One of our clients lost her husband in a snowmobile accident in upstate New York. The autopsy reported a BAC of 0.06. The insurer didn’t care about the icy trail or the fact that the machine malfunctioned. They pointed to a single phrase in the policy—“death resulting from the insured being under the influence of alcohol”—and denied the claim.
What they ignored: he’d been wearing a helmet, riding within legal speed limits, and the trail had recently been cited for safety hazards. He wasn’t impaired. He wasn’t reckless. But the insurer’s blanket use of an alcohol clause allowed them to keep $500,000 his wife and children were counting on.
We uncovered emails between the insurer’s adjusters and legal team that showed they had serious doubts about the denial—but issued it anyway, assuming the widow wouldn’t fight back. They were wrong. If you need an Illinois life insurance attorney call today.
What You’re Not Told About “Alcohol Exclusions”
Insurers don’t need to prove the policyholder was legally drunk. They just need to claim alcohol played any role—no matter how minor—and shift the burden to the family. These exclusions are vaguely worded, often say things like “any amount of alcohol” or “contributed to,” and are rarely explained when the policy is purchased.
Worse, most people have no idea what’s actually in their loved one’s policy until they’re already grieving—and blindsided by a denial letter.
Why These Denials Are Legally Weak
In most states, courts require insurers to show that alcohol was a direct and substantial cause of death—not just present. Yet insurers count on confusion, fear, and silence. They use the toxicology report as a shield, hoping families don’t dig deeper. But context matters.
Did the insured eat before drinking? Were there environmental risks unrelated to alcohol? Was the blood alcohol level even impairing? These questions matter—and often go unasked unless an attorney forces them to the surface.
How We Turn the Tables
We don’t send demand letters and hope for the best. We go straight to the inconsistencies, policy language flaws, and causation gaps insurers hope stay buried. We subpoena internal documents, hire forensic pathologists, and reconstruct the actual cause of death.
And we’ve seen behind the curtain. We’ve reviewed insurer training manuals that instruct adjusters to flag any mention of alcohol as grounds for deeper denial review. We’ve deposed corporate reps who admitted under oath that exclusions are enforced even when causation is “unclear.”
This isn’t risk assessment. It’s exploitation.
What to Do If You’ve Received an Alcohol-Based Denial
Don’t accept the explanation at face value. These letters are designed to intimidate.
Request everything in writing. You’re entitled to the policy, the toxicology, and any investigative reports the insurer relied on.
Document the full story. Where was your loved one? What happened? Who was there? What outside factors played a role?
Talk to a lawyer who actually litigates these claims. Not just any attorney—one who’s overturned alcohol-based denials before.
Because when you push back, insurers know they’re vulnerable. The law doesn’t give them the right to deny a payout based on vague, biased interpretations. But unless someone forces the issue, they’ll get away with it.