Generally, life insurance companies live up to their policy contracts and pay a total of approximately $40 billion each year in death benefits on individual policies. Although many insurance claims are accepted and paid, a recent study by the Washington, D.C.-based Doctor-Patient Rights Project revealed that denied insurance claims may be on the rise. In fact, they have tripled to 600 million annually. These claims may be denied for a number of reasons. On top of that, these reasons could be applied to nearly any type of insurance policy claim governed by the Employee Retirement Income Security Act (ERISA) including, health, auto, disability, dismemberment, and life insurance. In particular, intoxication exclusion is usually highly contested when cited as a rationale behind a denial of an insurance claim. If your insurance company refuses to accept a claim because of it, a Louisiana ERISA intoxication exclusion lawyer may be able to help.
Contact a knowledgeable ERISA lawyer to schedule an appointment. They could examine the case and help research potential legal strategies.
No matter the type of coverage, insurance policies generally name many different circumstances in which insurance coverage would not apply. Some life insurance policies could have a suicide exclusion, some disability insurance policies may have a preexisting condition exclusion, and almost any type of insurance coverage may include an intoxication exclusion.
When alcohol consumption is allegedly involved in the scenario surrounding an insurance claim, an intoxication exclusion may apply to both private and ERISA-governed insurance plans. Laws allowing intoxication exclusions were originally passed during the 1940s with the goals of discouraging alcohol use, decreasing drunk driving, and saving insurance companies money.
Currently, 36 states allow insurance companies to have alcohol exclusions in some form. However, even the National Association of Insurance Commissioners voted unanimously to recommend repealing all alcohol exclusionary laws.
Louisiana is among the 25 states in America that generally permit explicit drug and alcohol exclusions in insurance policies, as reported by the National Institutes of Alcohol Abuse and Alcoholism. Louisiana Revised Statutes §22:975 states that insurance companies are typically not liable for any losses that may result from the insured being intoxicated or under the influence of narcotic drugs unless they were prescribed by a doctor.
Although ERISA-governed plans are not forbidden from including an intoxication exclusion, a claim denial based on this exception could contain an arguable case. Even if the insured party had alcohol in their system at the time of their accident or death, an experienced Louisiana ERISA intoxication exclusion lawyer could work to demonstrate that their alleged alcohol consumption had little or nothing to do with their death or injury.
Having an insurance claim denied may be quite shocking, especially if it is for a reason you did not anticipate. If Louisiana’s allowance of intoxication exclusion clauses in ERISA-governed plans resulted in your health, life, dismemberment, or disability insurance claim being denied, seek the assistance of a Louisiana ERISA intoxication exclusion lawyer who is well-versed in state insurance regulations. Call today to find out more about the legal services and assistance available to you.
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