Insurers Continue to Try to Avoid Their Obligations Under Accidental Death Policies

Most people would say that if a person dies in an unexpected automobile crash, the person’s death was an unintended accident.

Not according to life insurance companies! Earlier this year (link:
), we mentioned a case we are handling involving accidental death insurance. In that case, our client’s claim was denied by Life Insurance Company of North America (LINA), a unit of Cigna. LINA contended that the car crash in which our client’s husband died wasn’t really an “accident” under the policy because the husband was driving drunk.

We prevailed in our argument that LINA used the wrong definition of “accident” in making its decision, and the court sent the case back to LINA to make a new decision under the right definition.

However, this is only one tactic used by life insurance companies. We have another case in our office involving a different insurer, Aetna Life Insurance Company. The facts are similar: a husband was driving drunk, failed to negotiate a turn, crashed, and died in a collision.

Unlike LINA, Aetna admits that this crash was an “accident” under its policy. However, Aetna refuses to pay the wife’s claim for benefits. Why? Because the policy has a limitation that says no benefits are payable if the death was caused or contributed to by “intentionally self-inflicted injury.”

Aetna contends that even though the husband “may not have set out to hurt himself he was aware of the consequences of his actions, and made the decision to drive under the influence of his own volition, thus his actions and the result of those actions were intentional and self-inflicted.”

Needless to say, this argument is absurd. The husband was happily married with a son and many friends. On the day before his death he and his wife took their son to a T-ball game and were looking for a new house. He was in good health and had been working out recently to lose weight. There is simply no evidence that the husband intended to hurt himself in any way. Indeed, the coroner’s report declared his death to be an “accident” and did not list any other contributing factors.

To be sure, the husband should not have been driving while drunk. But just because someone is driving drunk does not mean he is intending to hurt himself. Quite the opposite – drunk drivers, like all drivers, are simply trying to get somewhere.

We expect to prevail in this case, just as in our case with LINA, and we hope that our success in cases like these forces insurers to reevaluate the way they handle accidental death claims involving drunk drivers.

If you need help with a life insurance claim, let us know.

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