A life insurance claim should not rise or fall based on a diagnosis that had nothing to do with how someone died. Yet insurers sometimes deny claims by pointing to sexually transmitted diseases discovered after death and labeling them as proof of dishonesty on the application. These denials often rely on speculation rather than evidence, and they are frequently issued during the contestability period in hopes that beneficiaries will not challenge them.
This type of denial is not about disease risk. It is about stretching the concept of material misrepresentation far beyond its legal limits.
How Insurers Justify STD Based Denials
When a policyholder dies within the first two years after a policy is issued, the insurer is allowed to review the application and medical records. This is known as the contestability period. During that window, insurers often search aggressively for anything they can characterize as an error or omission.
In STD related denials, the argument usually follows the same pattern.
The insurer claims that the insured must have engaged in behavior inconsistent with their application answers. From there, the company jumps to the conclusion that the policy was issued based on false information and should be voided retroactively.
What is missing from this logic is proof.
A diagnosis alone does not establish knowledge, intent, or deception.
The Case That Exposed the Flaw
Sarah contacted our office after her husband Michael died in a car accident. He was thirty two, healthy, and recently insured through a group life policy at work. The application included a long health questionnaire with questions that were intrusive and poorly defined.
One of those questions asked whether the applicant had ever engaged in unprotected sex.
Michael answered no.
Six months later, he was killed instantly in a traffic collision. There was no dispute about the cause of death. It was accidental and unrelated to any medical condition.
During the insurer’s review, an autopsy report noted the presence of chlamydia. Based on that single finding, the insurer denied the claim. The denial letter asserted that Michael must have lied on the application and that the policy was therefore void.
No medical evidence was cited to show Michael knew he had the condition. No underwriting guideline was produced showing that the presence of chlamydia would have changed the insurer’s decision. The company relied entirely on inference.
Why This Reasoning Fails Legally
There are several problems with this type of denial.
First, many sexually transmitted infections are asymptomatic. A person can carry an infection without any symptoms and without any reason to believe they are infected. Knowledge matters in misrepresentation cases. Without proof that the insured knew about the condition, there is no intentional false statement.
Second, the application question itself was vague. It did not specify a time frame. It did not define what the insurer meant by unprotected. It did not explain how the answer would be used in underwriting. Courts routinely reject denials based on ambiguous questions.
Third, the insurer could not show materiality. Even if Michael had known about the infection, the insurer failed to demonstrate that this information would have changed the issuance or pricing of the policy. An STD that played no role in the cause of death is not automatically material.
How the Denial Was Overturned
We gathered medical literature showing that chlamydia can exist without symptoms and without awareness. We obtained expert opinions explaining that diagnosis after death does not establish prior knowledge. We also highlighted the lack of any underwriting guideline tying this condition to mortality risk in the context of accidental death.
The appeal focused on four points.
Michael did not know he had the condition
The application question was vague and undefined
The condition had no connection to the cause of death
The insurer failed to prove that underwriting would have changed
The arbitrator agreed. The insurer could not meet its burden of proof. The denial was reversed, and Sarah received the full policy benefit with interest.
Why Insurers Keep Trying This Approach
STD based denials are attractive to insurers for one reason. They are embarrassing.
Many beneficiaries feel uncomfortable challenging a denial that involves intimate medical information. Insurers count on that discomfort. They also rely on the mistaken belief that any inaccuracy on an application automatically voids coverage.
That belief is wrong.
Insurers must prove knowledge, intent, and material impact. Without all three, the denial fails.
What Beneficiaries Should Do After This Type of Denial
If a claim is denied based on an STD or sexual history allegation, beneficiaries should immediately request:
• The complete application
• The underwriting guidelines in effect at issuance
• The medical records relied upon
• A written explanation of how the condition affected risk
These cases are highly fact specific. Many are reversed once the insurer is forced to justify its assumptions.
The Bigger Lesson
This case illustrates a broader problem in life insurance claims handling. Insurers often treat the contestability period as a license to speculate. They search for any post death medical finding and attempt to reverse underwriting decisions after the fact.
That is not how the law works.
A policy cannot be voided based on conjecture, embarrassment, or hindsight.
If your life insurance claim was denied because of an alleged misrepresentation tied to an STD or personal medical issue that had nothing to do with the death, the denial deserves scrutiny. These cases are frequently winnable with the right legal pressure.
We review these denials every day. If the insurer overreached, we know how to expose it.