Many insurance companies attempt to deny life insurance claims by asserting that the policyholder's death was caused by self-inflicted injuries. In the world of life and health insurance, self-inflicted injuries are typically excluded from coverage. A self-inflicted injury refers to any harm intentionally caused by the individual, and many insurers argue that incidents like driving under the influence (DUI) qualify as such injuries.
A notable case that highlights this issue involves a Houston widow who sued Cigna for over $200,000 in denied benefits. The insurance company claimed her husband's death wasn't accidental because he was driving while intoxicated. They argued that her husband should have known the risks of driving under the influence and that his death was a foreseeable outcome, making it a self-inflicted injury rather than an accident.
Despite the widow's efforts to appeal Cigna's decision by providing an affidavit from the medical examiner, stating there was no evidence to suggest that her husband intended to harm himself or expected his death, the company still denied the appeal. Cigna continued to assert that her husband’s death was not an accident, and argued that intoxicated driving is an intentional act, not a mere accident.
What’s crucial here is that the insurance policy did not specifically exclude death resulting from intoxicated driving. The widow’s legal team argued that the death should have been covered under the policy, as there was no exclusion for DUI-related deaths. They also suggested that Cigna’s refusal to pay out the benefits might have been motivated by the company’s desire to reduce claims and increase profits.
This case serves as a reminder that insurance companies often use various tactics to deny claims, especially when it involves circumstances like driving under the influence. If you’re dealing with a denied life insurance claim involving self-inflicted injuries or DUI-related causes, it’s essential to consult with an experienced life insurance attorney. We specialize in helping families recover the benefits they’re entitled to when their claims are unfairly denied.