We successfully recovered a $75,000 life insurance benefit after Occidental Life Insurance Company denied payment based on an alleged criminal activity exclusion. The insurer claimed the insured was engaged in criminal conduct at the time of death and therefore outside the scope of coverage. After a detailed legal review and targeted challenge, the denial was overturned and the full benefit was paid to the family.
Criminal activity exclusions are among the most aggressively asserted life insurance defenses. Insurers often rely on incomplete police reports, assumptions about intent, or broad interpretations of policy language. As this case demonstrates, those denials are frequently vulnerable when examined carefully.
How Criminal Activity Exclusions Are Used to Deny Claims
Most life insurance policies contain exclusions for deaths occurring during the commission or attempted commission of a felony. Insurers argue that coverage should not apply when death results from serious criminal conduct.
In practice, these exclusions are often applied far more broadly than the policy allows. Insurers may deny claims even when:
The alleged crime was never charged or proven
The death occurred after the alleged conduct ended
The connection between the crime and death is indirect
The policy language is vague or undefined
The conduct may not qualify as a felony under state law
Families are often told the denial is automatic. It rarely is.
What Insurers Must Prove to Enforce a Felony Exclusion
A criminal activity exclusion does not apply simply because an insurer alleges wrongdoing. To deny a claim, the insurer must generally establish:
That the conduct qualifies as a felony under applicable law
That the insured was actively committing or attempting the felony
That the death occurred during the commission of that act
That the policy language clearly excludes coverage under those facts
If any link in that chain fails, the exclusion may not be enforceable.
Why These Denials Are Frequently Challenged Successfully
Insurers often deny felony related claims using assumptions rather than evidence. Common weaknesses include:
Relying on arrest reports instead of proven facts
Equating investigation with guilt
Failing to define what qualifies as a felony in the policy
Ignoring whether the death was accidental or unrelated
Applying exclusions without proving causation
In many jurisdictions, courts require insurers to strictly construe exclusions and resolve ambiguity in favor of coverage.
How We Challenged the Occidental Life Denial
In this case, our legal team conducted a focused review of:
The policy exclusion language
The circumstances and timing of the death
Law enforcement and investigative records
Medical and forensic evidence
Whether the alleged conduct met felony thresholds
Whether the death occurred during the alleged activity
Once those issues were tested, the insurer’s position could not be sustained. The exclusion did not apply as claimed, and the $75,000 benefit was recovered.
Criminal Allegations Do Not Automatically Void Coverage
One of the most common misconceptions beneficiaries face is that any alleged criminal activity voids life insurance coverage. That is incorrect.
Key factors that often defeat these denials include:
Deaths occurring after the alleged act ended
Deaths caused by unrelated medical or accidental events
Lack of intent or awareness
Conduct that does not legally qualify as a felony
Policies that fail to define or limit the exclusion clearly
Each case turns on facts, timing, and precise policy language.
Other Life Insurance Disputes We Handle
In addition to criminal activity exclusions, we regularly resolve denied and delayed claims involving:
Misrepresentation allegations
Contestability period investigations
Policy lapse disputes
Suicide exclusions
Foreign deaths and documentation issues
Beneficiary disputes and interpleader lawsuits
Our focus is life insurance litigation. We do not handle unrelated practice areas, which allows us to challenge denials with precision and efficiency.
Frequently Asked Questions About Felony Based Life Insurance Denials
Can a life insurance claim be denied because of a felony
Yes, but only if the insurer proves the exclusion applies under the specific facts and policy language.
Does the insured need to be convicted
Not always, but the insurer must present credible evidence. Speculation is not enough.
What does “during the commission of a felony” mean
This is often disputed. If the death is indirect, incidental, or occurs later, the exclusion may not apply.
Do misdemeanor offenses trigger these exclusions
Typically no. Most policies limit exclusions to felonies, which must be defined and proven.
Can these denials be appealed or challenged
Yes. Many felony based denials are reversed once evidence and policy language are examined.
How long do these disputes take
Some resolve quickly through appeal or negotiation. Others require litigation. Many result in full or substantial recovery.
Final Takeaway
Criminal activity exclusions are one of the most misapplied defenses in life insurance claims. Insurers often deny first and expect families not to challenge the decision. As this $75,000 Occidental Life resolution shows, those denials frequently fail when subjected to legal scrutiny.
A denial based on alleged criminal conduct is not the end of the claim. In many cases, it is the beginning of a successful recovery.