$160,000 Denied Life Insurance Claim Successfully Resolved
We are happy to announce that our life insurance law firm has resolved a $160,000 denied life insurance claim for our client. The denial stemmed from an alleged alcohol-related exclusion in the accidental death policy. Our legal team conducted a thorough investigation into the cause of death, challenged the insurer’s reliance on toxicology evidence, and ultimately secured the full payout. Cases involving high blood alcohol content (BAC) and illegal drug allegations are increasingly common and often used by insurers to avoid paying accidental death benefits. Fortunately, these denials can be fought—and overturned—with the right legal strategy.
Fighting a Denied Accidental Death Claim Due to High Blood Alcohol Content
Accidental death claims are frequently denied when insurers argue that the insured was intoxicated at the time of death. Many policies contain exclusions that void coverage if the death occurred while the insured was under the influence of alcohol above a certain threshold. However, these exclusions are often subject to interpretation and must be applied in good faith and with clear evidence. There are several ways to fight back if your claim was denied based on high BAC:
Review the Policy Language
First, determine whether the policy includes an intoxication exclusion and how it is defined. Some policies exclude coverage only when alcohol “contributed to” the death, while others may exclude any death that occurs while intoxicated—regardless of causation.Challenge the Causation Argument
Even if the BAC was elevated, the key question is whether the alcohol caused or materially contributed to the death. If the death was due to external trauma or another person’s actions (such as a car crash caused by another driver), the exclusion may not apply.Examine the Toxicology Report
Toxicology results are not always accurate. The timing of the test, the method used, or chain-of-custody issues can affect the reliability of the results. Independent review by a toxicologist may reveal flaws that undermine the insurer’s denial.Identify Procedural Failures
Insurers must follow proper investigative protocols. If the claim denial was issued without a complete investigation or in violation of policy terms, it can be challenged as a breach of contract or bad faith.Hire an Experienced Life Insurance Attorney
A life insurance lawyer can issue subpoenas, depose witnesses, analyze expert reports, and develop legal arguments to dispute the insurer’s conclusion. Many claims involving high BAC can be reversed with aggressive legal advocacy.
How a Life Insurance Lawyer Fights BAC-Based Denials
A skilled attorney will focus on challenging the underlying evidence and the insurer’s interpretation of the facts. Strategies include:
Questioning the validity of BAC testing (e.g., expired kits, improper storage, non-medical personnel collecting samples)
Asserting alternative causes of death unrelated to alcohol, such as mechanical failure or third-party negligence
Highlighting ambiguity in policy language (e.g., unclear definitions of "intoxicated" or "contributing cause")
Investigating the insured’s behavior and accident timeline to show alcohol was not a causal factor
Pursuing litigation if the insurer fails to honor the policy’s terms or abuses the exclusion
Many BAC-related denials are overturned once the insurer realizes the claim will be subjected to legal scrutiny.
Challenging a Denied Life Insurance Claim Due to Illegal Drugs
Denials based on drug use are similar to those involving alcohol and require a similar legal approach. Insurers often deny claims by citing toxicology reports that indicate illegal substances in the insured’s system. But presence does not equal causation. To challenge these denials:
Determine if the drug was the proximate cause of death. If the insured had drugs in their system but died from unrelated trauma, the exclusion may not apply.
Review the exclusion language. Some policies only exclude deaths “caused by” drug use, while others apply a broader exclusion.
Obtain expert toxicology opinions. These experts can assess drug levels, timing, and potential impairments at the time of death.
Assess whether the drug was legally prescribed. If the substance was prescribed—even if it’s considered a controlled substance—it may not qualify under an illegal drug exclusion.
Look for procedural flaws. Delayed or incomplete testing, improper lab procedures, or contamination may cast doubt on the insurer’s findings.
File an appeal or lawsuit. If negotiations fail, legal action may be necessary to compel the insurer to honor the policy.
In both drug and alcohol cases, the insurer bears the burden of proving the exclusion applies. If they fail to meet that burden, the denial can and should be reversed.
FAQ: Fighting BAC and Drug-Based Life Insurance Claim Denials
Can a life insurance claim be denied for high blood alcohol content?
Yes, if the policy includes an intoxication exclusion and the insurer proves the alcohol directly contributed to the death. However, this is often challengeable.
What if the insured had alcohol in their system but didn’t cause the accident?
The presence of alcohol alone does not justify denial. The insurer must prove alcohol caused or significantly contributed to the fatal event.
How can a lawyer fight a BAC-related denial?
An attorney can challenge the test results, the timing and handling of the toxicology report, and the insurer’s interpretation of causation.
Are there limits to how intoxicated someone can be under a policy?
Some policies set specific BAC thresholds, such as 0.08% or 0.10%. Others use vague terms like “under the influence,” which can be legally challenged.
What is needed to prove the exclusion doesn’t apply?
You’ll need to show either that the insured was not intoxicated, or that the intoxication did not contribute to the death. Independent experts can help support this claim.
Can life insurance be denied for drug use even if it wasn’t the cause of death?
No. The insurer must prove that the drug use was a proximate cause of death. Mere presence of drugs in the system is not enough.
Are prescription drugs considered “illegal” under policy exclusions?
Not typically. If a drug was legally prescribed and taken as directed, it is usually not excluded—even if it’s a controlled substance.
What if the toxicology report is inaccurate?
A second opinion from a forensic toxicologist can challenge the results. Testing errors, delays, or contamination may undermine the report’s credibility.
What if the insurer says the death was caused by “misuse” of a substance?
They must prove misuse and causation. If the insured had a valid prescription or trace amounts that didn’t impair them, the exclusion may not hold.
Do I need an attorney to fight these types of denials?
Yes. These cases require medical, legal, and contractual analysis. An experienced life insurance lawyer can build a compelling case to reverse the denial.