Everyone should know by now that drinking and driving never pays. But it could also cost family members some much needed help by way of life insurance proceeds.
In American Heritage Life Insurance Company v. Carmen Morales, a family was denied death benefits because the decedent had been drinking and was legally intoxicated at the time of the jet ski accident that resulted in his death. So his family was unable to recover any death benefits because the decedent was legally drunk at the time of his death.
By way of additional background, in that case, the insured purchased a death and dismemberment policy from American Heritage Life Insurance Company, which was subject to an alcohol exclusion provision. The provision excluded coverage of “any loss incurred as a result of . . . any injury sustained while under the influence of alcohol or any narcotic unless administered upon the advice of a physician.”
On July 31, 2011, the insured died in a crash involving a jet ski. An autopsy revealed that the cause of death was multiple blunt force traumatic injuries. A toxicology report indicated that his blood alcohol level was .10, which is .02 above the legal limit in Florida. An expert for the beneficiary testified that alcohol was not the cause of the accident but rather, that the accident was caused by multiple conditions, including alcohol. It is undisputed that alcohol was at least a contributing cause of the death. Citing the alcohol exclusion provision, American Heritage denied the beneficiary’s claim under the policy. Later, the trial court granted the beneficiary’s motion for summary judgement and ordered the insurer to pay the policy benefits to the insured.
The Appellate Court found that an alcohol exclusion provision in an accidental death policy will serve to bar recovery of benefits if there is some causal relationship between the insured’s intoxication and his death. It is unnecessary for the insured to prove that alcohol was the sole cause of the death.
However, the insurance company has the burden to show some causal relationship between the death and the intoxication in order for the exclusionary provision to be effective. The Court stated that no genuine issues of material fact existed concerning whether the insured’s alcohol intoxication contributed to his death and that American Heritage carried its burden in showing a sufficient causal relationship between death and intoxication.
Therefore, the alcohol exclusion provision applied to the facts of this case and summary judgement in favor of the beneficiary was inappropriate.
This case again serves as yet another reminder that it never pays to drink and drive.