Suicide and Life Insurance Claims

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5 years ago

Suicide and Life Insurance Claims

Most people think that if a person commits suicide then their life insurance policy will not pay the claim. We disagree. In fact, we’ve argued and won many claims where the insured’s death was said to have been a suicide.

In the world of life insurance claims if an insurer sees a death certificate that names the Manner of Death as ‘Suicide’ they’ll almost always end their investigation and deny the claim.

But, in fair claims handling, only relying on a death certificate is not enough. An insurer is obligated to first establish that the insured died by suicide before they deny a claim. Suicide means two things: that a person intentionally took their own life, and it was while he or she was in a state of mind that was coherent and lucid enough to understand the result of their suicidal act. If this basic tenet cannot be established then the life insurance claim has to be paid.

Many deaths are marked ‘Suicide’ by Medical Examiners even though the facts don’t prove it. A common example is when a person dies by gunshot wound but there are no witnesses or signs indicating suicide. Accidents happen every day and one such accident is the unintentional but deadly discharge of a firearm. It’s a reality that guns misfire and people handling guns wrongly assume the gun isn’t loaded. According to a 10 year sampling by the Injury Epidemiology Journal, there are 430 unintentional deaths by firearms per year in the US (Article).

In order for a death to be a suicide there must be an intentional act by the person to end their life. This is the question we most often address in our handling of life insurance claims where the insurer denies due to a suicide exclusion. Does the available evidence demonstrate intent to take one’s own life?

Some of the common facts-sets that show there was No Intent, are; the effects of recreational drugs, prescription drug-to-drug interactions, severe alcohol intoxication, autopsy results and medical history.

One of the biggest challenges to fighting a death claim for suicide is when there are no obvious signs of a planned suicide and no witness to the death. Medical Examiners often resort to using Suicide as a Manner of Death in these instances even though they don’t actually know whether a death was an intentional act or an accident. And again, in turn, negligent insurers who fail to conduct full investigations rely on the Examiner’s determination to deny death claims.

The bottom line is that life insurance claims that are marked as Suicide can be challenged and won. All facts have to be examined and all possibilities considered. We’ve fought and won many life insurance claims that were denied under a Suicide exclusion.

If you have a life insurance claim that was denied for suicide, contact us now to get your claim paid. We accept claims in all US states.

Notable recent Court cases where an insurer alleges suicide, without adequate proof.

Rowell v Northwestern Mutual Life. Stephen Burgess consulted on this alleged death by suicide case.

Coleman Estate v Gerber Life. The Center for Life Insurance Disputes uncovered the evidence that won this alleged death by suicide case.

Read More About Suicide Exclusions in Life Insurance Policies:

Standard Suicide Exclusion Policy Language

Most life insurance policies have a section that says, ‘if the insured dies by suicide within 2 years of the Policy Date, no benefits will be payable’. Suicide exclusions are part of the policy that was issued to the owner. But the policy isn’t a law, it’s a contract. When there’s a disagreement over the terms of a contract between two parties, the presiding laws have to be considered. Laws can be Federal or State.

When it comes to suicide too much is taken for granted. For example, just because someone is found dead next to a gun doesn’t mean that person committed suicide. Likewise, just because a Police Report has a notation that the cause of death was a suicide, doesn’t mean the police investigated the death and came to a conclusive determination. We’ve investigated many death claims that were marked as suicide only to discover that they weren’t.

What Happens When Suicide Cannot be Proven?

In the world of life insurance claims, suicide without a witness is one of the more controversial. Consider a person found dead in their hotel room. No suicide note, no witnesses. The hotel calls the police. The officer looks around the room, doesn’t see any obvious evidence of a break-in, and deems the death a suicide. The coroner reads the police notes and lists the cause of death as suicide. The insurer looks at one or both of these reports and denies the claim.

No one asks if the hotel has surveillance cameras, properly functioning emergency exit doors, whether any personal items are missing from the deceased or the background of hotel employees. Is this scene that of an obvious suicide? We think it’s not.

In matters like this a hard fight about evidence, or lack thereof, usually ensues in order to get claims that have been unfairly denied under suicide exclusions paid.

Who Determines Suicide if there are No Witnesses?

As noted in our example above, when it comes to suicide and life insurance claims many times the insurer will do nothing more than accept whatever the county medical examiner marks as the cause of death. But people who commit murder don’t usually announce it, in fact they try to hide it. Be it accidental or intentional homicide many people try to hide evidence. So if there’s no effort made and cause of death is simply one person taking the word of another person without and effort to prove the event, who’s to say it was suicide?

Consider how many accidents result in death. There can be a fine line between an accidental death and an appearance of suicide.

Therefore, if no investigation is done and there are no witnesses how can suicide be proven? And if an insurer can’t prove a suicide how can they deny a claim based on suicide? The answers are obvious. Death claims get denied even if there’s a lack substantive evidence. If there are no witnesses and the authorities don’t investigate to come to a conclusion based on evidence, then suicide isn’t proven.

1 Year vs 2 Year Exclusion for Suicide

A recent Court decision in Colorado about the 2-year suicide exclusion of a life insurance policy turned-out to override Met Life’s policy and will certainly have big implications in Colorado. While most life insurance policies have a 2 year suicide exclusion provision – meaning, if the insured commits suicide within two years of buying the policy the insurer doesn’t have to pay – the Colorado Court made it clear that their law limits an insurer’s exclusion to 1 year for any policy sold in Colorado.

Several other states are applying their own laws and changing the 2 years to 1 year as well. For example, as of this writing, Missouri, Colorado, and North Dakota limit the period to one year. There may be a state requirement to show proof of intent to commit suicide in order to invoke the suicide exclusion as well, which opens additional opportunities to challenge insurers and get these death claims paid.

In the Colorado lawsuit of Auwae vs Met Life Insurance Company, the insured of the policy committed suicide during the second year of the policy. The beneficiary filed a claim and Met Life denied the claim on the basis that the suicide happened within the 2-year suicide exclusion. Met’s argument was that the policy they issued had a 2-year exclusion for suicide. When the matter went before a judge, the judge over-ruled Met Life and stated that Colorado law limits any suicide exclusion in life insurance to 1 year (not 2) and Met Life was forced to pay the claim.

Colorado isn’t the first State to implement a 1-year exclusion for suicide instead of a 2 year exclusion. We verify the exclusion period for all of our client’s claims rather than accepting the decision of the insurers. The insurers interest is to not pay a claim. Our interest, aligned with all of our clients, is to get the claim paid. To that end we do our own research and make sure that applicable laws and standards are applied to our client’s claims.

With the Colorado Court making its position crystal clear, we’re now contacting past clients whose claims – based on suicide – were denied. Because the Court was so specific about how the 1-year exclusion applies we believe there are likely many claims that we can now reapply for and get paid to our clients.

Read: An Interview with our President, Stephen C. Burgess, featured in The Mighty regarding Mental Health and Life Insurance Denials