Accidental death policies can be very complex requiring the legal assistance of an attorney experienced in these claims. John Stennett and Barbara Casino have years of experience in successfully handling accidental death claims.
Stennett & Casino have successfully obtained accidental death benefits for numerous clients in the following cases:
Death due to overdose of heroine denied by insurer, claiming death was foreseeable and thus, not accidental.
An elderly gentleman, diagnosed with cancer, was found on his bedroom floor unconscious by his wife returning from church. He was transported to the hospital where he later died. The cause of death was subdural hemorrhaging (bleeding on the brain).
Our client had insurance that provided benefits if her husband died as a result of an accident. Zurich, who provided the Accidental Death Coverage, claimed that the subdural hematoma was caused by a spontaneous bleed due to the husband’s use of Coumadin prescribed by his physician (a blood thinner), and not by an accidental fall as our client claimed.
Zurich pointed to the lack of evidence of external trauma to the head and medical literature supporting the potential for spontaneous bleeds from coumadin use. Zurich additionally argued that even if there was some trauma caused by a fall it likely would not have been fatal without the aggravated bleeding caused by the blood thinner. Thus, Zurich denied the claim based on an exclusion in the policy for death “caused or contributed to by illness or the treatment thereof.”
Death due to drinking and driving a motorcycle at high speeds without a helmet, resulting in running off the road into a telephone pole denied by insurer claiming death foreseeable and thus not accidental. Insurer also claimed that an exclusion for, “loss resulting from the commission of a felony by insured” applied, claiming that decedent was riding a stolen vehicle and committed vehicular manslaughter by killing himself while intoxicated.
Death due to an accidental overdose of fentanyl prescribed for pain. The insurer denied the claim relying on an exclusion for loss caused by the “use of any drug…unless prescribed by a doctor or taken as directed by a doctor.” Though decedent had a prescription for fentanyl, post-mortem blood tests showed that he ingested substantially more than his doctor had prescribed.
Death due to single-car accident denied by Insurer claiming the accident was not an accident – it was foreseeable that decedent would be in a crash because of his abuse of Xanax. Also, Insurer claimed an exclusion in the policy for loss caused by “sickness, disease… or the medical or surgical treatment thereof” applied because Xanax was prescribed as a treatment for anxiety.
Death due to ATV accident with a BAC 0.19%. Insurer claimed the death was not unexpected given decedent’s consumption of alcohol and thus not accidental.
Death due to overdose of morphine sulfate prescribed for hip and knee pain denied by insurer claiming that two exclusions applied. One for death caused by the “voluntary ingestion of any narcotic…unless prescribed…and taken in accordance with the prescribed dosage.” Second for death caused by sickness, disease or the treatment thereof; in this case medications for hip and knee pain.
After watching football and drinking beer with his father, decedent, while driving home, got into a fatal accident. According to blood tests taken after his death, decedent had a BAC in excess of the legal limit. Insurer denied the claim on the basis that an accident was foreseeable due to his drinking and thus was not “accidental.” Insurer also cited an exclusion for loss caused by the voluntary intake of “alcohol in combination with any drug…” However, there was no evidence that decedent took any “drug”.
Death due to a car accident denied by insurer claiming death was not covered because of exclusion for loss while operating a motor vehicle under the influence of any intoxicant. Tylenol with codeine had been prescribed for decedent’s back pain and was found in his system after his death.
Death due to intersection accident while riding a motorcycle after having beer and pizza. Blood sample taken after death showed a 0.86% level, however this test was of plasma not whole blood. Insurer denied claim based on an exclusion for loss occurring while one is presumed intoxicated under California law. One is presumed intoxicated in California with a BAC of 0.08% whole blood. The plasma level of 0.86% when converted to whole blood is 0.067%.
Decedent passed out in his kitchen, fell and hit his head causing death. Insurer denied claim asserting that the cause of the fall was a seizure which was excluded as a loss “caused or contributed by” an illness.
Death due to accidental overdose of pain killer (OxyContin) denied by insurer claiming that death was not accidental and also was not covered due to an exclusion for death caused by intoxicants.
Death due to acute alcohol poisoning denied by insurer claiming 1) decedent intentionally harmed himself by drinking, thus death was not accidental and 2) it was not covered because of an exclusion for death “caused or contributed by” an illness, in this case alcoholism.
Death due to acute alcohol intoxication with a BAC 0.36% denied by insurer because of exclusion for “loss, which directly or indirectly, in whole or in part, is caused by…sickness, disease, bodily or mental infirmity…” Insurer claimed that chronic alcoholism was a contributing cause of death.
Death due to accidental overdose with a fentanyl patch prescribed by her doctor that was found in decedent’s mouth. Denied by insurer based on an exclusion for “loss sustained in consequence of the insured being intoxicated or under the influence of any controlled substance, unless administered on the advice of a physician.”