Life Insurance Lawyer Florida

Whether you reside in: Port St. Lucie; Fort Lauderdale; Cape Coral; Tallahassee; Hialeah; St. Petersburg; Orlando; Tampa or Miami; our life insurance attorneys who live and work here in Florida are here to help resolve your delayed or denied life insurance claim.

Suicide and life insurance

How life insurers use purported suicide to deny claims

There may be no more devastating event in life than the loss of a loved one due to suicide. Friends and family members are often left wondering why the death occurred, what they could have done to prevent it, and how they will possibly go on following the tragedy.

Notwithstanding those devastating impacts for survivors, suicide has become an increasingly unfortunate reality for many Americans. Indeed, according to one study, the rate of suicide in the United States jumped nearly 25% between 1999 and 2014. Even still, many experts believe a great number of suicides go unreported or misclassified in autopsy reports.

The interplay between suicide and life insurance has always been a tenuous one. This is especially true as life insurance companies try to deal with an ever-increasing onslaught of claims stemming from suicide. This article explores some of the hot topics surrounding suicide and life insurance. It also provides information for beneficiaries who have had claims denied when suicide is an issue.

The suicide exclusion in life insurance policies

On a purely intellectual level, most of us can understand why life insurance companies would not want to make death benefit payouts to the beneficiaries of policyholders who committed suicide. After all, it is not a far stretch of the imagination to see how an individual – distraught from financial struggles, depression, and other issues – might use a life insurance policy as a financial security blanket for his survivors.

Imagine, for example, a middle-aged husband and father of three who lost his job in the recession. The bills are piling up, the mortgage on the house is near foreclosure, and there doesn’t seem to be a good job opportunity anywhere on the horizon. If you could kill yourself to get your family a multi-million dollar life insurance death benefit that would lift them out of the financial hole, more people might consider that option than we like to admit.

From the life insurer’s point of view, however, this is a worst-case scenario. What profit-generating insurer would allow a policyholder to exert complete control over policy payouts? That is essentially what life insurance companies would be doing if they indiscriminately paid death claims when the cause of death was suicide.

Consequently, life insurance companies have built in a couple of policy exclusions that lessen their risk of paying death benefit payouts anytime suicide might be involved in the insured’s death. The first is what is known as an outright “suicide exclusion.” These provisions prohibit the payment of death benefits when the insured commits suicide at any point during the policy term.

The second is the “contestability period.” These provisions basically say that if the insured dies within the first two years of the policy – including if the cause of death is suicide – then the life insurance company does not have to pay a death benefit at all.

At face value, both of these provisions seem reasonable. Insurance companies want to discourage people from using their services as a macabre form of financial planning. Unfortunately, life insurers have twisted these provisions to work to their advantage – even when the death at issue did not come by suicide.

The suicide excuse from life insurers

As attorneys who specialize in contesting the wrongful denial of life insurance claims, we are never surprised when insurance companies issue claim denials that are “justified” by the insured’s alleged suicide – even in cases where the autopsy report deemed the death a result of an accident or natural causes. Indeed, insurance companies play these tricks all the time.

One illustrative case came out of Atlanta. The life insurance policyholder was a man named Allen. Allen held a $1 million life insurance policy that named his sister, Brenda, as his sole beneficiary. The policy contained an outright suicide exclusion that allowed the insurer to avoid paying a death benefit if Allen committed suicide at any point during the policy term.

Four years after the policy was issued, Allen went windsurfing for the first time in his life. As a novice to the sport, he was unsure exactly how to secure his body to the surfboard for maximum safety. As a result, he simply did not connect himself to the board in any appreciable way.

Two hours into his first windsurfing excursion, Allen experienced an unexpected wind surge. Friends watched in horror from the shore as Allen was swept away from his surfboard and into the swirling whitewater of the river. Much to their dismay, his body was recovered on the shore three days later. The coroner ruled his death an accidental drowning.

When Brenda submitted a claim to Allen’s life insurance company, she was surprised to receive a denial letter in the mail. In fact, the justification for the denial was even more shocking – the insurer proclaimed the incident a self-inflicted death that fell squarely within the policy’s suicide exclusion. Specifically, the insurer claimed that if Allen hadn’t wanted to die, he would have appropriately harnessed himself to the surfboard.

