What is "Accidental Death" in Life Insurance Policies?

Families rely on life insurance companies to pay death benefits when a family member accidentally dies. It's especially important that they be paid promptly if the breadwinner is the one who died. But life insurance companies have many escape routes that help them avoid paying benefits which families believe they paid for.

First, consider case law that, in many cases, creates an "out" for insurance companies. Suppose that a man gets seriously drunk, gets behind the wheel of his truck, heads home, and runs off the road. He's killed when his truck smashes into a tree. Is that an "accidental death" under a life insurance policy? Not according to a South Carolina judge who ruled that "[a] death that occurs as a result of DWI, although perhaps unintentional, is not an accident, because that result is reasonably foreseeable." Other courts have ruled differently. A California court has ruled that a death is accidental if it was "unexpected or unintentional." Construing what is unintentional raises other problems, though.

In another state, a motorcyclist died when his bike went out of control rounding a curve. He was highly intoxicated. The insurance company refused to pay the accidental death benefit, arguing that the death was not an accident, but was instead a self-inflicted injury since he intentionally drank the alcohol. The trial court disagreed, saying that an accident is a happening by chance, and the evidence showed that the man "fully intended to survive his ride home." You see the problem among different courts. Many policies have been bought in other states by people who are now Florida residents.

In the next couple weeks, I'll return to this subject to discuss policy language that provides other escape routes used by insurance companies to deny payment of accidental insurance benefits. For your financial planning, you need to know how these things work.

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