If your life insurance claim has been denied, you may feel confused and frustrated. After all, the essence of a life insurance policy is in the insurer’s promise to make a payout upon the insured’s death.
Unfortunately, that promise is not always kept. Almost every life insurance policy has a list of exclusions which outline scenarios of when the insurer will not pay the claim. What is alarming is that these reasons not to pay your life insurance benefits can often be interpreted in such a way that almost any death falls outside of the coverage area.
Illegal drug use is one of the reasons the insurance company will not pay your benefits. Keep on reading to find out how to fight this and win your case!
Will life insurance pay/cover for a drug overdose?
When dealing with a claim denial due to marijuana use, the most common reasons insurance companies use for refusing to pay are material misrepresentations on the application and drug exclusions in accidental death cases.
The illegal drug use exclusion states that the insurance company will not pay the claim if the insured’s illegal drug use caused or contributed to the death of the insured. This exclusion can be very broad and can encompass almost all cases where it has been determined that the insured had drugs in his/her system at the time of the death.
What exactly constitutes illegal drug use can be challenged by a life insurance attorney experienced in such cases.
It is not uncommon for insurance companies to deny claims based on the drug use exclusion in cases where the insured had used marijuana prior to his/her death. If marijuana intoxication from cannabis-infused cookies or other edibles is listed as a significant condition contributing to the death in the coroner’s report, the insurer will undoubtedly apply the drug use exclusion as a reason not to pay the claim.
Material Misrepresentations on the Application
When people apply for life insurance, they are asked to complete an application and answer several medical questions.
Applicants are expected to provide honest answers on which insurance companies rely when they issue policies. Where a question on the application asks about the insured’s drug use or prescription medication use, cannabis use should be disclosed. Since life insurance companies are not required by law to investigate the medical history of an applicant prior to issuing a policy, they generally take an applicant’s answers as true and correct.
If the insured dies within the first two years from the date the policy was issued, the insurance company will check the insured’s medical records to see if there are any inconsistencies with the answers provided on the application. Thus, if the insured used cannabis and did not disclose it on the application, the insurer may treat the nondisclosure as a material misrepresentation and deny the claim.
The outcome will depend on the laws of the state where the policy was sold.
If the policy was taken out in one of the states where cannabis use is legalized, the denial should be challenged. A life insurance lawyer experienced in this field will help you fight your unfairly denied claim.
If marijuana intoxication is listed in the blood results as a significant condition contributing to the death in the coroner’s report, and if the toxicology report shows marijuana in the insured’s system, the insurer will undoubtedly apply the drug use exclusion as a reason not to pay the claim.
Beneficiaries whose life insurance claims have been denied due to marijuana use should seek legal advice from an experienced life insurance lawyer. Since cannabis laws in different states vary, a life insurance attorney experienced in marijuana-related cases will guide you through the appeal process and will help you understand your options.
However, you do not have to accept the denial of your claim as the final verdict. The use of marijuana is legalized in 23 states.* In 4 out of those states (Alaska, Oregon, Colorado and Washington), the use of marijuana is not only authorized for medicinal purposes, but also for recreational consumption.
*Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oregon, Rhode Island, New York, Washington.
It means that the use of marijuana can be legal depending on whether the state where the insured consumed marijuana had legalized cannabis use, whether the dose consumed was in the proper range and whether there were valid prescriptions (medical marijuana cards) for medical marijuana. After a thorough investigation, it may be determined that your claim should be paid but that the insurance company wrongfully denied by misinterpreting the drug use provision or not considering state legalization of marijuana.
It is important to remember that not all life insurance cases are controlled by state laws.
Many claim denials are governed by federal laws. Federal law does not yet recognize medical marijuana.
For example, group life insurance claims (cases where the insured obtained an employer-provided policy), FEGLI, VGLI and SGLI claims are controlled by federal statutes. Federal law does not yet recognize medical marijuana. All drugs are regulated through the Controlled Substances Act (CSA) (21 U.S.C. § 811). The act does not recognize the difference between medical and recreational use of marijuana and treats all marijuana like other controlled substances (cocaine and heroin). Under the Act, every controlled substance is categorized according to its relative potential for abuse and medicinal value. Under the CSA, marijuana is classified as a Schedule I drug, or highly addictive and having no medical value.
How to win denied claims due to Marijuana use
As you see, laws surrounding life insurance claim denials and marijuana use are very confusing. An attorney specializing in this area of law will be able to overturn the denial. If your life insurance claim has been denied due to marijuana use or for any other reason, call us for help. Our life insurance attorneys will investigate the denial and will help you recover the life insurance proceeds to which you are entitled under the law.