Many life insurance policies contain a felony exclusion that allows an insurer to deny payment if the insured dies while committing a felony. Insurance companies often treat these exclusions as automatic, but courts do not. Whether a felony exclusion applies usually depends on intent, proof, causation, and how the underlying criminal law defines the alleged offense.
The following case examples reflect common fact patterns where insurers denied claims based on felony exclusions and beneficiaries challenged those denials.
Notable Felony Exclusion Disputes
1. Northwestern Mutual Life Insurance Felony Exclusion Denial
Case Overview:
A $500,000 claim was submitted after the insured died in a vehicle crash during a police encounter. The insurer denied the claim, asserting that the insured was committing felony evasion at the time of death.
Legal Issue:
Whether the insured knowingly fled law enforcement with the intent required to constitute a felony.
Challenge Focus:
Evidence showed the insured may not have been aware of the police pursuit and was not driving recklessly.
Key Takeaway:
Felony exclusions often fail when intent cannot be established.
2. Lincoln Financial Group Felony Exclusion Dispute After Shooting Death
Case Overview:
The insured died from a gunshot wound during an alleged home invasion. The insurer denied a $300,000 claim, asserting that the insured was committing burglary.
Legal Issue:
Whether the insured was unlawfully entering the property or had permission to be there.
Challenge Focus:
Witness statements and evidence suggested the insured was visiting someone who lived at the residence.
Key Takeaway:
Felony exclusions require proof that a crime actually occurred.
3. State Farm Claim Denied Based on Alleged Theft
Case Overview:
A $600,000 claim was denied after the insured died from a heart attack during a shoplifting accusation. The insurer characterized the incident as felony theft.
Legal Issue:
Whether the insured committed a felony or was merely accused without proof.
Challenge Focus:
Surveillance footage and witness accounts contradicted the accusation.
Key Takeaway:
An arrest or accusation does not equal a felony for insurance purposes.
4. Transamerica Trespass Based Felony Exclusion Denial
Case Overview:
The insured died of a cardiac event while detained for alleged trespassing. The insurer denied a $400,000 claim under the felony exclusion.
Legal Issue:
Whether the conduct constituted felony trespass or a misunderstanding.
Challenge Focus:
Evidence showed the insured had permission to be on the property.
Key Takeaway:
Misapplied criminal labels often lead to wrongful denials.
5. Protective Life Assault Based Felony Exclusion
Case Overview:
A $700,000 claim was denied after the insured died from stab wounds during a bar altercation. The insurer asserted the insured was committing felony assault.
Legal Issue:
Whether the insured was the aggressor or acting in self defense.
Challenge Focus:
Witness testimony supported a self defense narrative.
Key Takeaway:
Self defense negates felony conduct in many jurisdictions.
6. Guardian Life Insurance Company of America Illegal Hunting Felony Exclusion Dispute
Case Overview:
The insured was fatally shot during a hunting trip. The insurer denied a $450,000 claim, alleging the insured was hunting illegally.
Legal Issue:
Whether a regulatory hunting violation rose to the level of a felony.
Challenge Focus:
Licensing records and local regulations showed no felony offense.
Key Takeaway:
Regulatory violations do not automatically trigger felony exclusions.
Why Felony Exclusions Are Frequently Misapplied
Insurers often deny claims by relying on assumptions rather than proof. Common errors include:
• Treating arrests as convictions
• Ignoring intent requirements
• Misclassifying misdemeanors as felonies
• Overlooking self defense
• Applying criminal labels without legal analysis
Courts typically require a direct connection between the felony and the death.
What Courts Examine in Felony Exclusion Cases
When felony exclusions are disputed, courts usually look at:
• Whether the insured committed a felony under state law
• Whether intent was proven
• Whether the felony caused the death
• Whether exclusions are narrowly construed
• Whether ambiguity favors coverage
These cases are fact driven and heavily dependent on criminal law definitions.
How Life Insurance Lawyers Challenge Felony Exclusion Denials
Effective challenges often involve:
• Reviewing criminal statutes and police reports
• Examining autopsy and medical records
• Interviewing witnesses
• Challenging insurer assumptions
• Litigating causation and intent
Many felony based denials collapse once facts are examined.
Frequently Asked Questions
Can a felony exclusion be challenged
Yes. Insurers must prove that a felony occurred and that it caused the death.
Does an arrest automatically trigger a felony exclusion
No. Arrests and accusations are not proof.
Do misdemeanor offenses count
Usually no. Most policies specify felony conduct.
Does self defense matter
Yes. Self defense often defeats felony allegations.
Should felony exclusion denials be reviewed by a lawyer
Yes. These denials are among the most commonly overturned when challenged.