Alcohol Exclusion Life Insurance Claim Denial
Did you know that if alcohol is present in your system and you are injured or die, your insurance company can deny your claims?
In 2008, 29 states accepted the Alcohol Exclusion Law. Alcohol exclusion laws grant insurance providers the right to deny claims if any amount of alcohol is found in the policyholder’s system. These alcohol exclusion laws vary from provider to provider and between states, but every provider will have some stipulations regarding the use of alcohol.
These laws were meant to deter individuals from partaking in risky behavior while under the influence of alcohol such as driving or operating machinery. However, the law instead deterred individuals from seeking medical treatment when injury did occur. For this reason, many states have dropped the Alcohol Exclusion Law, but some alcohol exclusion will persist in insurance law.
To understand what sort of alcohol exclusion laws apply to you, it is important to read through the details of your insurance policy as well as specific laws of your state.
Alcohol exclusion denied insurance claims
Some sort of alcohol exclusion is sure to remain regardless of your state or insurance provider. Whenever any amount of alcohol or drugs show up in a person’s system, an insurance provider will be extremely cautious concerning their claims. If they don’t deny the claims outright, they will surely need to know very intricate details about the situation before accepting a claim and paying out thousands of dollars.
Some of the most common reasons for a denied insurance claim due to alcohol include: alcohol addiction, self-harm or attempted suicide due to alcohol, and simple presence of alcohol during an injury or death.
If you have an alcohol addiction or dependency when you applied for your insurance policy but did not reveal it to the provider, your claim is likely to be denied. Alcohol addiction can lead to serious damage to important bodily organs such as the liver. An insurance provider needs to know about these risks before providing coverage. They likely won’t deny you coverage, but they almost certainly raise your rates.
Additionally, lying about anything on an insurance policy is a guaranteed way to lose a claim. In such an event there will be little chance an appeal is won. And getting a new insurance policy in the future will prove to be a headache.
If alcohol addictions or dependencies begin after the insurance policy was signed, there will be a bit more wiggle room. Of course, it will be up to you and the beneficiaries to prove that the addiction began after the policy started which will certainly be hard to prove. But, if insurance denies your claims on these grounds, at least there is a hope for a successful appeal.
Self-inflicted harm or suicide attempt
Any self-inflicted harm is almost guaranteed to result in a denied insurance claim. Insurance providers deny these claims to avoid loopholes whereby individuals can cheat the system and obtain large sums of money by injuring themself.
Getting an insurance payout likely has nothing to do with an incident of self-harm or suicide attempt, but the outcome will still be the same. And, the presence of alcohol will not change the situation, even if the alcohol makes someone do something they otherwise would not have done. Likely, the presence of alcohol will only make any claim or appeal more difficult to win.
This typically includes things like drunk driving, or even driving while intoxicated, and other misdemeanors.
Presence of alcohol during an injury or death
Many insurance providers will deny claims where the BAC of the policyholder was above the legal limit of 0.08%. But any presence of alcohol or drugs alone during an injury or death are likely grounds for insurance companies to at least contest a claim, even if the alcohol had nothing to do with the events that transpired. It will be difficult to prove that the alcohol played no role for the claimants.
It is not hard to imagine scenarios where individuals are above or very near that legal limit and an accident occurs. Even when the accident seemingly has little to do with the presence of alcohol, it can be frustrating to see a claim denied on such grounds. A denied claim only adds more confusion to an already grim situation.
Bad faith drug exclusion cases
Some common cases of bad faith drug exclusion cases include the following:
Inaccurate BAC readings
Betrayal of data: for example, getting a BAC of 0.07% from medical examiner but assuming the BAC must have been 0.08% at the time of death
Confused timeline regarding alcohol addiction or dependency
Wrongfully attributing death as suicide
Handling an alcohol exclusion case
Whether you have been injured while under the influence of alcohol or a loved one has died while intoxicated, if your insurance claim has been denied due to alcohol exclusion, there are steps you can take.
The first thing you need to do is fully understand the details of your insurance policy and the regulations set forth by your state. An experienced life insurance lawyer can decipher the terminology and help you understand the big picture.
If you think there are grounds for a bad faith denial, the next step will be to compile all the necessary information. This means getting intimate details of the accident, collecting data on the policyholder’s BAC, reviewing similar cases, and gathering expert testimony. Again, an experienced life insurance lawyer will help you navigate these steps.
Once all the information is complete, an appeal can be made. A qualified life insurance attorney will make a major difference in the outcome of your claim.
Our life insurance lawyers have been handling denied life insurance claims and drug exclusion cases successfully for years. Give us a call today and get your life insurance questions taken care of.