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Recreational Marijuana life insurance claim denials

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Life insurance claims are sometimes delayed or denied after insurers discover evidence of marijuana use in the insured’s medical records or toxicology reports. These denials often occur even when marijuana use had no connection to the cause of death.

Recreational marijuana use presents unique issues in life insurance claims because legality, disclosure requirements, and medical relevance vary widely by policy and circumstance.

How Insurers Identify Marijuana Use

Insurers typically learn about marijuana use through:

  • Medical records reviewed after death

  • Toxicology results from an autopsy

  • Physician notes referencing occasional use

  • Prescription history or patient disclosures

In many cases, the information relied upon by the insurer was never relevant to underwriting at the time the policy was issued.

Marijuana Use Versus Material Risk

Recreational marijuana use is not automatically a material risk in life insurance underwriting. Many insurers issue policies to applicants who disclose occasional marijuana use, sometimes with no premium increase at all.

Problems arise when insurers attempt to retroactively treat marijuana use as a material factor after death, even when:

  • The policy was issued with full disclosure

  • The use was occasional or remote in time

  • The cause of death was unrelated

  • The insured was elderly or had other dominant health risks

Denials Based on Alleged Misrepresentation

Some marijuana related denials are framed as application misrepresentation cases. Insurers may claim the insured failed to disclose marijuana use or understated frequency.

These denials often fail when:

  • The application question was vague

  • The insured answered honestly based on their understanding

  • Marijuana use was not medically significant

  • The insurer cannot show underwriting reliance

An omission does not void a policy unless it was material and relied upon.

Toxicology Results and Cause of Death

In other cases, insurers rely on toxicology findings showing THC metabolites at the time of death. This is especially common in accidental death or AD&D claims.

THC metabolites can remain in the body long after impairment has passed. Their presence alone does not establish intoxication or causation.

Courts frequently distinguish between:

  • Presence of metabolites

  • Actual impairment at the time of death

  • A causal link between marijuana use and the fatal event

Without proof of causation, many denials are unsustainable.

Marijuana Use in Elderly or Cardiac Death Cases

In deaths involving heart attacks, strokes, or other medical events, insurers sometimes attempt to attribute the death to marijuana use based on generalized risk arguments.

These claims are often speculative. Insurers must show that marijuana use directly contributed to the fatal event, not merely that it existed in the insured’s history.

Age, underlying cardiac disease, and other medical factors frequently outweigh any alleged role of marijuana.

Group Life and Employer Sponsored Policies

Group life insurance claims may involve different disclosure rules. Employees often do not complete full medical underwriting, and insurers cannot later impose individual disclosure standards retroactively.

Denials based on marijuana use are especially problematic in group policies where:

  • No medical questionnaire was completed

  • Coverage was guaranteed issue

  • The employer handled enrollment

When Marijuana Based Denials Are Challenged Successfully

Beneficiaries frequently prevail when:

  • Marijuana use was legal where the insured lived

  • The policy did not clearly exclude marijuana

  • There is no evidence of impairment

  • The cause of death was medical, not accidental

  • The insurer relies on assumptions rather than proof

Courts generally require a clear connection between substance use and the reason for denial.

What to Do If a Claim Is Denied Based on Marijuana Use

If a life insurance or AD&D claim is denied due to alleged marijuana use:

  1. Obtain the full policy and underwriting file

  2. Review the application questions and answers

  3. Examine toxicology timing and methodology

  4. Analyze whether causation is required

  5. Identify whether the policy distinguishes legal and illegal substances

These cases are fact specific and often hinge on medical and underwriting evidence rather than moral judgments.

How This Issue Fits Into Life Insurance Claim Denials

Recreational marijuana denials fall into a broader category of life insurance claim disputes involving substance use, underwriting interpretation, and causation. Insurers frequently overstate the significance of marijuana in post claim reviews.

For a broader explanation of how denied claims are evaluated and challenged, see your Denied Life Insurance Claims page.

Do You Need a Life Insurance Lawyer?

Please contact us for a free legal review of your claim. Every submission is confidential and reviewed by an experienced life insurance attorney, not a call center or case manager. There is no fee unless we win.

We handle denied and delayed claims, beneficiary disputes, ERISA denials, interpleader lawsuits, and policy lapse cases.

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