The Importance of the Death Certificate in Life Insurance Claims 
The death certificate is a critical document in the life insurance claims process. It provides a detailed account of the cause of death, which can help life insurers determine whether the policyholder’s death falls within the terms of the policy. Life insurance companies rely heavily on the information provided in the death certificate to process claims accurately.
For most policies, the primary question insurers ask is whether the death is accidental, natural, or the result of some other factor. If the death certificate lists alcohol or drug use as a contributing cause, the insurer may investigate whether this factor falls within the scope of any exclusions mentioned in the policy. In many cases, insurers will review the circumstances around the death to determine if the substance use played a direct role in the individual’s passing.
Can Insurers Deny a Claim Based on Alcohol or Drug Use?
Life insurance policies often contain clauses or exclusions related to dangerous or risky behavior, which may include alcohol and drug use. These exclusions can vary significantly depending on the insurance provider and the specific terms of the policy. For example, some life insurance policies may have provisions that deny claims if the insured person’s death is a result of drug overdose or alcohol-related accidents.
Common Exclusions in Life Insurance Policies
Policies often include a suicide clause, which typically denies benefits if the insured person dies by suicide within the first two years of the policy. Another common exclusion is related to deaths caused by alcohol or drug intoxication. Some life insurers may stipulate that if a policyholder dies while under the influence of alcohol or illegal drugs, the death is not covered under the policy. Additionally, certain high-risk behaviors, such as participating in dangerous activities while intoxicated or engaging in illegal drug use, can trigger policy exclusions. In these cases, if the insurer can prove that the death was related to substance abuse or an overdose, they may attempt to deny the claim.Understanding Substance Use Clauses
Even if a policy does include such exclusions, it’s important to understand the language in the policy. Insurers can only deny a claim if the policy language explicitly covers the situation. For example, a policy might cover accidental death or death resulting from an overdose, but it may not cover deaths from a self-inflicted injury caused by alcohol intoxication. In these cases, the specific wording of the exclusion becomes crucial in determining whether the insurer has grounds to deny the claim.
We contacted Trief & Olk to help us with a life insurance issue and Shelly Friedland was the attorney assigned to our case. Before Shelly took our case she explained to us that the likelihood of our success without going to court was possible but not likely. Unfortunately we did not get the outcome we had hoped for but it was our decision to not move forward and have our case litigated. Shelly is very knowledgeable and was very straight-forward in her assessment of our case as we moved forward. She was very patient and thorough in answering our questions. She always responded in a timely manner and listened to our concerns. We would certainly recommend Shelly and would use her firm again in the future.”
- John Ramig
If there is any possibility of winning your life insurance case – this is the place to do it for you. They are efficient, honest and will achieve the best possible outcome.
Shelly Friedland worked on my case where a life insurance policy had lapsed and was even a few days beyond the grace period. Farmers had rejected my claim twice and was unwilling to take a second look. Shelly was able to get them to pay the entire claim without going to court, and the full amount was deposited in my account within a couple months. Highest recommendation.”
- Kathleen Brown
Trief & Olk is a superior law firm. Their attorneys and other legal professionals have a brilliant understanding of the law and the litigation process. They diligently perform their work in an efficient, strategic and cost-effective manner to ensure the best possible outcomes for their clients.
- Christopher Hughes
The Incontestability Clause: Protecting Beneficiaries from Denials
While life insurance companies may try to deny a claim based on alcohol or drug use, the incontestability clause in many life insurance policies offers some level of protection for beneficiaries. This clause typically states that after a policy has been in force for a certain period—usually two years—the insurer cannot contest or deny the claim based on misrepresentation, unless fraud is involved. If a life insurance policy has been active for two years or more, insurers can no longer use the death certificate or the insured’s alcohol or drug use as a reason to deny the claim, unless there was an intentional misrepresentation on the application. In cases where the insured did not disclose a history of substance abuse or where there was some other form of fraud, the insurer may still contest the claim. However, if there is no evidence of fraud or misrepresentation, the incontestability clause prevents the insurer from denying the claim based on substance use alone.Challenging a Denied Life Insurance Claim Due to Alcohol or Drug Use
If an insurer denies a claim based on alcohol or drug use, it doesn’t mean the matter is settled. In many cases, claim denials can be appealed. Beneficiaries have legal recourse to challenge the denial, especially if they believe the insurer is misinterpreting the policy or if they feel the denial is unfair.Life Insurance Denial Statistics
20%
The annual average number of life insurance claims denied.
$50 Million
The yearly average dollar amount of claims denied by life insurance companies.
.2%
The number of claims appealed annually by consumers.