Our life insurance attorneys successfully recovered a $50,000 death benefit after the insurer denied the claim based on a felony exclusion. The insurance company asserted that the insured’s death was connected to criminal activity and therefore fell outside coverage. After a careful review of the policy language, the underlying facts, and the applicable law, we challenged the denial and secured full payment for the beneficiary.
This case illustrates a common tactic used by life insurance companies: broadly invoking felony or criminal activity exclusions even when the policy language does not clearly support denial.
Understanding Felony and Criminal Activity Exclusions in Life Insurance
Many life insurance policies contain exclusions that limit or eliminate coverage when the insured’s death occurs in connection with illegal conduct. These exclusions are often poorly understood by policyholders and beneficiaries, and they are frequently misapplied by insurers.
There are two related but distinct concepts that matter in these cases.
Felony Exclusions
A felony exclusion typically applies only when the insured dies while actively committing a felony offense. The insurer must usually prove more than the mere existence of criminal conduct. They must show a direct connection between the felony and the death.
Common insurer arguments include:
The insured died during the commission of a robbery or burglary
The insured was killed while fleeing law enforcement
The insured was engaged in felony drug activity at the time of death
What insurers often overlook is that many felony exclusions require the death to result directly from the felony itself. If the death was accidental, incidental, or caused by a third party in a way not clearly tied to the criminal act, the exclusion may not apply.
Criminal Activity Exclusions
Criminal activity exclusions are broader and may apply to misdemeanors or illegal conduct that does not rise to the level of a felony. These provisions are often written vaguely and give insurers wide discretion to deny claims.
Examples insurers commonly rely on include:
Driving under the influence
Minor drug possession
Participation in civil disturbances or unlawful assemblies
Regulatory violations classified as crimes
Courts frequently scrutinize these exclusions closely, especially when the policy does not define what qualifies as criminal activity or fails to explain how closely the activity must relate to the cause of death.
Why These Exclusions Are Frequently Misused
Life insurance companies often treat felony and criminal activity exclusions as automatic bars to coverage. In reality, these provisions are narrowly construed under insurance law.
Key legal principles that protect beneficiaries include:
Exclusions must be clear and unambiguous
The insurer bears the burden of proving the exclusion applies
Any ambiguity is interpreted in favor of coverage
The criminal act must usually be a direct cause of death
In the Manulife John Hancock case, the insurer attempted to rely on an exclusion without establishing a sufficient causal connection between the alleged criminal conduct and the death. Once that weakness was exposed, the denial could not stand.
How We Challenged the Manulife John Hancock Denial
Our legal review focused on several critical issues:
Whether the policy clearly defined felony or criminal activity
Whether the exclusion required a conviction or merely alleged conduct
Whether the death was directly caused by the alleged crime
Whether the insurer relied on assumptions rather than proof
We demonstrated that the insurer was applying the exclusion far more broadly than the policy allowed. Under a fair reading of the contract, the exclusion did not bar payment. The result was full recovery of the $50,000 death benefit.
When Felony Based Denials Can Be Overturned
A denial based on felony or criminal activity may be successfully challenged when:
The policy language is vague or undefined
The death was not directly caused by the criminal act
No conviction occurred or charges were never filed
The insurer relies on police reports rather than final findings
The exclusion is applied retroactively or expansively
These cases are rarely as clear cut as insurers claim. Many denials collapse once the policy language is tested against established contract law.
Help With Denied Life Insurance Claims Involving Criminal Allegations
Felony and criminal activity exclusions are among the most aggressively misused provisions in life insurance policies. Insurers rely on beneficiaries assuming that any allegation of wrongdoing defeats coverage. That assumption is often incorrect.
Our firm focuses exclusively on denied life insurance claims nationwide. We regularly overturn denials based on felony exclusions, criminal activity clauses, and other narrowly written exclusions that insurers attempt to stretch beyond their limits.
We offer free consultations and handle all cases on a contingency basis. There are no fees unless benefits are recovered.