Insurance Denial - $1 Million Accident Policy - 2020

Insurance Denial Bad Faith – Confidential Settlement.  This case involved the denial of payment under a $1 Million accidental death insurance policy.  We were hired by the widow of a middle-aged professional who died as a result of accidental overdose of medications prescribed by his doctors.  At the time of his death, our client’s husband was insured through several life insurance policies including a $1 Million accidental death insurance policy.  Unlike many life insurance policies, an accidental death insurance policy only provides coverage for a death resulting from an “accident.” Like all insurance policies, it contained several exclusions which allowed the company to deny coverage in various instances.  One of the exclusions, which is common to most accidental death insurance policies, excluded coverage if the death was caused, directly or indirectly, by any sickness, disease, or infirmity.  The insurance company relied on this exclusion to deny our client benefits.  It claimed that because her husband’s death resulted from taking medication, which was prescribed to treat an illness or disease, this exclusion applied and therefore no coverage was available.  Despite the efforts of our client and her previous attorney to appeal the denial decision through the insurance company’s two-year appeals process, it continued to deny benefits.  After retaining our firm, we began a detailed coverage analysis and obtained all claims documentation for the purpose of not only establishing insurance coverage, but also to demonstrate that the insurance carrier was acting in bad faith towards its insured beneficiary.  After our firm took over the case, we were able to demonstrate to the insurance company that it was construing its own insurance policy incorrectly and, further, that we could successfully pursue a claim for insurance bad faith.  After we placed the insurance company representatives on notice of their errors and insurance bad faith, the insurance company agreed to pay benefits owed.  The case settled in the year 2020 for significant confidential amount.