It’s still possible to get a denied accidental death claim paid despite an intoxication exclusion.

In one case, a young man drowned in a river after attempting to kayak with friends down the turbulent waters of a dam. Toxicology results revealed a blood alcohol content (BAC) of 0.12%, well above the state’s legal limit of 0.08%. The parents’ claim for their son’s accidental death policy benefit was denied. The policy contained an “intoxication exclusion,” which denies payment of the death benefit when the insured’s intoxication contributed to the accident. The Life Insurance Lawyers agreed to represent the parents, and they appealed the denial.

The lawyers argued that the cause of death was drowning and the manner of death was an accident. They discussed and analyzed the relevant law, and they explained that the alleged fact of alcohol intoxication was irrelevant to the accidental death policy.

The lawyers pointed out more flaws in the company’s denial. The alleged ethanol level in the man’s body was misleading, for example. His body was in the river for three days before being discovered. The advanced decomposition indicated that alcohol was produced after death, which would have skewed the BAC result. Moreover, the blood used for testing was taken from the heart, when other sources of blood should have been considered.

All of these facts, legal analyses and arguments were significant. Still, the insurance company insisted on additional proof of decomposition, such as death scene photographs and autopsy photos. The lawyers worked with the coroner’s office and obtained these items to provide further proof.

The company reversed its denial and paid the claim. The parents intended to use the insurance proceeds to raise awareness about the dangers of kayaking around dams.

Each case is based on different facts, laws, and circumstances. With every case, the Life Insurance Lawyers use their legal experience and medical knowledge to make persuasive arguments with the goal of getting clients the benefits they deserve.