We obtained an award of $260,000 from the insurance company which had denied our client’s claim for accidental death benefits. We won the full benefit based on our appeal within the insurance company.
If your claim has been denied by the insurance company please call me immediately at 800-581-1434.
The client was the beneficiary on her friend’s various insurance coverages. The friend died in a automobile crash in Sullivan County in the Catskill Mountains. The friend lost control due to speeding on a snowy and icy road. This was the conclusion of the New York State Police.
Our client was able to collect on her friend’s life insurance. However, our client’s claim for accidental death coverage was denied. The insurance company determined that a policy exclusion applied. The policy excluded accidental death caused by intoxication. The toxicology tests showed that the friend’s blood alcohol was above the legal threshold for intoxication.
We were able to prove that although there was no question that the driver was intoxicated, there was no proof that the client was impaired. In order for the insurance to uphold its denial it had to show that the driver was not only intoxicated but that the intoxication impaired her ability to drive. The insurance company had no proof of impairment.
We were able to prove our case by doing the following investigation:
- Three friends provided affidavits that the driver was not impaired. The friends and the driver were together having dinner and watching the Grammys on television. The driver did not appear to be intoxicated or impaired. If she had shown such signs, the friends would have driven her home or would have insisted that she stay the night.
- The road conditions were very dangerous. On the same night, another woman in the same county died in a car crash due to ice and snow.
- The insurance company never bothered to interview the State Police. We did, and the State Police concluded that unsafe speed on an icy road was the sole cause of the accident.
We made the presentation to the insurance company, and we were able to get the insurance company to pay without having to proceed to suit.
Therefore, do not accept the insurance company’s “no” as the final answer.
If the insurance company has denied your claim, please call me immediately at 800-581-1434.
Prior case results do not guarantee a similar outcome.
Mark E. Seitelman, 3/19/09, http://www.seitelman.com.