Accidental life insurance is the kind of insurance that pays out the death benefit where the insured dies from an accident-causing injury. It sounds easy enough, but accidental death benefit claims can often be complicated. Here’s a possible scenario:

The insured dies soon after an unfortunate accident, like a vehicle crash. Later on, the insured’s relatives seek payment of the accidental benefits from the insurance carrier. But it turns out the insured had a pre-existing medical condition, such as heart disease, which the carrier says was the real cause of the insured’s death. The carrier then denies benefits because there was no “injury”. What does the law in Florida say about this?

Accidental DeathThe cases in Florida illustrate two types of accidental injury policies. The first type of accidental death policy contains a “caused solely by accident” language. This language effectively says that death benefits will be paid where the injury results directly, independently, and exclusively from other causes. When the policy only has this type of language, the law provides that that the insurance carrier will be liable to pay benefits if the accident is the moving, sole, and proximate cause of the death, even if there may have been a pre-existing disease or physical infirmity which contributed to the death.

The case of Anglin v. Nationwide Mutual Insurance Company, 306 So.2d 147, illustrates the caused solely by accident situation. In that case, a deputy sheriff got in a scuffle with a driver on the side of the road. The deputy was hit by the driver multiple times causing him eventually to fall over and die at the scene. It turned out that the deputy had coronary artery disease, and the pathologist at trial testified that the deputy had an immediate heart attack that was brought on by the external injuries. The issue in the case was whether the death was caused by accident, thus allowing benefits to be paid. The trial court ruled in favor of the beneficiary and the appeals court affirmed the ruling. The policy did not contain a sickness exclusion clause and only had the “solely by accident” language, permitting the court to rule that the factual issue of whether an accident had occurred was properly decided by the jury in favor of the claimant.

Kamagra 100mg has on line levitra you could check here been an efficient medicinal device which works well to aid men have * The urge to have sex* A longer lasting erection* The opportunity to have somewhat normal penis function in the form of tablets accessible in 50mg and 100mg dosage strengths. Medical sildenafil 50mg price industry has recorded 96% efficacy of the medicine. Due to the impotence of one partner, relationships undergo great change, as partners withhold all expressions of order generic viagra sexual attraction. In case of pills failure try seeking the help of your diabetic spediscount viagra t. The other type of accidental injury policy is one that contains an express exclusion clause. The exclusion clause will prevent liability where the loss or death results directly or indirectly from any bodily infirmity, sickness or disease. These policies are generally less favorable to the claimant’s case.

The sickness exclusion clause type of policy is illustrated in Edwards v. Bankers Life and Casualty Company, 381 So.2d 761. In this case, the claimant sought payment of disability benefits from the carrier. The carrier denied the disability benefits because it alleged that the claimant’s present injury was a recurrence of a prior infirmity. There was an exclusion clause in the disability policy which precluded recovery for a loss resulting from any bodily infirmity, sickness or disease. Since the appeals court found that the undisputed evidence revealed that the claimant’s pre-existing infirmity was a contributing factor to his present disability, it affirmed the trial court’s ruling in favor of the carrier.

What if the use of alcohol contributes to the insured’s death? Is the claimant still entitled to recover the accidental death benefit? In Buck v. Gulf Life Insurance Co., 548 So.2d 715, the insured drowned when his car rolled off the road and overturned into a canal. At the time of the incident the insured had a high blood alcohol level. The carrier denied accidental death benefits asserting that the insured’s death did not result from accident but from his use of alcohol, which it considered to be an “infirmity” subject to the sickness exclusion in the policy. The court, however, interpreted the sickness exclusion narrowly, concluding that alcohol or drug use was not subject to the policy’s exclusion in the absence of language that clearly evidenced an intention to exclude such conduct (alcohol use) from accidental coverage.

If your life insurance benefits were denied under an accidental death policy you should seek the advice and assistance of an experienced Florida life insurance lawyer. Please call the law firm of Joseph J. Rosen, P.A., for assistance with your insurance claim.

Filed under: Florida Business

Like this post? Subscribe to my RSS feed and get loads more!