It’s No Accident: Life Insurance Lawsuits Over Cause of Death
Accidental death insurance policies cover causes of death that are unrelated to a person’s body. If the death can be connected to an illness or the policyholder’s physical condition, claims will not be paid.
Causes of Death That Are Likely to Result in Denied Accidental Death Insurance Claims
Lawsuits related to life insurance often occur over accidental death insurance claims because insurance companies apply the narrowest definition of accident possible. For example, if a person has an operation for an illness or a medical condition and the physician makes a mistake that results in death, the insurance company is likely to say the death is not covered because if the person had not needed surgery for an underlying condition, the accident would not have occurred.
Similarly, if a policyholder dies in a car crash and the accident was caused by the policyholder having a heart attack, the claim will be denied. The insurance company will claim that the heart attack was actually the cause of death, not the auto accident.
While death as a result of drugs or alcohol is often excluded from both standard life insurance policies and accidental death policies, sometimes it can be hard to determine whether the substance caused the death. For instance, if an insured drowns at the beach because the waves are rough and there is a strong rip current, but she or he was drinking before going in the water, the insurance company may deny the insurance claim. However, because of the strength of the rip tide, any swimmer caught in it would have drowned.
Sometimes accidents result in death, but a long amount of time passes between the two events. A person may be injured in a car accident, lapse into a coma and eventually die. Many accidental death policies only pay if the death occurs within a certain number of days after the accident. If the death does not occur within that timeframe, the insurance company will not pay, even though the original event that led to the death was an accident.
Accidental death coverage usually does not extend to complications from injuries sustained in an accident. If a car accident victim required surgery, contracted an infection while in the hospital because of the surgery, and died from the infection, an insurance company may claim that the infection, not the accident was the direct cause of death, and therefore not pay.
Reasons for Accidental Death Coverage
Since accidental death policies are so limited in scope, who is buying them? One group of people is young people in good health who are concerned about burial costs. Accidental death premiums are much lower than standard life insurance premiums. Since the policyholder does not expect to die because of poor health or disease and is not looking to support dependents for a long time on the proceeds, the accidental death policy may be appealing.
In addition to this demographic, many people who have accidental death coverage receive it through work. Some employers pay for accidental death and dismemberment benefits for their employees.
Insurance attorney Chad G. Boonswang has filed many insurance-related lawsuits to ensure that life insurance beneficiaries obtain the benefits to which they are entitled. Contact Boonswang Law today for your free consultation.by