Brenda immediately contacted an attorney specializing in the denial of life insurance claims. He quickly recognized that the insurance company was trying to wrongly invoke the suicide exclusion clause to deny an otherwise valid claim. After a detailed consultation with the attorney, Brenda decided to sue the insurance company for the benefits she believed Allen intended for her.

Ultimately, Brenda prevailed in court. There was simply no evidence on the record that suggested Allen had any suicidal ideation. While he may have made a poor decision in ignoring available safety equipment, that – in and of itself – was not enough to warrant his death a suicide for purposes of the life insurance policy.

Every day in our practice, we see insurance companies playing tricks like these to avoid policy payouts. If you have experienced a claim denial based on a life insurance company’s determination of suicide, call us today. We successfully contest claim denials like these all the time. We’re happy to review your case and help get the benefits you deserve.

Florida denied life insurance claims are nothing new. Existing for many years, life insurance policies have been used to safeguard families and friends alike in case emergencies or accidents come unexpectedly. Unfortunately, denials of life insurance claims, as well as delays, are commonplace.
Our life insurance lawyers who live and work in Florida can help, whether you are in: Jacksonville; Miami; Tampa; Orlando; St. Petersburg; Hialeah; Tallahassee; Cape Coral; Fort Lauderdale; Port St. Lucie; or anywhere in the state of Florida, we will get you the benefits to which you are entitled.
Florida Life Insurance Law
Policies through work are governed under ERISA. The primary regulating force here in Florida is Title 37 of the Florida Statutes, and oversight is provided by the Florida Office of Insurance Regulation.
Most Common Reasons for a Denied Life Insurance Claim in Florida
  • Number one is a misrepresentation on the application. This typically involves failing to disclose a medical condition. However, we can get over this hurdle the majority of the time.
  • A lapse of a life insurance policy is probably second most common. What happens is that the insured gets sick and misses a payment or two. These are tough, but often we can get these claims paid.
  • Probably third is the type of death exclusion. This could be a suicide or it could be a self-inflicted injury. Murder is another exclusion. Health again can fall under this exclusion. We often win suicide exclusions as we cite case law that the death was actually accidental.
  • A very common exclusion is the alcohol exclusion. The insured may have been killed in a car crash, but the autopsy revealed alcohol in the person’s system. We have many legal briefs to combat this exclusion.
  • Heroin and opiates or illegal drug exclusion is one of the biggest now. With the opioid crisis, there are tens of thousands of deaths.
  • Prescription drug overdose exclusion may involve an overdose of medicine or taken medicines that are contraindicated.
  • An ex-spouse being cut off from life insurance benefits is a big one. We actually have a half dozen ways to get over this hurdle.
  • Having a spouse not listed as a beneficiary is another reason for denial
  • Having a child not listed as a beneficiary is one too.
  • Having only a primary beneficiary who is deceased is another.
  • On an AD&D (accidental death and dismemberment) life insurance policy, a fall not being considered an accident is extremely common.
  • The insured’s age not being correct on the initial application is a reason for denial.
  • Having the wrong social security number listed is common.
  • An autoerotic asphyxiation exclusion is an easy one for us to beat.
  • An omission on the application is a big reason for denying a life insurance claim, but we have legal briefs to this effect.
  • Not providing the required documents to the insurance company after death is a reason.
  • Information which is argued to not be correct is one.
  • When there is a dispute between two or more beneficiaries, an interpleader may occur, and we always get these resolved quickly.
  • A beneficiary not named is a reason for not paying it out.
  • A life insurance policy may be transferred from one company to another by the employer which causes major problems.
Denied Life Insurance Claim: Accidental Death & Dismemberment Denial
You’ve depended on your spouse for financial support for years and you’ve grown accustomed to your standard of living. You’ve begun raising a family and building a life. You planned for your future. Together.
But tragedy struck and now your spouse is gone. In addition to the soul-crushing loss of your life-companion, you’re left with a house you can’t afford and children you can’t fathom raising alone. It wasn’t supposed to be this way.
Thankfully, you had life insurance with an Accidental Death and Dismemberment (AD&D) clause in your policy that pays out double the policy value in the event of an automobile accident.
