Our life insurance attorneys successfully recovered a $90,000 death benefit after Southern Farm Bureau Life Insurance denied the claim based on alleged alcohol related health issues. The insurer asserted that the insured’s death was excluded because alcohol use supposedly caused or substantially contributed to the medical condition that led to death. After a detailed policy review and legal challenge, we demonstrated that the denial relied on an unsupported and overly broad interpretation of the policy’s exclusions. The insurer reversed its position and paid the full benefit.
This case highlights how life insurance companies often misuse alcohol related medical histories to deny otherwise valid claims, particularly when policy language is vague or when the medical record does not clearly support the insurer’s conclusions.
Can Alcohol Use Justify Denial of a Life Insurance Claim
Alcohol use alone does not automatically justify denial of a life insurance claim. Insurers must rely on specific policy provisions and must show that those provisions clearly apply to the cause of death. Many denials fail because insurers assume alcohol involvement equals exclusion, which is not how life insurance contracts work.
Alcohol related denials typically fall into three narrow categories, each with its own legal requirements.
Alcohol Related Medical Conditions and Cause of Death
Some policies attempt to exclude deaths caused by alcohol abuse or chronic substance use. Insurers often cite conditions such as cirrhosis, pancreatitis, cardiomyopathy, or gastrointestinal bleeding as justification for denial. However, the insurer must still prove a direct causal connection between alcohol abuse and the death.
Common problems with these denials include:
The death certificate lists a general medical cause without attributing it to alcohol
Alcohol use is historical rather than active at the time of death
The policy does not define alcohol abuse or chronic use
The exclusion applies only to intentional self harm or acute intoxication
In the Southern Farm Bureau case, the insurer relied on past references to alcohol use in the medical file but could not establish that alcohol caused the fatal event. That failure alone defeated the exclusion.
Application Misrepresentation Based on Alcohol History
Another frequent tactic involves alleging misrepresentation on the application. Insurers argue that the insured failed to disclose alcohol abuse, treatment, or related diagnoses and therefore the policy should be rescinded.
These denials only succeed if all of the following are true:
The application specifically asked about alcohol use or treatment
The insured’s answer was false or misleading
The misstatement was material to underwriting
The death occurred within the contestability period
If any one of these elements is missing, the denial fails. Many applications use vague questions such as excessive alcohol use or treatment for substance abuse without defining what qualifies. Courts routinely reject rescission based on unclear questions.
Alcohol Mentioned but Not the Cause of Death
One of the most common wrongful denials occurs when alcohol appears in medical records or toxicology reports but is not the cause of death. Insurers frequently treat presence as causation, even though the policy does not support that leap.
Examples include:
Alcohol detected but death caused by infection or organ failure
Prior alcohol use but long term sobriety at time of death
Alcohol listed as a contributing condition rather than primary cause
Life insurance policies generally pay benefits unless the exclusion clearly applies. Contributing factors alone are often insufficient to justify denial.
How We Challenged the Southern Farm Bureau Denial
Our analysis focused on four key issues:
Whether the policy actually excluded alcohol related medical deaths
Whether the exclusion was clearly defined and enforceable
Whether the medical evidence established causation
Whether the insurer relied on assumptions instead of proof
Once those weaknesses were identified, the insurer could not sustain the denial. The claim was paid in full without litigation.
When Alcohol Based Denials Can Be Overturned
Alcohol related life insurance denials are frequently reversible when:
The policy language is vague or undefined
Alcohol is mentioned but not the cause of death
The insurer cannot prove direct causation
Application questions were ambiguous
The contestability period has expired
These cases often turn on careful policy interpretation rather than medical disputes.
Help With Denied Life Insurance Claims Involving Alcohol Allegations
Life insurance companies regularly overreach when alcohol appears anywhere in the medical record. They count on beneficiaries assuming the denial is justified. In many cases, it is not.
Our firm focuses exclusively on denied life insurance claims nationwide. We regularly overturn denials involving alcohol related medical conditions, alleged nondisclosure, and misapplied exclusions.
We offer free consultations and handle cases on a contingency basis. There are no fees unless benefits are recovered.