$101,250 Ethos Denied Life Insurance Claim: Victory Against “Criminal Activity” Exclusions
When a loved one passes away, the last thing a family expects is to have their life insurance claim denied—especially during such a vulnerable and difficult time. Unfortunately, insurance companies like Ethos have increasingly relied on “criminal activity exclusions” to avoid paying out death benefits. At LifeInsuranceAttorney.com, we fight these denials—and we win. Our legal team recently secured a $101,250 payout on a denied Ethos life insurance claim, successfully challenging an illegal acts exclusion.
We've also defeated similar denials from other major life insurers including Globe Life, Mutual of Omaha, Mass Mutual, AARP, Corebridge, Americo, Zurich, Liberty Mutual, and more.
What Are Criminal Activity or Illegal Acts Exclusions?
Many life insurance policies include exclusions that allow insurers to deny a claim if the insured dies while participating in unlawful activity. These are often labeled as:
Felony exclusions
Illegal acts exclusions
Criminal conduct clauses
These clauses are intended to protect insurers from moral hazard—where beneficiaries could profit from unlawful conduct—and to discourage risky or reckless behavior. However, insurers often interpret these clauses broadly, denying claims even when the criminal activity was minor or tangential to the cause of death. That’s where our legal expertise makes a difference.
How Insurance Companies Use These Clauses to Deny Claims
Life insurers will scrutinize the circumstances of a death to determine whether any criminal act occurred—even if the policyholder was never convicted or if the incident involved alleged misconduct. Insurers argue that deaths occurring during or as a result of illegal activity fall outside the policy’s coverage. However, the language in these exclusions is often vague or overreaching—and we use that ambiguity to our clients’ advantage.
Real Cases Where Denials Were Overturned
In one high-profile case, a New York man died during a police chase. The insurer, Lincoln National, denied the life insurance claim, citing an illegal acts exclusion. Their argument was that he died while committing a felony—namely, fleeing from law enforcement at high speed. Our firm fought this classification, arguing that the exclusion was overly broad and did not clearly apply to the facts of the case. We won.
Another case involved a Philadelphia man who died in a car accident while transporting narcotics and fleeing police. Haven Life denied the claim based on drug trafficking-related activity. However, the actual cause of death was the accident—not drug use or overdose—and we proved that the exclusion was misapplied.
In a third case, Brighthouse Financial denied a claim after a man was killed during an attempted robbery. The company pointed to the policy’s felony exclusion clause. We challenged the policy language and the insurer’s interpretation, showing that coverage could not be denied without clear evidence that the policyholder’s conduct directly caused the death in the context of the exclusion. Once again, we prevailed.
Why These Exclusions Are Not Always Ironclad
The key to successfully fighting illegal acts exclusions lies in the wording of the policy and the specific facts surrounding the death. Insurance companies must prove a direct and causal link between the criminal activity and the death. This is often more difficult than they portray. Many denials rely on assumptions, circumstantial evidence, or police reports that lack full legal context.
Our legal team challenges the denial by asking the following:
Was the insured convicted of a crime related to the incident?
Was the activity actually a felony or just a misdemeanor?
Was there intent to commit a crime, or was it accidental?
Did the policy clearly define the terms of the exclusion?
Did the criminal activity cause the death, or was it incidental?
If the insurer cannot establish that the exclusion applies beyond a reasonable doubt, we fight for—and win—the full benefit.
Why You Need a Life Insurance Lawyer for These Cases
Insurers count on families giving up when they hear legal language like “felony exclusion” or “illegal acts clause.” They may send a cold, legalistic letter that makes the denial sound final. But it’s not. These exclusions can be fought, especially when they’re based on vague language, weak evidence, or overly broad interpretations.
Our attorneys at LifeInsuranceAttorney.com are experts in denied life insurance claims involving criminal activity. We’ve won cases others thought unwinnable, secured payouts where policies were voided, and forced insurers to honor their obligations.
If your life insurance claim was denied by Ethos—or any other insurer—we will fight back for you.
FAQ About Life Insurance Denials Involving Criminal Activity
Why do life insurance policies have criminal activity exclusions?
These exclusions are intended to prevent insurers from paying claims tied to unlawful behavior. Insurers argue that they shouldn’t have to pay if the insured died while committing a crime.
Can a claim be denied even if the insured wasn’t convicted?
Yes. Insurers often deny claims based on police reports or circumstantial evidence, not criminal convictions. We challenge those assumptions in court.
Does the type of crime matter in these exclusions?
Absolutely. Many policies specify that only felonies are excluded. If the activity was a misdemeanor—or the legal classification is unclear—we can fight the denial.
What if the death was accidental but occurred during criminal activity?
That’s a common scenario. We argue that accidental deaths are not intentional and may not be excluded—even if the insured was breaking a law at the time.
Can family members sue the insurance company after a denial?
Yes. If the claim is wrongfully denied, you may pursue legal action to recover the policy benefit. Our attorneys handle these lawsuits regularly.
What kind of evidence do insurers use to deny claims?
Police reports, coroner findings, toxicology results, witness statements, and any mention of criminal behavior. We challenge how this evidence is interpreted.
Are all criminal activity exclusions valid?
No. Some are vague, overly broad, or unenforceable under state law. We analyze each policy carefully to determine if the exclusion is legally valid.
Do courts favor the insurer or the beneficiary in these cases?
Courts often interpret ambiguous policy language in favor of the beneficiary. That gives our legal team a powerful advantage in challenging vague exclusions.
Can exclusions apply if the policyholder was in the wrong place at the wrong time?
Not typically. If the insured was an innocent bystander or had no intent to commit a crime, the exclusion likely does not apply.
What insurers deny claims based on illegal activity?
We’ve handled denials from Ethos, Globe Life, Mass Mutual, AARP, Corebridge, Zurich, Liberty Mutual, and others. These insurers often overreach—but we push back.