You should receive a large enough benefit to pay off the house and have enough left over to put away for the kid’s tuition. It won’t be easy. You’ll need time to recover and things won’t ever be the same. But you and your children will be OK.
However, the insurance company only pays out the face value of the life insurance policy and denies your AD&D claim, stating that the accident wasn’t the true cause of your spouse’s death. Now, you’re left with half the money you feel you are entitled to and a lot of questions.
What is Accidental Death & Dismemberment (AD&D) Insurance
Sometimes, AD&D insurance is a standalone policy that only covers you if an accident causes your death or dismemberment. Typically however, AD&D is added as a clause or rider to an existing life insurance policy as an added layer of protection and financial support should you die tragically or unexpectedly.
Many people know AD&D insurance as something called a double indemnity clause. Put simply, your life insurance pays you benefits when you die for any reason. However, if you die as a direct result of an accident, the benefit payout is doubled.
There is also typically a payout structure in place in the event of dismemberment such as loss of limb or the use of one or more eyes or ears. This will differ among carriers, but it is extremely rare to receive a 100% payout for anything short of death or complete disability.
When do insurance companies pay AD&D claims?
Life insurance companies pay claims when it is crystal clear an accident caused your death. If you are in an automobile accident and are pronounced dead at the scene and there were drugs or alcohol or crimes involved, the company will pay the claim.
Other clear cases include:
• Homicide (when the murderer isn’t the beneficiary)
• Heavy equipment accidents
• Drowning
• Fatal falls
If it can’t be determined that the cause of death was accidental —or basically if there is any question at all whether or not it was accidental— the insurance company will instead deny your claim. In this case, it is wise to consult with an experienced life insurance claim denial attorney to discuss your options.
When do insurance companies deny ADD&D claims?
Two common reasons insurance companies deny AD&D claims are policy exclusions and they conclude that the cause of death was not accidental or other factors contributed the death of the insured.
It is important to read your policy thoroughly, especially the fine print, to discover any hidden clauses that may exclude you from coverage. The exclusions are often different from your standard life insurance policy.
Most AD&D policies have exclusions —clauses that identify certain circumstances or situations under which you would not be covered in the event of your death. Common AD&D exclusions include suicide, drug overdose, and acts of war.
While standard life insurance will cover you in the event of suicide (provided you’ve passed the contestability period), you will not be covered under your AD&D insurance.
Drug Overdose
This usually applies to illegal narcotics or drugs not prescribed by a physician. However, it can also pertain to prescribed medications as well if there is proof that the death was caused by a dose above the prescribed dosage or if the decedent ignored clear warnings on the label or directly from their physician.
Act of War
Insurance companies protect themselves from a catastrophic payout event that would render them insolvent with Act of War Exclusions. It essentially relieves them of benefit liability if death results from an insurgency, coup de tat, revolution, invasion or act of terrorism.
Defining “Accidental” and cause of death
For insurance purposes, accidental can be defined as any death that is not intended or foreseeable. But that definition is arbitrary and is at the center of many life insurance claim denial disputes.
For example, say a person is in an automobile accident and doesn’t die at the scene, but rather dies later from complications of a concussion that could have been prevented. What was the cause of death? An insurance adjuster and a life insurance claim attorney will likely have to different answers to that question.
Another example would be if someone suffered a heart attack while operating a vehicle and crashed. Did the heart attack cause the crash or did the crash cause the heart attack? Again, there could be different answers depending on who is asked.
What if your AD&D benefits claim was denied?
As you have seen, AD&D claim denials can quickly become complicated. You should never simply take your insurance company’s word that a death wasn’t accidental. If your claim was denied, you probably have a limited time to appeal before your benefits disappear forever.
Our clients have received millions worth of life insurance claim denial settlements. Call us today for a free AD&D claim denial consultation. We are available day and night and will tirelessly fight for you to get you the compensation you deserve.