Life insurance companies deny thousands of claims every year, often relying on exclusions, contestability arguments, or narrow interpretations of policy language. Many beneficiaries assume a denial letter ends the matter. Court decisions around the country show the opposite. Judges routinely scrutinize insurer conduct and reverse denials when carriers stretch policy language beyond its limits.
Below are eight notable court cases where beneficiaries challenged denied life insurance claims involving major insurers. These cases illustrate how courts analyze exclusions, misrepresentation defenses, and insurer obligations.
Lincoln National Life Insurance
Intoxication Exclusion Challenged in AD&D Class Action
In October 2022, a beneficiary filed a class action lawsuit in Illinois federal court challenging Lincoln National’s denial of accidental death benefits. The insured died after falling from a window, and Lincoln denied the claim based on an intoxication exclusion.
The lawsuit alleged that California law restricts the use of intoxication exclusions in AD&D policies and that Lincoln unlawfully applied a clause that conflicted with state insurance regulations. The case highlights how state law can override policy language and why intoxication based denials are frequently litigated.
Metropolitan Life Insurance Company
Pre Existing Condition Exclusion Dispute
A California federal court heard a case in June 2021 involving a denied claim for a death caused by colon cancer. MetLife relied on a pre existing condition exclusion, arguing the insured had received treatment before the policy became effective.
The beneficiary challenged the denial, asserting the exclusion was vague and poorly explained. Courts often require insurers to clearly define pre existing conditions and prove the exclusion applies. This case illustrates how ambiguity is typically interpreted in favor of coverage.
Prudential Insurance Company of America
ERISA and Contestability Violations Alleged
In March 2021, a New Jersey federal court reviewed a lawsuit involving a Prudential life insurance policy governed by ERISA. The insurer denied the claim based on alleged misrepresentation related to a breast cancer diagnosis.
The beneficiary alleged Prudential violated its fiduciary duties and misapplied the contestability period. ERISA cases are significant because insurers must meet strict procedural and evidentiary standards. Courts closely review whether the insurer acted fairly and consistently.
American General Life Insurance Company
Smoking History Used to Deny Claim
A Texas state court addressed a dispute in February 2021 after American General denied a claim following a lung cancer death. The insurer asserted the insured misrepresented smoking history within the contestability period.
The estate argued the denial was made in bad faith and that smoking disclosures were not material to the issuance of the policy. Smoking related denials are common and frequently challenged when insurers cannot show intent or material impact on underwriting.
Transamerica Life Insurance Company
Accidental Death Only Policy Dispute
In January 2021, a Georgia federal court reviewed a case where a beneficiary believed the policy provided standard life insurance coverage. Transamerica denied the claim, asserting the policy covered only accidental death, not illness.
The lawsuit alleged the policy was misleading and that the insured reasonably believed broader coverage existed. Courts regularly examine how policies are marketed and whether exclusions are adequately disclosed.
United of Omaha Life Insurance Company
Suicide Exclusion Misapplied to Illness Death
A Florida federal court heard a case in December 2020 involving a denial based on a suicide or self inflicted injury exclusion. The insured died from ovarian cancer, but the insurer alleged an intentional medication overdose.
The beneficiary argued the death resulted from terminal illness, not suicide. Courts generally require clear evidence of intent before enforcing suicide exclusions. Speculative conclusions often fail under judicial review.
Minnesota Life Insurance Company
Drug and Alcohol Exclusion Challenged
In November 2020, an Alabama federal court reviewed a case involving a liver cancer death. Minnesota Life denied the claim under a drug or alcohol abuse exclusion.
The beneficiary argued the death was caused by cancer, not substance use. Courts frequently require insurers to prove a direct causal link between excluded conduct and the cause of death, a burden insurers often struggle to meet.
Globe Life and Accident Insurance Company
Disease Contraction Clause Disputed
An Oklahoma federal court heard a lawsuit in October 2020 involving a denial based on an illness contraction clause. Globe Life argued the insured developed cervical cancer within the exclusion window.
The beneficiary challenged the timing and applicability of the clause, alleging breach of contract. Courts often scrutinize disease timing exclusions, especially when diagnoses occur after policy issuance but symptoms existed earlier.
What These Court Cases Reveal
Across jurisdictions, courts repeatedly reject life insurance denials when insurers:
Apply exclusions too broadly
Rely on vague or undefined policy terms
Fail to prove material misrepresentation
Ignore state insurance laws
Speculate about intent or causation
Judicial decisions consistently emphasize that insurers bear the burden of proof and that ambiguities favor beneficiaries.
When Legal Action Makes the Difference
Life insurance lawsuits are not about technical loopholes. They focus on fairness, evidence, and whether the insurer honored the contract it sold. Many denials collapse once subjected to discovery, expert review, and judicial oversight.
If your claim was denied based on intoxication, illness exclusions, misrepresentation, or policy type disputes, court precedent may already be on your side.
Frequently Asked Questions
Can a life insurance claim be denied for intoxication?
Only if the policy and state law allow it. Some states restrict intoxication exclusions, especially in AD&D policies.
What if the insured did not know they were sick when applying?
Insurers must prove intentional misrepresentation. Lack of knowledge often defeats pre existing condition denials.
How does ERISA affect life insurance lawsuits?
ERISA imposes fiduciary duties and procedural requirements that insurers must follow. Violations can lead to reversal of denials.
Can beneficiaries sue for bad faith?
Yes. When insurers misapply policy language or fail to investigate properly, bad faith claims may be available.