Life Insurance Lawyer Hawaii
Our Hawaii life insurance lawyers are here to help. Call us at 800-330-2274 for a free consultation.
To dispute a life insurance denial based on illegal drug use, the beneficiary or the insured's estate may need to obtain legal counsel and provide evidence to support their case. This may include medical records, toxicology reports, witness statements, or other relevant information. It may also be helpful to review the specific language of the policy to determine if there are any loopholes or ambiguities that could be used to argue for coverage. Ultimately, the success of any challenge to a life insurance denial based on illegal drug use will depend on the individual facts and circumstances of the case.
Settled Life Insurance Claims in Hawaii
- Metropolitan Life lapse of payment $97,000.00
- CMFG Life coronavirus denied payment $30,000.00
- Banner Life sickness exclusion we won $105,000.00
- Denied SGLI claim beneficiaries $403,127.00
- Accidental Death & Dismemberment $890,000.00
- Navy Life girlfriend versus ex-spouse $406,430.00
- Woodmen Life prescription drug denial $65,000.00
- Accordia Life lapse of policy we won $50,000.00
- Lafayette Life felony exclusion resolved $25,000.00
- Symetra long delay of payment resolved $77,000.00
- AD&D denied life insurance claim won $740,000.00
- AIG autoerotic asphyxiation denied claim $508,700.00
- Forethought Life alcohol exclusion $159,000.00
- CNO Financial coronavirus exclusion $51,000.00
- Globe alcohol exclusion drunk driving $113,250.00
- Confederation Life denial of benefits $77,000.00
- Guarantee Security Life delay of claim $40,000.00
- Maui mistake as to age on application $526,000.00
- ERISA appeal of the life benefits won $104,000.00
- Denied FEGLI claim resolved in 5 days $179,000.00
- SGLI beneficiary dispute wife and ex-wife $400,000.00
- Prudential irrevocable beneficiary dispute $364,000.00
- AIG AD&D denial not accidental $512,430.00
- Principal material misrepresentation $105,312.00
- Denied SGLI claim dispute $402840.00
- Hawaii denied life insurance claim $1,300,000.00
- Oahu agent filled out the application $465,000.00
- Fidelity 2 year contestability period $138,000.00
- Denied AD&D claim shooting $730,900.00
- Colonial suicide clause exclusion $282,000.00
- VGLI appeal successfully resolved $400,000.00
- Gerber beneficiary dispute interpleader $370,000.00
- Denied life insurance claim Hawaii $518,400.00
- Honolulu dispute among beneficiaries $1,020,000.00
- Metlife accidental death benefit exclusions $430,000.00
- SGLI dispute who is beneficiary $400,000.00
- Bankers drug overdose denial $212,900.00
Hawaii Life Insurance Law
If your hobbies cost you higher premiums, your beneficiaries should be protected
It goes without saying that life insurance companies, like most for-profit businesses, exist for the sole purpose of making money. One of the key strategies they employ for doing this is to collect the highest premiums possible from policyholders, while paying out the fewest amount of claims when those people die.
As attorneys who specialize in contesting the wrongful denial of life insurance claims, it never ceases to amaze us just how underhanded life insurance companies can be in carrying out this strategy. One of the best examples involves the interplay between two provisions that are used in almost all life insurance policies – the “inherently dangerous activities” clause and “intentional self-harm” clause. This article explores how life insurance companies manipulate those provisions to try to deny completely legitimate claims for death benefits.
Inherently dangerous activities and life insurance
On some level, none of us are shocked that life insurance companies exist to generate revenue. Thus, it is understandable that they charge increased premiums for policyholders who have a greater chance of dying early in life than others.
A prime example of this involves what life insurers call “inherently dangerous activities.” As the name suggests, inherently dangerous activities are sports, hobbies, or other activities that put a person in somewhat regular danger of being seriously hurt or killed. They include things like downhill skiing, skydiving, SCUBA diving, motocross racing, and rock climbing.
Life insurers would go broke quickly if they treated people who engage in these activities like they treat all other policyholders. While the actual risk of dying from these activities may not be extreme, the truth is that people who engage in these hobbies die more frequently than their peers who abstain. Consequently, life insurance companies require policy applicants to reveal their participation in such activities when they are applying for insurance.
Once it comes to issuing a life insurance policy for these individuals, the insurance company charges higher premiums because of the greater risk of being injured or killed during an “inherently dangerous activity.” That seems logical.
What people expect in return, however, is that insureds who have: (a) truthfully revealed their participation in inherently dangerous activities; and (b) paid higher premiums to be insured notwithstanding those activities, will have their beneficiary’s death benefit claims paid without exception. Unfortunately, that is not always the case.
Self-inflicted injury and life insurance
Life insurance companies do not make the payment of claims that easy. To the contrary, they purposefully write-in other policy provisions that will help them deny death benefits regardless of the policyholder’s payment of higher premiums due to their dangerous hobbies.
Specifically, life insurers consistently try to deny valid claims based on what they refer to as “intentional self-harm” clauses. A real-life example from a case out of Alaska illustrates this scheme perfectly.
A 49 year-old man named Tom sought a life insurance policy after he married his wife Rita. The policy application asked Tom if he participated in any dangerous hobbies. Tom truthfully responded that he was an avid skydiver, averaging some 50 jumps per year.
The life insurance company issued Tom a policy, but they charged him nearly 40% higher premiums than other men his age. The justification for the high premiums was that skydiving is “inherently dangerous.” Thus, according to the insurance company, Tom was at a greater risk of death than other men his age. Tom understood this and paid his increased premiums without fail each and every month.
Three years into the policy term, Tom was at a skydiving event in southern Alaska. While performing what was intended to be a routine skydive, Tom’s parachute failed to open. On that particular jump, Tom was not wearing a backup parachute. Tom died as a result of the fall. Several weeks later, his wife Rita submitted a claim for death benefits with Tom’s life insurer. Because Tom had paid so much higher premiums due to his skydiving hobby, Rita was certain the claim would be paid.
An unexpected denial of life insurance benefits
Much to Rita’s surprise, a claim denial arrived in the mail some two months later. It contained the following justification for the denial:
While we understand and agree that the policyholder paid increased premiums due to his skydiving hobby, that does not require us to pay death benefits in every instance. Please note policy provision 22.4 which specifically excludes coverage if the insured engaged in intentional self-harm.
We note that at the time of his death, the insured was skydiving without a reserve parachute, which is common within the sport. From this failure to maintain even the most basic safety guidelines of his sport, we presume that the policyholder took intentionally unsafe acts to hasten his own death. As such, we must deny coverage under provision 22.4.
Life insurance companies play this game all the time. They allow a policyholder to pay high premiums in exchange for the unfettered right to engage in dangerous hobbies, only to deny death benefits based on a claim of “intentional self-harm” if the insured dies during one of those events.
Fortunately for Rita, a friend suggested she contact an attorney specializing in the wrongful denial of death benefits. After reviewing her file, the attorney agreed to take Rita’s case against the life insurance company on a contingency basis. The also attorney agreed that the claim denial seemed bogus, and sued the life insurer on Rita’s behalf.
Ultimately, the court agreed that Rita was entitled to the full death benefits, plus interest. In its ruling, court noted that Tom had specifically asked for (and paid higher premiums for) a policy that would cover his participation in skydiving. It also noted that there was no external evidence of Tom’s intention to harm himself. These two factors persuaded the court to side for Rita.
We have dealt with scenarios like these over and over through the years. If you have had a claim denied based on similar circumstances, please give us a call.
We’re here to help.