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Common Life Insurance Exclusions Include Substance Abuse and Suicide

Top Reasons Life Insurance Claims Get Denied

An important piece to any life insurance policy with which one should become familiar is the policy’s exclusions.  Exclusions in a life insurance policy are provisions that set forth certain situations in which the life insurance company will not pay out the death benefit.

The most common exclusions relate to suicide, self-inflicted injury, illegal drugs, alcohol, prescription drugs, sickness, and/or felonies.

Life Insurance Suicide Exclusion

If your life insurance policy has a suicide exclusion, this means that the beneficiaries will not receive the benefits of the policy if the insured person died by committing suicide.  Suicide clauses often differ depending on what state’s law applies to the policy.

These exclusions commonly state something along the lines of, “if you commit suicide within the first two years of this contract, the beneficiaries will receive a premium refund, but not the death benefit.”

One common complication with enforcing suicide exclusions is proving that the insured actually committed suicide.  It is not uncommon for an insured to die accidentally, resulting in what might look like a suicide. One case in which we got our beneficiary client paid arose when the insured died due to autoerotic asphyxiation. The autopsy stated that the cause of death was accidental, as the insured had laid out clothing for the next morning. The insurance company had the burden of proving that the insured “purposefully injured himself” (an exclusion) and could not as there was evidence the insured intended to survive.

Keep in mind that although we were successful in this case and many others, we cannot guarantee the result of any other matter. But we can guarantee that at the Boonswang Law Firm, our attorneys have extensive experience in taking on the challenge of disputing these suicide exclusions.  As a result of our skill and knowledge in insurance law, we have been able to successfully obtain death benefits for clients who had previously been denied payment in the face of suicide exclusions.

Life Insurance Drug Exclusion

Many policies also have exclusions that will prevent a beneficiary from receiving the death benefit if the insured died as a result of illegal drug use and/or even prescription drug use.

Insurance companies often apply this exclusion in situations where marijuana or some other drug was found in the insured’s toxicology report after the death.  Insurance companies also will apply the exclusion in cases involving heroin overdoses or when someone took too many prescription pain pills.

Some states, however, have laws that provide protections for life insurance policyholders who are prescribed narcotics or who are deemed disabled due to addiction.

One recent case in which we were successful in getting our client beneficiary paid arose when the insured died in a motorcycle accident. The toxicology report stated that the insured had “acute amphetamine intoxication” so our client’s death benefit claim was initially denied.  However, ultimately it was determined that the insured died as a result of injuries sustained in the motorcycle accident some several weeks later, not from a drug overdose the day of the accident.

Of course, we cannot guarantee the result of any matter. However, our attorneys at The Boonswang Law Firm are extremely knowledgeable in life insurance laws across the country and of the nuances one must argue when faced with claim denial due to policy exclusions. Our knowledge and experience help us to zealously fight for our clients and get them the death benefits they deserve.

Experienced Life Insurance Lawyers

When a life insurance company denies someone death benefits due to an exclusion in the policy, it is not always the end of the story.  Here at The Boonswang Law Firm, we have helped countless beneficiaries receive benefits from a policy when they were initially told that they were being denied due to an exclusion.

It is common for life insurance policies to contain these exclusions, and even more common for the insurance companies to utilize them whenever they can.  Sure they will – they only make money when they DON’T pay claims! Our attorneys at The Boonswang Law Firm are trained and adept with assisting beneficiaries who have been denied benefits due to a life insurance policy’s exclusion. Call us today.

Written By: Chad Boonswang
Chad G. Boonswang, Esquire is a litigation lawyer based in Philadelphia, PA. Selected as an ASLA 2014, 2015, 2016, 2017 and 2018 Top 100 Litigation Lawyer, Mr. Boonswang plays to win. As a lawyer, athlete, and scholar, he has always put in the energy, time, and commitment to be the best. After working for several prominent law firms in Philadelphia, including Montgomery McCracken Walker & Rhoads LLP, he founded his own practice in 2002.  Since then Chad has recovered tens of millions of dollars on behalf of his clients from life insurance claims and catastrophic injury cases.  Year after year, he has earned a 10.00 Superb rating on Avvo.

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