Can a Life Insurance Claim Be Denied for Drug Use? Yes—But It’s Harder for Insurers to Prove Than You Think
Life insurance companies often include drug use exclusions in their policies, but proving impairment due to non-prescribed drug consumption is significantly more difficult than proving alcohol impairment. These exclusions are frequently misused, and many denied claims are reversed when properly challenged.
While alcohol exclusions are relatively well-known and easier for insurers to enforce, many policies also contain provisions that deny coverage if the insured was impaired by non-prescribed or illegal drugs at the time of injury or death. These clauses are often tucked into the same section as alcohol exclusions but carry far more complexity when it comes to enforcement. Unlike alcohol, which has a clear legal limit and widely accepted testing protocols, drug impairment is a gray area—one that insurance companies routinely attempt to manipulate in their favor.
How Insurers Attempt to Prove Drug Impairment
To rely on a drug impairment exclusion, insurance companies must establish two things: that the insured consumed a prohibited substance and that the substance caused impairment at the time of the incident. While that sounds simple in theory, it’s anything but in practice. State laws vary in how they define impairment, and there is no equivalent to the 0.08% blood alcohol standard. Different drugs metabolize at different rates, affect individuals uniquely, and may linger in the system long after their impairing effects have worn off. All of this creates substantial uncertainty—and an opportunity for beneficiaries to challenge the denial.
In criminal cases, prosecutors routinely struggle to prove drug intoxication in DUI cases. Insurance companies, unlike law enforcement, do not have access to court-level evidentiary tools. Yet, they still often issue denials based on thin or incomplete data. That’s why these types of exclusions are among the easiest to contest with the help of an experienced life insurance attorney.
Step One: Examine the Evidence Cited in the Denial Letter
Insurers cannot deny claims on suspicion alone. The denial letter must reference specific evidence—typically toxicology reports, medical records, or law enforcement documentation. However, these records are often ambiguous or missing key data. For example, a toxicology report might show the presence of THC or opioids but say nothing about the quantity consumed or whether the insured was actually impaired. If the insurer’s conclusions are speculative or unsupported, that denial may be challengeable.
It’s important to insist on full disclosure of the documentation the insurer relied upon. You are legally entitled to access this evidence. Any delay, vagueness, or refusal to produce the full record is a red flag—and may signal a bad faith denial.
Step Two: Identify the Drug and Establish Context
Insurers must specify the exact drug they allege caused impairment. A broad claim of “drug use” is not enough. Was it marijuana? A sedative? A narcotic? Each substance behaves differently in the body, and insurers must show a direct causal link between the substance and the policyholder’s inability to function. Even more, they must prove that this impairment caused or contributed to the death or injury. If they can’t, their denial lacks legal grounding.
Marijuana adds an additional layer of complexity. With recreational and medical legalization spreading across the U.S., denying a claim based on marijuana use is legally risky for insurers. If the policyholder had a valid medical marijuana card, and used the drug under medical supervision, insurers face a steep uphill battle justifying denial—especially if the death was not clearly linked to impairment. Courts in several states have ruled against insurers attempting to use outdated policy language in jurisdictions where cannabis is legal.
Step Three: Know the Law in Your State
Understanding the specific legal definition of drug impairment in your state is critical. Some states require clear evidence of impaired behavior or an expert medical opinion to determine the influence of a substance. Others may rely more heavily on toxicology thresholds. Either way, facts alone are not enough—the insurer’s position must also align with state law.
This is especially important when the cause of death is contested. For example, if the insured died in a car accident and had benzodiazepines in their system, the insurer must show that the medication actually impaired the insured’s judgment or reaction time—not merely that it was present. Presence does not equal impairment, and courts have upheld this principle repeatedly.
The Importance of a Thorough and Strategic Appeal
Appealing a drug-related claim denial requires a methodical approach. First, gather all relevant records, including the denial letter, medical reports, police documentation, and any statements made by witnesses. Second, have these records reviewed by both legal and medical professionals. Expert toxicologists can often discredit insurer claims, especially when impairment is inferred rather than supported by evidence. Third, work with an attorney who understands both the science and the law. These cases often hinge on fine details, and insurers know that most policyholders are not equipped to fight them alone.
In many cases, insurers deny claims based on little more than assumption. They know that policy language—especially around drug use—can be intimidating. But in reality, these denials are often hollow. We've handled cases where the drug cited was medically prescribed, or where the impairment assumption was based on irrelevant timelines or incomplete reports. In each case, once we pressed for evidence, the insurer was unable to prove its case—and the denial was reversed.
Never Accept a Drug Use Denial Without a Fight
Insurers rely on ambiguity to deny drug-related claims. But their burden of proof is high—and most can’t meet it when properly challenged. If your loved one’s life insurance claim was denied because of alleged drug use, you may still be entitled to full benefits. Whether the drug was marijuana, a prescription opioid, or another controlled substance, you should not accept a denial based solely on presence or suspicion.
Let us help. We specialize in life insurance claim denials, particularly those involving exclusions for drugs or alcohol. We understand the legal landscape and the tactics insurers use. More importantly, we know how to dismantle weak claims and hold insurers accountable for bad faith conduct.