$50,000 Denied Life Insurance Claim Successfully Won
Our top life insurance lawyers are pleased to announce the successful resolution of a $50,000 denied life insurance claim. The claim had been denied due to a felony exclusion clause, but after a detailed review and legal challenge, we were able to secure the full benefit for the rightful beneficiary. This case highlights the importance of fully understanding the terms and conditions of life insurance policies, particularly felony exclusions and criminal activity exclusions, which can often lead to wrongful claim denials.
What Are Felony Exclusions and Criminal Activity Exclusions in Life Insurance?
Life insurance policies often contain exclusions that can be invoked to deny claims if the insured person’s death was related to criminal activity or a felony. The felony exclusion and criminal activity exclusion are two of the most common reasons insurers deny life insurance claims. These exclusions can be complex and vary widely between policies, making it essential for beneficiaries to understand how they work.
Felony Exclusion
A felony exclusion denies coverage for deaths that occur while the insured is involved in committing a felony. In these cases, the insurer may argue that the insured’s participation in a criminal act invalidates the claim, even if the death was accidental or unrelated to the felony itself.
Examples of Felony Exclusion:
Robbery: If the insured person is killed while committing a robbery, the life insurance company may deny the claim, even if the insured was killed by a third party during the crime. For instance, if the insured was shot by a store owner or a police officer during the robbery attempt, the claim may be denied under the felony exclusion.
Evading Law Enforcement: If the insured dies while attempting to evade law enforcement, such as during a high-speed police chase, the claim may be denied. In such cases, even if the death resulted from the accident during the chase, the insurer may invoke the felony exclusion based on the insured’s involvement in a criminal act.
Drug Trafficking or Smuggling: If the insured dies during a criminal activity like drug trafficking, the insurer may deny the claim, arguing that the death was a direct result of engaging in felony conduct.
Criminal Activity Exclusion
The criminal activity exclusion is broader and includes coverage denials for deaths that result from participating in illegal activities, even if the act was not a felony. These exclusions often encompass reckless behavior or activities that violate the law, such as driving under the influence (DUI) or participating in unregulated high-risk activities.
Examples of Criminal Activity Exclusion:
Driving Under the Influence (DUI): If the insured dies in an accident while driving under the influence of alcohol or drugs, the claim may be denied. The insurer may argue that the insured’s impaired driving constitutes reckless behavior and falls under the criminal activity exclusion.
High-Risk Activities: Some life insurance policies may also exclude coverage for deaths resulting from high-risk activities like skydiving, rock climbing, or bungee jumping, particularly if the insured was not following safety protocols or was engaging in the activity illegally (e.g., participating without a permit or insurance).
Unlawful Behavior: If the insured dies while participating in a protest, riot, or civil disturbance, the insurer may deny the claim based on the exclusion for involvement in illegal activities, even if the insured’s death resulted from an act of violence not directly linked to their participation in the event.
How to Protect Yourself and Fight Denied Life Insurance Claims
If your life insurance claim has been denied due to felony exclusions or criminal activity exclusions, here are the steps you should take to protect your rights and fight for the death benefit:
1. Request a Detailed Explanation
Always request a written explanation from the insurer detailing why your claim was denied. This will help you understand which policy exclusions they invoked and provide you with a starting point for contesting the decision.
2. Review the Policy Terms Carefully
Carefully examine the policy’s exclusions section. Some policies contain vague or overly broad language that can be misapplied. Ensure that the terms are clear and that the exclusion applies to the specific circumstances of the insured’s death.
3. File an Appeal
If the insurer’s explanation is unclear or you believe the denial was based on an improper interpretation of the policy, file an internal appeal. Provide any additional evidence or context to support your case. This could include medical records, witness statements, or proof that the death was not related to criminal activity.
4. Seek Legal Help
If your appeal is unsuccessful, or if you believe the insurer is acting in bad faith, consider seeking the help of an experienced life insurance attorney. They can help assess whether the exclusion was properly applied, challenge ambiguous policy language, and represent you in court if necessary.
Our team of experienced life insurance lawyers has successfully fought and overturned claim denials based on felony exclusions and criminal activity exclusions. We have helped clients recover benefits from insurers like Prudential, AIG, MetLife, and more.
Frequently Asked Questions
What is a felony exclusion in life insurance?
A felony exclusion is a clause in a life insurance policy that denies coverage if the insured dies while participating in a felony crime. This can include activities like robbery, smuggling, or attempting to evade law enforcement.
Can a life insurance claim be denied for participating in a criminal activity?
Yes. Many life insurance policies have criminal activity exclusions that deny claims if the insured dies while engaging in illegal behavior, such as driving under the influence or participating in a violent protest.
How can I fight a life insurance claim denial based on criminal activity?
To challenge the denial, request a detailed explanation from the insurer, review the policy language, and file an appeal. If necessary, consult with a life insurance lawyer to assess the legal validity of the insurer’s denial and potentially take legal action.
Does the policy automatically void if the insured commits a crime?
Not necessarily. The policy must include a specific exclusion for criminal activity or felonies. Even then, the insurer must prove that the death occurred due to participation in a criminal act, and not merely as a result of accidental circumstances.
Can I still receive life insurance benefits if the insured was involved in a crime but wasn’t the cause of death?
It depends on the policy’s terms. Some policies may pay out even if the insured was involved in criminal activity, as long as their death was not directly caused by the crime. It’s essential to review the policy’s specific wording and exclusions.
Can life insurance be denied if the insured was involved in high-risk activities like skydiving?
Some policies exclude coverage for deaths resulting from high-risk activities, particularly if the insured did not follow proper safety procedures or disclosed participation in such activities. Check your policy for any hazardous activities clauses.
How much does your firm charge for handling denied life insurance claims?
Our firm works on a contingency fee basis, meaning you pay nothing unless we win your case. We offer free consultations to review your situation and discuss potential legal strategies.