Life Insurance Lawyer Michigan
Whether you reside in: Dearborn; Flint; Ann Arbor; Lansing; Sterling Heights; Warren; Grand Rapids or Detroit; our life insurance attorneys who live and work here in Michigan are here to help resolve your delayed or denied life insurance claim.
What if you die while doing something really dumb?
It is hard to deny that certain people, at certain times in their lives, are more likely to make poor decisions than others. Insurance companies recognize this and set premium rates accordingly. Teenage drivers, for example, tend to pay higher rates for car insurance than older individuals because they generally lack the experience and maturity it takes to safely navigate the roadways.
Life insurance is slightly different. Aside from actuarial tables dictating that older individuals pay higher life insurance premiums, it is hard for a life insurance company to predict with any degree of certainty whether a person in a particular age group is more likely to engage in conduct that increases the likelihood of death.
Consequently, life insurance companies simply draft broad policy language that exonerates them from paying death benefits if the policyholder dies while doing something … well, stupid. That’s not what the policy actually says, of course. Instead, the policy will say something along the lines of “the insurance company is not obligated to pay a death benefit to the insured’s beneficiary if the policyholder dies as a direct and proximate result of voluntary and wantonly exposing himself to unnecessary and known danger.”
As one Illinois family found out, however, life insurance companies often rely too heavily on such language as an excuse for denying valid claims. This article explores a case that tested the boundaries of this sort of policy language. The results may surprise you. They may also give you hope.
A night on the town turns ugly
This case involved a group of friends who might be described as “rowdy.” On the night in question, five men in their 30s all went out for a night on the town. They were reported to have visited several bars and taverns throughout the evening, yet the records are unclear as to whether the young man driving the car had anything to drink that night.
As the group left the last establishment of the evening, a man named Derrick was feeling especially boisterous. As his buddies all climbed into the driver’s sedan, Derrick decided to jump onto the roof of the car and hang on for dear life as the car drove off into the night. Derrick was a rather tall and strong young man, and the sheer length of his arms allowed him to hold onto the roof of the car perhaps better than most.
In fact, Derrick had ridden on the roof of this car several times before. Additionally, several of his friends had also taken a “roof ride” over the course of the past several months. Until the night at issue, this activity had been nothing but a silly game played by a group of friends who liked to party and have fun.
On this fateful night, however, things didn’t go as they had before. Rather, as the driver sped away from that final tavern, Derrick lost his grip on the roof of the car, slid off, and hit his head and neck directly on the pavement. Derrick’s friends didn’t even know anything was wrong until they drove back that way sometime later and found his deceased body lying in the roadway.
A young widow is scared to make a life insurance claim
Unfortunately, Derrick left behind a young widow named Nancy. Nancy didn’t know much about the law or about life insurance but she was almost embarrassed to make a claim for death benefits against Derrick’s life insurance policy. Nonetheless, she really needed the $100,000 payout if she was ever going to get her life back on track without him. She submitted the claim, which included police reports of the incident, as well as a toxicology report showing that Derrick’s blood alcohol content was .16%.
It didn’t surprise Nancy one bit when the insurer denied her claim. While she never read the policy language, she was pretty sure the insurer wouldn’t cover a death that happened while the insured was doing something she viewed as incredibly stupid.
Fortunately, one of Nancy’s friends was not willing to give up so easily. The friend talked Nancy into talking with a lawyer who specialized in the wrongful denial of life insurance claims. Nancy forwarded the lawyer Derrick’s policy and later had a one-hour consultation with him.
Derrick’s case was not as cut-and-dried as Nancy originally believed. According to the attorney, it was highly relevant that: (a) Derrick had engaged in “roof-rides” many times before; (b) his friends had done the same; and (c) up until the night in question, none of them had ever suffered any injuries. The lawyer knew that courts tend to construe policy language in a light most favorable of the insured. In light of all that, he thought he might be able to convince a court that Derrick’s actions were not the type of “known danger” that would justify a claim denial.
With Nancy’s blessing, the lawyer sued the life insurance company for wrongful denial of claim. As it turned out, Nancy’s lawyer was correct in his assumptions. The court did find that the past actions of Derrick and his friends (without injury) took Derrick’s actions out of the realm of a “known danger.” As such, the court ordered the insurance company to pay Nancy the full death benefits, with interest.
The moral of this story is simple: beneficiaries who have had a life insurance claim denied should never take the insurance company’s initial denial letter as the final word on the matter. This area of the law tends to favor policyholders over insurance companies. Cases with even the most embarrassing factual scenarios can be won.
As attorneys who specialize in the wrongful denial of life insurance claims, it is our job to help assess your case and get you the benefits you deserve. If you are facing a life insurance claim denial – no matter what the circumstances of your loved one’s death – call us today. We’re here to help.
- 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.