We recently secured a three hundred thousand dollar payout for a beneficiary after Corebridge Financial denied a life insurance claim based on vague and poorly defined policy language. The insurer relied on an exclusion buried deep in the policy and applied it in a way that stretched far beyond its plain meaning. Once the language was scrutinized and challenged under contract law principles, the denial collapsed and the full benefit was paid.
This case is a textbook example of how insurers use ambiguity as a denial strategy and how that strategy often fails when properly confronted.
How Ambiguous Policy Language Leads to Denials
Life insurance policies are drafted entirely by insurance companies. Policyholders and beneficiaries have no ability to negotiate the wording. As a result, insurers are legally required to draft exclusions clearly and narrowly. When they do not, courts interpret those ambiguities against the insurer.
Despite this, insurers routinely deny claims by relying on undefined phrases, elastic wording, or exclusions that are not clearly connected to the cause of death. These denials often sound authoritative on paper, but they are frequently unsupported when the policy language is examined closely.
In this Corebridge case, the insurer denied a claim after the insured died from a fatal head injury sustained during a fall inside his home. The company cited an exclusion for injuries “related to physical impairment” and argued that the insured’s arthritis must have contributed to the fall.
The problem was simple. The policy never defined what “related to” meant. It did not explain whether the impairment had to directly cause the injury, substantially contribute to it, or merely exist in the background. That lack of definition made the exclusion unenforceable as applied.
Why “Related To” Clauses Are Frequently Abused
Phrases like “related to,” “arising from,” or “in connection with” appear in many life insurance exclusions. Insurers favor this language because it gives them room to argue almost anything after the fact.
In practice, these clauses are often applied retroactively. The insurer looks at the insured’s medical history and tries to draw a loose connection between a condition and the death, even when the condition played no meaningful role.
In this case, there was no medical evidence that arthritis caused the fall. There was no finding that the insured lost balance due to joint instability. The insurer simply assumed a connection and denied the claim.
Once challenged, that assumption could not be defended.
Additional Examples of Policy Language Denials We Have Overturned
Ambiguous wording denials are not unique to one insurer or one type of exclusion. We routinely see similar tactics across the industry.
In Indiana, an insurer denied a claim after a woman died from a venomous snake bite during a camping trip. The denial relied on an exclusion for injuries occurring during “unsanctioned travel.” The policy never defined what made travel sanctioned or unsanctioned. There was no reference to permits, legality, or location. Because the term had no objective meaning, the exclusion could not be enforced. The claim was paid in full.
In New Mexico, a man collapsed and died from heatstroke during a local charity run. The insurer denied the claim under an exclusion for “physically extreme activity.” The policy provided no definition of extreme and offered no examples. We demonstrated that a community five kilometer run could not reasonably be classified as extreme. The denial was reversed after appeal.
In North Carolina, a homeowner died after falling from a ladder while repairing his own roof. The insurer cited an exclusion for “occupational hazards.” The insured was not a contractor, was not being paid, and was performing routine home maintenance. Because the policy failed to define occupational activity, the insurer could not expand the exclusion to cover personal home projects. The beneficiary recovered the full benefit.
How Courts Treat Ambiguous Life Insurance Provisions
Contract law provides strong protection for policyholders and beneficiaries when language is unclear. The governing rule is that ambiguities are interpreted against the drafter. In life insurance cases, that rule is applied strictly because the insurer controls the wording and the insured relies on it.
An ambiguity exists when reasonable people could read a clause in more than one way. The insurer does not get to choose the interpretation that favors denial after the insured has died. If the language fails to clearly notify the policyholder of what is excluded, the exclusion fails.
This applies to phrases involving medical conditions, activities, intent, and causation. Undefined terms cannot be retroactively defined by the insurer during a claim investigation.
How Insurers Try to Pair Language Denials With Application Issues
When a policy language denial is weak, insurers sometimes attempt to bolster it by alleging an omission or misstatement on the application. This is often done to create leverage rather than because the omission actually mattered.
Whether that tactic works depends heavily on timing.
If the death occurs within the contestability period, the insurer may attempt to rescind the policy for a material misstatement. Even then, they must prove the information would have changed the underwriting decision. Minor conditions, temporary medications, or irrelevant history usually do not qualify.
If the contestability period has expired, the insurer must prove intentional fraud. That is a much higher standard. Honest mistakes, forgotten details, or misunderstandings do not meet it.
In a Florida case we handled, an insurer attempted to void coverage because the insured did not list anxiety medication on her application. She later died in a boating accident. The medication had no connection to the cause of death and would not have affected underwriting. Once challenged, the insurer abandoned the denial.
Why These Denials Are Often Winnable
Policy language denials depend on silence, not strength. Insurers assume beneficiaries will not question how a term is defined or whether an exclusion actually applies. Once forced to explain and defend their interpretation, many denials fall apart quickly.
In the Corebridge case, the insurer could not explain how arthritis caused a sudden head injury. It could not point to policy language defining “related to.” It could not support its theory with medical evidence. Faced with those gaps, reversal became inevitable.
Final Takeaway
Ambiguous policy language is one of the most common and most abused tools insurers use to deny life insurance claims. Undefined terms, elastic exclusions, and vague causation language are routinely stretched beyond their limits.
When those denials are challenged using contract law principles and the insurer is forced to defend its interpretation, many claims are paid in full.
This three hundred thousand dollar Corebridge Financial case shows that a denial based on unclear wording is not the end of the road. In many cases, it is the insurer’s weakest point.