Accidents are one of the top five causes of death in the U.S., trailing only cancer, heart disease, stroke and lower respiratory disease.  According to the CDC, accidents are responsible for nearly forty percent (38 percent) of all deaths of those age 1-24, approximately one-fourth of deaths of those age 25-44, almost one-third of those age 45 and 64 and one-quarter of those 65 and older.  While life insurance and accidental death policies can provide valuable financial security to replace lost income of a family breadwinner, many beneficiaries are left in a dire financial situation when benefits are denied based on alcohol intoxication.

Life insurance policies or stand-alone accident death or dismemberment (ADD) policies provide coverage for accidental death.  An abundance of case law has been decided regarding what constitutes an accidental death.  Despite extensive litigation of this issue over the last twenty years, there are many policies issued that do not contain an explicit exclusion for alcohol or drug use.  Court decisions have taken conflicting positions on whether a death that involves alcohol or drug use as a factor is an accident under these types of policies.  Case law has developed three basic positions:

Majority View: An accident while one is driving drunk is not an accident that entitles beneficiaries to benefits.

Minority View: Drunk driving is an accident under such policies.

Other Grounds: Some courts have avoided the issue by denying coverage based on a policy exclusion.

The majority of courts deny coverage if a driver is intoxicated when involved in a fatal accident based on the theory that the crash does not meet the definition of an accident.  The courts that follow this reasoning view intoxication as a voluntary act, so drunk driving does not constitute an accident.  Further, the injury does not meet the definition of “accidental” under these policies because the injury or death is not “unexpected”, “unforeseeable” or “unanticipated”.  Courts that take this majority view point out that even if the driver did not foresee or intend harm, a reasonable motorist should know that driving under the influence of alcohol poses a significant risk of injury or death.

The minority view permits a beneficiary to recover for a drunk driving crash.  These courts generally find that a person’s drunk driving death can be accidental because it is reasonable to assume that the driver will not be involved in a motor vehicle crash.  Under this theory, a small percentage of drivers who operate a motor vehicle while intoxicated are involved in collisions, so it is reasonable to believe that an alcohol impaired driver will not suffer injury or death in a crash.  Even if drivers have consumed more than the legal limit of alcohol, they still intend and reasonably foresee arriving at their destination safely.

The third position avoids the question of whether injury or death related to alcohol intoxication is accidental and denies coverage based on an express exclusion for injury or death caused by alcohol or drug use.  In these states, a drunk driver’s beneficiaries cannot recover under the policy if the driver had a blood alcohol concentration (BAC) of .08 percent or above, or the driver’s mental or physical ability to drive was actually impaired.  Put another way, this exclusion applies when a motorist is engaged in DUI/DWI under state law.  In a small number of these cases, courts will deny coverage under the policy exclusion for self-inflicted injuries.  However, this typically requires more than simply drunk driving.  The circumstances must support a conclusion that the drunk driver intended to cause his or her own death.

If you are the beneficiary of a life insurance policy or an ADD policy who is denied benefits because alcohol use played a role in causing injury or death, you might still be entitled to benefits

You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].

J.P. Gonzalez-Sirgo
J.P. Gonzalez-Sirgo, P.A.
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