As a practical matter, an insurance claimant fighting an ERISA life or accidental death insurance intoxication clause denial on administrative appeal or in court without the help of a seasoned ERISA attorney is ill-advised. But that doesn’t mean you can’t win. It just means you may need help. The reason an ERISA attorney’s help is advised is that ERISA law is complex, and some of the arguments you need to make to be successful are very technical. The legal battle in an ERISA case, done right, can also be very tedious and time-consuming. The fight requires a ton of work from the time of the insurance company’s initial denial, through the administrative appeal process, through judgment at the district court level, then finally through judgment at the appeal court level. And the insurance companies typically hire several attorneys who specialize in ERISA law from some of the largest law firms in the country to fight the claimant’s attorney every step of the way. Our client’s case, summarized above, is a perfect example of the amount of work that can be required to beat an insurance company who argues an intoxication defense. We took a loss on administrative appeal to CIGNA. Then we took another loss at the district court level, meaning the district court judge agreed with CIGNA’s lawyers on the intoxication exclusion defense. It wasn’t until after taking an appeal to a three-judge panel of the U.S. Fifth Circuit Court of Appeal that my client finally received justice. All told, bringing our client’s case to a successful conclusion took hundreds of hours of work in researching and briefing the facts from an administrative record over 1000 pages long. It took finding the one critical toxicologists report that CIGNA first withheld, buried deep in that record. It took meeting with the Coroner to secure his testimony clarifying his comment made on the death certificate. It took researching and arguing the law to four judges in two separate court proceedings. And at the formal Fifth Circuit court hearing (called “oral argument”), where the attorneys make their arguments in open court to the judges, who pepper them with questions, comments and arguments about their positions, it was hard to tell whose position the judges actually favored. It was certainly nerve-racking for our client, who watched it. It wasn’t until the Court’s formal opinion landed in our email inbox a couple of months later that we could tell our client the good news.