Our firm recently recovered a $160,000 life insurance payout after Liberty Mutual denied an accidental death claim based on an alleged intoxication exclusion. The insured died after falling from a second-story deck. Rather than investigate the physical cause of the fall, the insurer relied almost entirely on a blood alcohol reading and denied the claim outright.
That decision did not hold up. After a full factual and legal challenge, Liberty Mutual reversed course and paid the benefit in full.
This case reflects a common denial strategy. When alcohol appears in a toxicology report, insurers frequently stop asking questions. They assume intoxication equals causation and issue a denial without examining whether alcohol actually played any role in the death.
How Intoxication Exclusions Are Commonly Misused
Most accidental death policies contain some form of intoxication exclusion. But those clauses are not uniform, and they are often applied incorrectly.
Some policies exclude coverage only if intoxication contributed to the accident. Others require proof of impairment. A smaller number attempt to exclude any accident occurring while alcohol is present, regardless of causation. Even then, the insurer still bears the burden of proving the exclusion applies under the specific facts.
In practice, insurers shortcut that analysis. They see a BAC number and deny the claim without examining the scene, interviewing witnesses, or analyzing alternative causes.
That is exactly what happened here.
Why the Liberty Mutual Denial Failed
In this case, the insured was leaning against a deck railing that failed. Multiple witnesses confirmed the railing gave way. Photographs taken after the incident showed rotted wood and loose fasteners. The fall occurred because the structure was unsafe, not because the insured lost balance due to alcohol.
Liberty Mutual did not inspect the deck. They did not address the physical defect. They did not reconcile witness statements with their denial. They simply pointed to the toxicology report and closed the file.
Once forced to confront the actual cause of the fall, their intoxication argument collapsed.
Presence of Alcohol Is Not Proof of Causation
This distinction is critical and frequently ignored. Alcohol can be present without causing an accident.
A person can have alcohol in their system and still be injured or killed due to:
Structural failures such as broken railings, collapsing stairs, or faulty ladders
Third-party negligence such as reckless drivers or unsafe premises
Mechanical failures involving vehicles, tools, or equipment
Environmental hazards like ice, debris, or poor lighting
In these situations, alcohol is incidental, not causal. Courts routinely reject denials that rely on presence alone without a demonstrated causal link.
Toxicology Reports Are Often Overstated
BAC results are treated as definitive when they are not. Postmortem toxicology is subject to numerous limitations that insurers rarely disclose in denial letters.
We regularly encounter issues such as:
Postmortem fermentation artificially elevating alcohol levels
Delayed sample collection increasing BAC readings
Improper storage or contamination of samples
Lack of correlation between measured BAC and functional impairment
No expert analysis tying alcohol levels to accident mechanics
In many cases, the toxicology report raises questions but does not answer them. Insurers nevertheless present it as conclusive evidence.
Similar Denials We Have Overturned
The Liberty Mutual case is not an outlier. Alcohol-based denials follow predictable patterns.
In one case, a man fell from a ladder and died. The insurer denied the claim after finding a BAC slightly above the legal driving limit. A forensic engineer later determined the ladder hinge was fractured and would have collapsed under any user. The claim was paid after appeal.
In another matter, a pedestrian was struck in a crosswalk by a speeding vehicle. The insurer cited alcohol in the pedestrian’s system to deny the claim. Traffic footage showed the driver ran a red light at excessive speed. The denial was withdrawn once causation was addressed.
We have also handled cases where insurers blamed alcohol for drownings, falls down stairs, and workplace accidents despite clear evidence of external causes.
Drug Exclusions Are Used the Same Way
The same flawed logic appears in drug-related denials. Insurers find traces of prescription medication, marijuana, or over-the-counter drugs and assert impairment without analysis.
We routinely challenge denials involving:
Prescription opioids taken as directed
Anxiety or sleep medications at therapeutic levels
Cannabis metabolites that indicate past use, not impairment
Cold or allergy medications mischaracterized as intoxicants
Again, the issue is not presence. The issue is causation.
Policy Language Is Often Ambiguous
Many intoxication exclusions are poorly drafted. Terms like intoxicated, impaired, or under the influence are left undefined. Some policies reference legal standards designed for driving offenses and attempt to apply them to unrelated accidents.
When language is ambiguous, courts generally interpret it in favor of coverage. Insurers know this. That is why they rely on beneficiaries not pushing back.
Why Insurers Expect Families to Walk Away
Alcohol-related denials are designed to discourage challenges. Insurers assume beneficiaries will see the toxicology report and conclude the case is unwinnable. They rely on grief, uncertainty, and lack of legal guidance to avoid paying legitimate claims.
Once the denial is challenged with evidence, expert review, and policy analysis, the confidence behind it often disappears.
The Bottom Line
Intoxication exclusions are one of the most aggressively misused tools in accidental death claim denials. Insurers frequently substitute assumption for analysis and presence for causation.
The $160,000 Liberty Mutual recovery shows that these denials are often reversible when the facts are properly examined.
If an accidental death claim has been denied based on alcohol or alleged drug use, the denial may be far weaker than it appears. A careful review of the policy language, toxicology evidence, and accident mechanics can make the difference between a closed file and a full payout.