The Fifth Circuit Court of Appeals in New Orleans, Louisiana recently reversed LINA’s (Cigna’s) denial of life insurance benefits for a woman whose husband died in an automobile accident. In White v. Life Insurance Company of North America, the Fifth Circuit determined that LINA should have paid benefits.
Dabdoub Law Firm has handled similar cases. The firm won a case at the Court of Appeals that involved a denial of benefits based on application of a pre-existing condition exclusion. We can help if you have a life insurance claim.
Exclusions in Life Insurance Policies
One of the most common exclusions in a life insurance policy states that no benefits will be paid if the policyholder’s death was caused or contributed to by use of alcohol or un-prescribed narcotics.
White v. Life Insurance Company of North America
In White v. LINA, Mr. White’s policy included an exclusion for any death caused, at least in part, either by intoxication or by the voluntary ingestion of any narcotic or drug that is not prescribed.
Mr. White died after failing to follow the highway as it curved to the right. Instead, he proceeded straight, colliding head on with an eighteen-wheeler truck.
A toxicology report was conducted after the accident and the preliminary results showed that Mr. White tested positive for amphetamines, cocaine, opiates, benzodiazepine, and cannabinoids. Importantly, the testing did not determine the level of drugs in Mr. White’s system or when the drugs had been consumed.
In reviewing his claim, LINA hired Dr. Fochtman – a toxicologist – to complete a report. LINA’s doctor determined that there was no way to determine the level of Mr. White’s intoxication or level of impairment at the time of the crash. Despite this fact, LINA still denied the life insurance claim by claiming the death was caused by the voluntary ingestion of narcotics and/or drugs.
LINA’s Mistake
LINA made a critical mistake. When Mrs. White requested all information LINA had relied upon in reaching its initial denial decision, LINA did not turn over the toxicology report by its doctor. This omission resulted in a procedural violation of ERISA.
The Fifth Circuit Court ruled in favor of Mrs. White and awarded her benefits.
Having an Experienced Life Insurance Attorney Matters
Life insurance law is complicated. If your claim for life insurance benefits was denied or is being delayed by an insurance company, it is important to get legal help from a lawyer with experience.
As a law firm built to focus on insurance, all our lawyers spend every day working to get our clients benefits from insurance companies.
Because federal law applies to most life insurance claims, we do not have to be located in your state to help.
Dabdoub Law Firm represents clients nationwide with:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Negotiating a lump-sum settlement; or
- Filing a lawsuit against your disability insurance company.
Call to speak with a life insurance attorney.
