Life insurance companies sometimes deny claims by invoking a felony exclusion, arguing that the insured’s death occurred during the commission of a felony. These denials can be devastating for beneficiaries, especially when the insurer applies the exclusion broadly or incorrectly. While felony exclusions do exist, they are far more limited than insurance companies often suggest, and many denials based on these clauses can be successfully challenged.
Understanding how felony exclusions actually work is critical to determining whether a denial is valid or unlawful.
What Is a Felony Exclusion in a Life Insurance Policy?
A felony exclusion is a policy provision that allows the insurer to deny benefits if the insured dies while committing or attempting to commit a felony. These clauses are not triggered simply because the insured had a criminal record. In most policies, the exclusion applies only when there is a direct connection between the felony conduct and the death.
This distinction matters. Insurers frequently attempt to deny claims by pointing to alleged criminal behavior without proving that the death resulted from the felony itself.
When a Felony Exclusion May Apply
A felony exclusion may apply if the insurer can establish all of the following:
The insured was actively committing or attempting to commit a felony at the time of death
The conduct qualifies as a felony under applicable law
The felony conduct directly caused or substantially contributed to the death
If any one of these elements is missing, the exclusion may not apply.
Insurers most commonly attempt to invoke felony exclusions in deaths involving allegations of violent crimes, serious theft offenses, or drug related conduct. Even in those cases, the burden is on the insurer to prove the exclusion applies.
Common Situations Where Insurers Assert Felony Exclusions
Life insurance companies most often raise felony exclusions in cases involving:
Alleged participation in violent crimes such as armed robbery or assault
Deaths occurring during police encounters or pursuits
Deaths involving alleged drug manufacturing or trafficking
Fatal incidents tied to arson or burglary accusations
Importantly, an arrest or allegation is not the same as proof. A conviction is not always required, but insurers must still show that felony conduct occurred and that it caused the death. Many denials fail on this point.
What Does Not Trigger a Felony Exclusion
Felony exclusions do not apply simply because the insured:
Had a prior felony conviction unrelated to the death
Was charged but never convicted
Engaged in conduct classified as a misdemeanor
Died in an incident unrelated to any alleged criminal act
Insurers often blur these distinctions, hoping beneficiaries will accept the denial without challenge.
Prior Felony Convictions and Policy Issuance
One of the most common wrongful denials occurs when an insurer attempts to rely on a prior felony conviction that existed before the policy was issued. If the insurer knew about the conviction, or should have known through underwriting, and still issued the policy, it may have waived its right to rely on that history to deny a claim later.
Life insurance companies cannot retroactively void coverage based on facts they accepted at the time of issuance. Courts routinely reject attempts to do so.
Challenging a Felony Exclusion Denial
Felony exclusion denials are highly fact specific and often vulnerable to legal challenge. Key questions include:
Was the insured actually committing a felony at the time of death
Did the alleged conduct legally qualify as a felony
Was there a causal connection between the conduct and the death
Did the insurer rely on assumptions rather than evidence
Did the insurer waive the exclusion by issuing the policy with knowledge of prior convictions
Medical records, police reports, autopsy findings, and criminal case outcomes often undermine the insurer’s position when carefully reviewed.
Why These Denials Are Frequently Overturned
Insurance companies often apply felony exclusions aggressively because they know beneficiaries are under pressure and unfamiliar with the law. However, courts generally interpret exclusions narrowly and resolve ambiguities in favor of coverage.
Many felony based denials fail because the insurer cannot prove causation, misclassifies the alleged offense, or relies on conduct unrelated to the death.
What to Do If Your Claim Was Denied for a Felony Exclusion
If a life insurance claim was denied based on a felony exclusion, do not assume the denial is correct. Request the full policy, the complete claim file, and the specific evidence the insurer relied on. These denials often collapse once the facts are examined closely.
An experienced life insurance attorney can identify whether the exclusion was misapplied and take steps to recover the full death benefit.
Bottom Line
Felony exclusions do not give insurers unlimited authority to deny claims. They apply only in narrow circumstances and require clear proof. When insurers stretch these clauses beyond their limits, beneficiaries often have strong grounds to fight back and win.