Many people are surprised to learn that not every life insurance company will refuse to pay a claim if the policyholder died from suicide. In truth, the decision whether or not to pay is based strictly on the policy language, and most policies only impose a suicide exclusion for the first two to three years that the policy is effective.
Nonetheless, life insurance companies frequently rely on those short-term suicide exclusions as a justification for denying claims. In fact, almost any time a person dies within the first few years of a policy and their death resulted from anything other than a diagnosed terminal illness, the insurance company will deem the death a suicide in order to avoid payment. Sadly, they often do this even when there is no indication of suicide and police reports surrounding the incident conclude a different cause of death entirely. All it does is force an already grieving beneficiary to walk away from the money they’re owed or face a fight with a large insurer.
As attorneys who specialize in the wrongful denial of life insurance claims, we wish that each and every one of those people knew that lawyers like us exist to protect them. We have seen life insurance companies wrongfully invoke the suicide exclusion more times than we can count. We have not only made it our mission to help overturn those wrongful denials, but we have the tools and experience to do so in an expeditious manner.
This article discuss is one case that serves as a good example of the way life insurers wrongfully rely on suicide exclusions and how those wrongful denials can be overturned by the right lawyer.
A death nobody saw coming
This case involved a woman named Samantha. At the time of her death, Samantha was just 37 years old. She worked as a professor at the local college and was well liked by students and faculty alike. Although her job was never going to make her rich, it did provide good benefits. One of those benefits was a life insurance policy worth $500,000. Upon receiving the policy, Samantha named her husband Max as the sole beneficiary.
Anyone who knew Samantha personally knew that there were a few things she truly coveted – a fine glass of wine, a good book, and a long, hot, bath after the end of a busy week. In fact, Samantha’s friends were so aware of her end-of-the-week bath ritual, that they all knew better than to ever invite her out on a Friday evening.
Just under two years after receiving her life insurance policy through the University, Samantha was engaging in her Friday night ritual. She had splurged on an expensive bottle of her favorite French wine, she had a copy of the latest novel from her favorite author, a bevy of luxurious bath products, and she was ready to hide away for hours simply relaxing.
Unfortunately, it was probably a bad idea for Samantha to bring the full bottle of wine into the bathtub with her. She ended up drinking the entire bottle while reading the book and soaking in a tub that she continually refreshed with piping hot water. Her husband would later report that he heard her re-filling the tub in that manner for at least a couple of hours before everything went silent.
It was at that point that he went up to investigate and make sure Samantha was alright. Sadly, she was not. At some point, she had either fallen asleep or passed out from the alcohol and drown in her own tub. By the time paramedics arrived, she was dead at the scene and could not be revived.
The insurer decides without evidence the death was a suicide
Max was of course grief stricken. Nonetheless, a few weeks after Samantha died he gathered all of the necessary paperwork to file a claim for life insurance benefits. Given the accidental nature of Samantha's death, he never thought for one second that the claim would be denied.
Unfortunately, that's exactly what happened. When Max read the claim denial letter from the life insurance company, he was beside himself. The insurer claimed that because Samantha died in the bathtub, her death was “obviously” a suicide. Because her policy contained a three year suicide exclusion, the company claimed it had no choice but to deny payment.
This was a shock to Max as no one had ever even hinted at the idea that Samantha's death was a suicide. The police and coroner both reported that her death was due to an accidental drowning. Max had no idea what to do about this injustice. Luckily, a good friend of his knew a lawyer specializing in the wrongful denial of life insurance claim and connected the two men by telephone.
The lawyer listened to Max’s story and reviewed all of the official reports concerning Samantha's death. He could immediately see the claim denial for what it was -- a veiled attempt by the insurance company to simply avoid paying money it owed to Max.
The lawyer told Max he would so some research, put together relevant evidence, and submit an appeal to the insurer’s internal appeals board. The appeal included: (a) statistics revealing that one American dies every single day in an accidental bathtub drowning; (b) Samantha had no history of depression or suicidal ideation; (c) she had multiple trips planned in the near future, suggesting a will to live and enjoy life; and (d) a letter she had written to her friend days before her death talking about how happy she was.
Faced with this evidence, the insurer overturned the claim denial – suggesting that it had only issued the denial to see if Max would give up and walk away. Luckily, he did not. Max received the full policy benefit within a week of the appeal hearing.If you have received a claim denial based on a suicide exclusion or any other reason that you believe is unjust, please call our office today. We deal with these issues every day and we're here to help.