When Self-Defense Is Misused to Avoid Paying Benefits
Life insurance companies often deny claims by citing exclusions that sound straightforward but are applied in deeply unfair ways. One of the most abused is the felony exclusion. Insurers frequently claim that if a policyholder died while committing a felony, no benefits are owed. What they do not explain is how loosely they define both “felony” and “committing.”
In practice, insurers sometimes label conduct as criminal even when no charges were filed, no arrest was made, and no conviction ever occurred. In some cases, they rely on nothing more than a police report summary or an initial allegation. This article focuses on one specific and recurring problem: life insurance denials based on alleged felonies where the insured acted in self-defense.
How the Felony Exclusion Is Supposed to Work
Felony exclusions are intended to prevent payouts when a policyholder dies while actively committing a serious crime. The classic example is death during an armed robbery or violent felony where criminal conduct directly caused the death.
What insurers often ignore is that exclusions must be applied narrowly. Most policies require that the insured was actually committing a felony, not merely involved in an incident that could be characterized that way after the fact. Many policies also require a causal connection between the alleged felony and the death.
Self-defense is not a felony. Conduct that would be legally justified is not criminal. And uncharged conduct is not the same as criminal activity.
The Problem With Post-Death Criminal Labeling
When the insured is deceased, they cannot explain what happened. Insurers sometimes take advantage of this by imposing their own narrative on ambiguous events. They treat police involvement as proof of criminal conduct, even when law enforcement made no such finding.
This is especially common in fights, altercations, and confrontations where the insured reacted to a threat.
Brian’s Case: A Denial Built on Self-Defense
Brian was a shipyard welder who had maintained life insurance coverage through his union job for years. His wife Sue was the named beneficiary. There were no issues with premiums, disclosures, or coverage status.
One evening, Brian and Sue attended a baseball game. After the game, a confrontation occurred outside the stadium when an intoxicated individual shoved Brian from behind. The situation escalated quickly. Brian was punched and instinctively struck back once in response. The other individual fell, struck his head, and suffered a concussion.
Moments later, several people attacked Brian. He sustained severe head injuries and died shortly thereafter.
Police reports were clear on several points:
• Brian did not initiate the confrontation
• Brian was physically threatened first
• Brian acted defensively
• No criminal charges were filed
Despite this, the insurance company denied Sue’s claim.
How the Insurer Justified the Denial
The insurer asserted that Brian committed felony assault by striking another person and that his death occurred during the commission of that felony. Based on this assertion, the company invoked the felony exclusion and refused to pay the death benefit.
The denial letter did not cite a statute. It did not reference any criminal charge. It relied entirely on the insurer’s own interpretation of the event.
Why the Denial Was Legally Wrong
Self-defense is a complete defense to assault. Conduct that is legally justified cannot simultaneously be criminal. Courts consistently reject insurance denials that rely on hypothetical crimes or uncharged conduct.
Equally important, Brian did not die while committing any alleged act. He died days later from injuries inflicted by others. The supposed felony had no causal connection to his death.
The insurer attempted to stretch the exclusion beyond recognition.
What Changed the Outcome
Sue retained a life insurance attorney experienced in felony exclusion denials. The attorney demanded the insurer’s claim file and focused on three critical points:
• No felony charge existed
• Self-defense cannot constitute criminal activity
• The alleged conduct did not cause Brian’s death
Faced with the legal reality and the risk of litigation, the insurer reversed its decision and paid the full policy benefit.
Why Insurers Use This Tactic
Felony exclusions give insurers leverage in emotionally charged situations. Fights, accidents, and chaotic events create ambiguity. Insurers exploit that ambiguity, hoping beneficiaries will accept the denial or feel powerless to challenge it.
They often assume beneficiaries do not understand criminal law standards or the burden of proof required to apply an exclusion.
What To Do If a Claim Is Denied Based on Alleged Criminal Conduct
If an insurer claims your loved one died while committing a felony, ask the following questions immediately:
• Was the insured ever charged or convicted
• Does the policy require an actual felony or just alleged conduct
• Was the conduct legally justified
• Did the alleged conduct actually cause the death
Do not assume the insurer’s characterization is correct.
Final Thought
Felony exclusions are not blank checks for insurers to deny claims. They must be applied carefully, lawfully, and based on real criminal conduct. Self-defense is not a crime. Uncharged conduct is not a felony. And insurers do not get to invent criminal liability after someone has died.
If your life insurance claim was denied based on an alleged felony and the explanation feels wrong, that instinct is often correct. We focus exclusively on life insurance claim denials and regularly overturn exclusions that were never meant to apply.
Consultations are free. No fee unless we recover benefits.