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Will a life insurance policy payout in the event of an accidental overdose?

Accidental Overdose and Life Insurance

Seeing how that in 2019, more than 69,000 people died from an accidental overdose in America alone, it’s no wonder what was once an uncommon question asked by an individual now becomes a “somewhat” common topic.

Particularly when someone is looking to purchase a life insurance policy on another person!

This is why…

We wanted to take a moment and discuss some of the main factors that can come into play when determining if and when a life insurance policy would provide a death benefit to an insured’s beneficiary in the event that the did die from an accidental overdose.

Questions that will be addressed will include:

  • Will a life insurance policy pay a death benefit if an insured dies from an accidental overdose?
  • What is a “contestability period” with regards to a traditional life insurance policy?
  • Do all life insurance products have a “contestability period”?
  • What options do I have if a life insurance company chooses to deny a loved one’s life insurance policy?

So, without further ado, let’s dive right in!

Will a life insurance policy pay a death benefit if an insured dies from an accidental overdose?

This is a tricky question because there are some cases where a life insurance company may be justified in not wanting to or “having” to pay out a death benefit to an insured due to an accidental overdose.

For example…

If an individual purchased a life insurance policy two months ago, and on their application they KNOWINGLY CHOSE not to disclose that they were taking any kind of prescription medications and/or narcotics which they know would have prevented them from being able to qualify for coverage.

It is reasonable to assume that a life insurance company would NOT want to be held responsible for a legal contract where they were lied to.

Conversely…

If an individual purchased a life insurance policy two months ago, then immediately afterward was involved in a car accident and was prescribed a powerful pain narcotic which ultimately causes the insured to suffer from an accidental overdose, an insurance company wouldn’t have any recourse or objection to paying out on this claim.

This is why…

There isn’t a “yes” or “no” answer to this question. It’s all going to come down to one’s circumstances. That would be, of course, if the accidental overdose occurred within the “period of contestability” clause within the life insurance policy being questioned.

What is a “contestability period” with regards to a traditional life insurance policy?

The period of contestibility is a provision in a life insurance policy that allows the insurance company to investigate the circumstances surrounding the policyholder’s death and to verify the accuracy of the information provided on the policy application. This period typically begins when the policy is issued and lasts for a certain number of years, usually two or three.

During the period of contestibility, the insurance company has the right to contest the payment of the death benefit if it determines that the policyholder made material misrepresentations on the application or if there is evidence of fraud.

If the insurance company finds that the policyholder made material misrepresentations or engaged in fraud, it may void the policy and refuse to pay the death benefit.

The purpose of the period of contestibility is to protect the insurance company from paying out on a policy based on false or misleading information.

It is important for policyholders to be honest and accurate when completing their life insurance applications to avoid any issues during the contestibility period.

But notice…

This “period of contestability” only lasts for two or three years and is exclusively designed to help protect an insurance company against potential “fraud.” This is why, during this period of contestability questions like:

  • Was the applicant honest during the time of purchase?
  • And/or did the applicant intentionally omit anything that would have potentially prevented him or her from being able to qualify for coverage?

If so…

There is a chance that an insurance company might have a valid reason for not wanting to honor their side of the insurance contract.

This brings us to our next question, which is…

Do all life insurance products have a “contestability period”?

Up until now, we’ve pretty much only focused on traditional term or whole life insurance policies, which will use one’s current health status and other “lifestyle” choices to determine who can and can’t qualify for coverage.

That said however…

There are some “alternative” products some individuals may turn to if they are not able to qualify for a traditional term or whole life insurance policy.

These “types” of products will typically be much more straight forward about what they will and won’t cover, and typically won’t need to rely on a contestiblity period to determine whether or not they are required to pay a death benefit to an insured.

Guaranteed Issue Life Insurance policies

&

Accidental Death Policies.

And discuss whether or not either one of these types of products would provide coverage to someone if they died from an accidental overdose.

Guaranteed Issue Life Insurance Policies and Accidental Death Policies.

Guaranteed issue life insurance policies are life insurance policies that won’t require one to have to “medically” qualify for coverage. This is why, during the application process, you won’t be asked any medical questions other than how old you are.

Which means that…

They’re not going to ask if you are taking any prescription medications or whether or not you use any illicit drugs. In fact, most guaranteed issue life insurance policies are only going to ask you three questions:

  • How old are you?
  • Are you a US citizen?
  • And what state do you live in?

So, unless you lie about your age, citizenship, or permanent resident, it’s pretty much impossible to mislead an insurance company about your current health status. After all, it’s not like they are even going to ask you about it.

But…

This is only because guaranteed issue life insurance policies use a particular clause called a “graded death benefit” to protect themselves from insuring anyone too risky.

You see…

A graded death benefit limits a life insurance companies exposure to undo risk by stating that a guaranteed issue life insurance policy will only begin covering an individual for “natural causes” or a “self-inflicted” causes of death after they have owned their policy for a minimum of two years.

During this time…

Most (if not all) guaranteed issue life insurance policies will essentially function like an Accidental Death Policy in that they will only provide your loved one if you die from an “accidental cause” like a:

  • Motor vehicle accident,
  • Slip and fall,
  • Victim of crime,
  • Natural disease.

This is why…

If you do decide to purchase a guaranteed issue life insurance policy on yourself, one should assume that an accidental overdose would not be covered for at least the first two years.

And that…

Probably wouldn’t ever be covered by an accidental death policy unless, of course, you specifically see it as being something that is covered within the actual policy itself.

This brings us to the last topic that we wanted to cover here today, which is…

What options do I have if a life insurance company chooses to deny a loved one’s life insurance policy?

If a life insurance company denies a claim on a loved one’s policy, the beneficiaries may have several options for recourse. Here are a few things the beneficiaries can consider:

  1. Review the policy: The first step is to carefully review the policy and the reason for the claim denial. Make sure you understand the terms of the policy and the specific provisions that apply to the denial.
  2. Contact the insurance company: If you believe the claim was denied in error, you can contact the insurance company and ask for an explanation of the decision. You can also ask about the appeal process and how to file an appeal.
  3. Seek legal advice: If you believe the insurance company is acting in bad faith or denying the claim without a valid reason, you may want to seek legal advice. An attorney who specializes in life insurance law can help you understand your options and determine the best course of action.
  4. File a complaint: If you are unable to resolve the issue with the insurance company, you can file a complaint with the insurance regulator in your state. The regulator can investigate the issue and may be able to help you get the claim paid.

It is important to act quickly if you believe a life insurance claim has been wrongly denied. Many states have time limits for filing an appeal or taking other legal action, so it is important to consult with an attorney as soon as possible.

One additional step one can take if they haven’t already applied for coverage it to review the customer satisfaction ratings for any and all insurance companies that they are considering.  Individuals who feel that they have been wronged by an insurance company tend not to be quiet about it and will usually express their feelings on line.

2 comments… add one
  • Michael M. December 6, 2020, 7:49 pm

    Hello,
    Very, very nice Read. Learned sone things. I’m going thru a hard tme with an Insurance Company regarding Accidental Overdose. It’s literally hell..please excuse my language. Not a Rich person. I’m on Social Security, people. Anyway…Keep up the good work.
    Sincerely,
    Michael

    • IBUSA December 7, 2020, 7:36 am

      Michael,

      Sorry to hear about your situation, we’re glad this article helped and wish you the best.

      Thanks,

      InsuranceBrokersUSA.

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