When Life Insurance Denials Add to the Grief: A Wrongful Claim Rejection After a Fatal Crash
Losing a loved one is painful enough, but when a life insurance company wrongfully denies a claim, the emotional toll intensifies. One tragic example involved Bill, a 52-year-old cancer survivor who died in a horrific car accident. His family filed a claim under his MetLife accidental death and dismemberment (AD&D) policy, expecting to receive the $250,000 benefit. Instead, they were met with a shocking denial. Despite the crash being officially ruled an accident, MetLife refused to pay, claiming that Bill’s death was the result of an "intentionally self-inflicted injury."
MetLife’s Baseless Allegation of Suicide
Bill’s wife was blindsided. After enduring the loss of her husband, she was now facing an insurance company that not only withheld the financial benefit she desperately needed but also implied that her husband had taken his own life. This was not only an emotional blow—it was a complete contradiction of the facts. Bill had survived cancer, was actively planning for his family’s future, and left no indication of suicidal intent. The police and coroner officially ruled his death accidental, yet MetLife relied on its internal assessment to override those findings. This denial wasn't just about money; it was about protecting her husband's reputation and legacy.
The Hidden Challenges of Fighting Life Insurance Denials
Most people assume that if a claim is denied, it must be justified. But life insurance companies often rely on broad policy exclusions and vague terms to avoid paying valid claims. This is especially true when AD&D coverage is involved, as insurers may attempt to reclassify accidents as intentional or linked to preexisting conditions. In Bill’s case, the AD&D exclusion for "self-inflicted injuries" was misapplied. Even worse, the policy was governed by ERISA—the Employee Retirement Income Security Act—which creates additional hurdles for claimants. Under ERISA, the standard of review favors insurance companies. Beneficiaries can’t seek punitive damages or a jury trial, and insurers only need to show that their decision was reasonable based on limited evidence. This imbalance often leaves grieving families fighting an uphill battle against powerful insurers.
How Common Are Disputed Life Insurance Claims?
Life insurance disputes are not rare. In fact, data from the Insurance Information Institute shows that about 34% of claims face some form of delay, dispute, or denial. While insurers paid out more than $68 billion in death benefits last year, countless claims were delayed for months—or denied outright—for technical reasons. These denials frequently involve:
Disputed cause of death (e.g., suicide vs. accident)
AD&D exclusions for sickness or self-harm
Alleged misrepresentations on the policy application
Policy lapse due to missed premiums
ERISA-governed limitations on beneficiary rights
For beneficiaries unfamiliar with the claims process, these denials can feel final. But with the right legal help, they often aren’t.
FAQ: Life Insurance Denials After Accidental Death
Can a life insurance company deny a claim after an accidental death?
Yes, but only under specific exclusions such as suicide, intoxication, or policy lapse. If the death is ruled accidental and none of these apply, a denial may be improper.
What does MetLife consider a self-inflicted injury?
In AD&D policies, this typically refers to intentional harm or suicide. However, insurers sometimes misclassify accidents as self-inflicted to avoid payment.
Does an official ruling of accident override the insurer’s opinion?
In many cases, yes. If police or a coroner determine the death was accidental, insurers must provide strong evidence to dispute that. Courts often defer to official findings.
What if the policy is governed by ERISA?
If the life insurance was provided through an employer, ERISA limits your legal rights. You can’t request punitive damages or a jury trial, and the insurer's decision only needs to be "reasonable"—not necessarily correct.
How can a lawyer help with an ERISA denial?
An attorney can build a strong administrative appeal, introduce supporting medical and legal evidence, and challenge the insurer’s findings under ERISA standards.
Why are AD&D claims more frequently denied?
Accidental death policies often contain more exclusions than traditional life insurance, giving insurers more room to deny benefits based on technical grounds.
Can I still win if the insurer says the death was intentional?
Yes. With proper evidence—such as autopsy reports, mental health records, and witness statements—you can challenge and overturn the denial.
How long does it take to fight a denied claim?
Timelines vary. Some appeals resolve within weeks; others may take several months, especially if litigation is involved. Our attorneys work to resolve cases as quickly as possible.
Is a free consultation really free?
Yes. We offer free, no-obligation consultations. If we take your case, you don’t pay unless we win.
What should I do if my claim is denied for “self-inflicted injury”?
Do not accept the denial as final. Contact an experienced life insurance attorney to review the policy, the evidence, and the validity of the insurer’s determination.