knew her daughter wanted to give her mother financial security in her later years.
It never dawned on Margaret that the insurance company would refuse to pay her claim, but that's what happened. Just about one month after submitting the claim, Margaret received a claim denial letter in the mail. The reasoning behind the claim denial was as shocking as it was disturbing to Kristin’s mom.
Specifically, the letter stated that the life insurance company was refusing to pay the claim due to the fact that Kristin’s death was a “suicide.” Margaret was shocked at mention of the word suicide. No one had ever, since the day of her daughter's death, suggested that Kristen intended to kill herself. Rather, she was enjoying a day doing something she loved to do with dozens of other vacationers.
Just to make sure she wasn't missing something, Margaret went back and read the police report surrounding her daughter's death. As she thought, was no mention in the police report of the possibility of suicide. To the contrary, there were several witness statements recounting how much fun Kristen had seemed to have that day diving off the cliff. Every single one of the witnesses stated that her death was a complete accident.
Fortunately, Margaret did an Internet search and quickly found an attorney specializing in the wrongful denial of life insurance claims. During her first phone call with that attorney, he immediately recognized that the insurance company was just trying to see how much it could get away with. Life insurers count on the fact that many beneficiaries will accept a bogus claim denial and simply go away rather than press for payment of policy benefits. Every time that happens, the life insurance company reaps greater profits.
The following Monday, the attorney called one of the in-house lawyers for the life insurance company and explained the situation. Within an hour, he had also emailed to that attorney copies of the relevant police reports, along with travel brochures illustrating what a popular spot this was for tourists who wanted to cliff dive. In other words, there was plenty of evidence that Kristen intended to enjoy the sport of cliff diving, but zero evidence that she intended to commit suicide. Margaret's attorney explained that if the claim denial was not overturned, he would be filing suit on Margaret's behalf within the week.
Luckily, the insurance company’s attorney recognized that there was no way the insurer could prevail in a lawsuit. Within a matter of days, the insurer paid Margaret the full policy benefit and she was able to begin living her life again.If you have received a life insurance claim denial that seems unsound or illegitimate, please call our firm today. We're here to help.