Many people have no idea that their life insurance policy may contain an alcohol exclusion.
These clauses are usually buried deep in the policy and never explained when the policy is sold. They are often written in vague language such as “no benefits will be paid if the insured dies while intoxicated or under the influence of alcohol.”
That wording sounds simple.
In reality, it is one of the most abused tools insurance companies use to deny valid claims.
The Problem With “Under the Influence” Language
What does “under the influence” actually mean?
Does it mean legally intoxicated
Does it mean any measurable alcohol at all
Does it mean alcohol caused the death
Or does it mean alcohol was simply present
Insurance companies often treat these phrases as if they mean whatever is most convenient for denying the claim.
Many policies and many state laws do not allow that.
In a large number of situations, the insurer must prove that alcohol actually caused or contributed to the death. Mere presence is not enough.
Real Cases Where Insurers Abused Alcohol Exclusions
We routinely see insurers deny claims based on nothing more than a toxicology report.
For example:
In one case, a man died after falling at a cabin in Maine. Toxicology showed he had two drinks earlier in the evening. He was well below the legal limit. The death was ruled accidental. There was no evidence alcohol caused the fall.
The insurer denied the claim anyway.
After legal action, the company was forced to pay the full benefit.
In another case, a man in Georgia drowned while fishing. The autopsy showed trace amounts of alcohol in his system. There was no evidence he was impaired and no evidence alcohol caused the drowning.
The insurer denied the claim anyway.
They only changed their position after lawyers got involved.
The Legal Rule in Most Cases: Causation Matters
In many states and under many policies, the insurer must show more than alcohol being present.
They must show:
The insured was actually impaired
And that the impairment caused or contributed to the death
A number on a lab report does not automatically prove either of those things.
Post death alcohol levels can be misleading. Levels can change after death. Timing matters. Medical conditions matter. Circumstances matter.
Insurance companies often ignore all of that and deny the claim anyway.
Why These Denials Are So Common
Alcohol exclusions are attractive to insurers because:
Alcohol carries stigma
Families are uncomfortable fighting these cases
The denial sounds “reasonable” on the surface
Many people assume the company must be right
So insurers deny first and wait to see if anyone challenges them.
Many families never do.
The State Law Factor and Why Charts Matter
Some states strictly limit how alcohol exclusions can be used. Some require proof of causation. Some restrict these clauses heavily. Some have consumer protection laws that make these denials much harder to defend.
Other states are more insurer friendly.
That is why these cases are very state specific and very policy specific.
You cannot assume the insurance company is applying the law correctly.
How We Attack Alcohol Exclusion Denials
These cases are won by focusing on:
The exact wording of the policy
The exact wording of the state law
The actual cause of death
The timing and reliability of toxicology results
And the insurer’s investigation or lack of one
We often find that:
The policy does not actually say what the insurer claims
The state law requires proof of causation that the insurer does not have
The medical evidence does not support the denial
Or the insurer is relying on assumptions instead of facts
What You Should Do If Your Claim Was Denied for Alcohol
If your denial letter mentions:
Alcohol
Intoxication
Being “under the influence”
Or a blood alcohol level
You should:
Get a complete copy of the policy
Get a copy of the denial letter and claim file
Get the autopsy and toxicology reports
And talk to a lawyer who handles life insurance denials
Do not assume the insurer is right.
Alcohol Exclusions Are One of the Most Abused Denial Tactics
We see these denials all over the country. Many of them collapse the moment the insurer is forced to actually prove causation in front of a lawyer or a judge.
Do Not Let Them Use a Lab Result to Take Your Benefits
Our firm focuses exclusively on denied life insurance claims, including cases involving alcohol exclusions and high BAC arguments.
We know how often these denials are based on weak evidence, vague language, and incorrect legal assumptions.
We offer free consultations and handle these cases on a contingency basis. You do not pay anything unless we recover money for you.
If your life insurance claim was denied because of alcohol or alleged intoxication, contact us. There is a very real chance the insurance company is wrong.