Our life insurance attorneys recently secured a full $218,000 payout after National Western Life Insurance denied a claim based on an alleged intoxication issue. The insurer relied heavily on a high blood alcohol content listed in the autopsy report and argued that the presence of alcohol justified refusing payment. After a detailed factual and legal review, we demonstrated that the insurer’s position was unsupported by the policy language and the medical evidence. The denial was reversed and the beneficiary received the full death benefit.
Alcohol related denials are among the most aggressively pursued by life insurance companies, but they are also among the most frequently overturned when properly challenged.
How Life Insurers Use BAC to Justify Denials
When toxicology reports show alcohol in the insured’s system, insurers often treat that fact as a shortcut to denial. In reality, alcohol alone is not enough. For a denial to be valid, the insurer must tie the BAC to a specific policy provision and prove that it actually matters.
Most alcohol based denials fall into one of two categories.
BAC Issues During the Contestability Period
During the first two years of a life insurance policy, insurers are allowed to investigate the original application for material misrepresentations. A high BAC after death often triggers this review.
Insurers typically look for:
Alleged failure to disclose alcohol abuse or dependency
Prior treatment, counseling, or DUI history
Application answers about lifestyle or substance use
Any claim that alcohol use increased underwriting risk
To rescind a policy, the insurer must show that the insured made a false statement and that the statement was material to issuing the policy. Casual drinking, social alcohol use, or a single intoxication event is usually not enough to meet that standard.
In the National Western case, the insurer could not show that the insured lied about alcohol use or that any alleged omission would have changed underwriting. That alone defeated the rescission attempt.
BAC Based Exclusions After the Contestability Period
Once the contestability window closes, insurers can no longer void a policy for application errors. Instead, they rely on exclusions.
Some policies contain exclusions for death occurring while intoxicated or during illegal acts. Others do not. Even when such exclusions exist, the insurer must still prove causation.
Key questions include:
Does the policy actually contain an intoxication exclusion
Does the exclusion require alcohol to cause the death
Is there evidence linking the BAC to the fatal event
Is the exclusion written clearly or vaguely
Many policies are silent on alcohol altogether. Others use imprecise language that courts interpret narrowly.
High BAC Does Not Automatically Mean Cause of Death
This is the most important point beneficiaries often miss. A toxicology number does not explain how or why someone died.
Alcohol may be present but unrelated. Examples include:
Medical events such as heart attacks or aneurysms
Structural failures like broken railings or ladders
Third party negligence such as being struck by a vehicle
Environmental hazards unrelated to impairment
In the $218,000 National Western case, the insurer assumed intoxication equaled causation. The medical records and investigative findings proved otherwise. Once causation fell apart, the denial collapsed.
Common Flaws in Alcohol Based Denials
We routinely see insurers make the same mistakes in BAC related cases.
Relying solely on toxicology without investigating the scene
Ignoring mechanical or environmental causes
Treating alcohol presence as automatic disqualification
Stretching vague exclusion language beyond its limits
Overlooking postmortem alcohol production issues
These weaknesses are often enough to reverse a denial when properly documented.
How Alcohol Denials Are Successfully Challenged
Winning a BAC related life insurance dispute requires focusing on evidence and policy language, not assumptions.
Effective challenges often include:
Medical expert review of cause of death
Toxicology analysis addressing timing and reliability
Witness statements about the incident
Engineering or accident reconstruction evidence
Policy interpretation arguments based on ambiguity
In many cases, insurers retreat once they are forced to defend their interpretation under scrutiny.
Why Legal Review Matters in BAC Denials
Insurance companies know that alcohol accusations intimidate beneficiaries. Many families assume the denial is final once they see a toxicology report. That assumption benefits the insurer.
Alcohol related denials are highly technical. They involve contract interpretation, medical causation, and evidentiary standards. Without legal pressure, insurers rarely revisit their conclusions.
The $218,000 National Western recovery is a clear example of how these denials can be overturned when the facts and the policy are properly examined.
If a Life Insurance Claim Was Denied Due to BAC
If a denial letter references intoxication, alcohol, toxicology, or BAC, the claim deserves immediate review. Presence of alcohol is not the same as policy exclusion, and intoxication is not the same as causation.
Many of these claims are recoverable. Acting quickly and focusing on the right issues often makes the difference between a permanent denial and full payment.