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Alcohol is the decisive factor in a dispute over life insurance benefits

life insuranceAlcohol consumption is the decisive factor in a dispute over life insurance benefits.

Javier Lopez (“the Insured”) purchased an accidental death and dismemberment policy from the Insurer. The policy contained an alcohol exclusion provision excluding from coverage “any loss incurred as a result of . . . any injury sustained while under the influence of alcohol or any narcotic unless administered upon the advice of a physician.” Sometime during the night of July 31, 2011, the Insured died in a crash while operating a jet ski in Biscayne Bay. Citing the alcohol exclusion provision, the Insurer denied the Beneficiary’s claim for proceeds under the life insurance policy.  The Beneficiary then filed a lawsuit.

The Insured was last seen alive around 10:00 p.m. on July 31, 2011, when he left an island north of the Venetian Causeway in the Intracoastal Waterway. When the Insured failed to return, the Coast Guard was called and a search of the area located the jet ski at approximately 4:00 a.m. on the north side of the Julia Tuttle Causeway. The Insured’s body was found later that morning at approximately 7:44 a.m. on the south side of the causeway. The autopsy report indicated the cause of death was multiple blunt force traumatic injuries sustained in a front-end collision with a fixed object. The toxicology report indicated that the Insured’s blood alcohol level was .10, which is above the legal limit of .08 in Florida.

The Beneficiary’s expert agreed that the Insured was operating the jet ski with a blood alcohol level in excess of the legal limit and that the Insured collided with a fixed object. The Beneficiary’s expert, however, opined that the Insured’s blood alcohol level was not the sole cause of the accident because other factors contributed to the accident, including: (a) the Insured’s operation of the water craft in a negligent or reckless manner; (b) the dark nighttime conditions; and (c) the Insured’s failure to keep a watchful eye on his surroundings. Although not disputing that the Insured’s blood alcohol level contributed to the accident, the Beneficiary’s expert opined that “it does not mean [alcohol] was the cause of the accident.” (emphasis added). In the expert’s opinion, “for one to say alcohol was the cause of the accident is pure speculation.” (emphasis added).

The trial court agreed with the Beneficiary, and ordered the insurance company to pay the policy benefits to the beneficiary.  The insurance company then filed an appeal.

On appeal, the appellate court ruled in the insurance company’s favor.  The court reasoned that there was no disputed question of fact that alcohol played a role in the accident.  Given that it was undisputed that alcohol played a role in the subject accident, the appellate court had to decide whether the alcohol exclusion applied when the insured’s intoxication played a role in the cause of loss, or whether intoxication needed to be the sole cause for the exclusion to apply.


Holocaust Profiteering – Insurance Companies Refuse to Pay Life Insurance Policies for those that Died during the Holocaust

6a00d83451c36069e2016302472e25970d-800wi.jpgThe Holocaust took place in Germany from 1933, when Adolf Hitler became Chancellor of Germany, and lasted until the end of WWII in 1945.

During this time, Jews in Europe were subjected to harsh persecution that ultimately led to the systematic murder of 6,000,000 Jews (1.5 million of these being children) and the destruction of 5,000 Jewish communities. These deaths represented two-thirds of European Jewry and one-third of world Jewry. The Jews who died were not casualties of the fighting that ravaged Europe during World War II. Rather, they were the victims of Germany’s deliberate and systematic attempt to annihilate the entire Jewish population of Europe.

Many of those that died during the Holocaust had purchased life insurance with such companies like Allianz and others. They paid their premiums to secure said coverage. Yet the death benefit of those policies has never been paid by the insurance companies.

Many of those insurance companies that are refusing to pay the life insurance proceeds actually even went so far as to actually cooperate with the German government during the Holocaust to insure death camps.

It is believed that companies such as Allianz, Generali, AXA and other global insurers wrote almost 900,000 insurance policies in Eastern Europe before the Holocaust. The amount owed on these policies has been estimated at $20 billion.

Yet, after the war ended many of the grieving families that had lost loves ones during the Holocaust submitted claims to the insurance companies. The insurance companies refused to honor the requests. Part of the reason was because many of the families were unable to provide death certificates. However, it is a known fact that the German government never issued any death certificate for those murdered during the Holocaust.

The International Commission on Holocaust Era Insurance Claims (ICHEIC) was established by the National Association of Insurance Commissioners in August 1998 to identify, settle, and pay individual Holocaust era insurance claims at no cost to claimants.

But the ICHEIC did not pay out the full benefits purchased by the life insurance policies. In some cases, they only paid a fraction of what was owed.

Contributions to reparations agreements are not a substitute for addressing the breach of contract that is the failure to pay legitimate claims of policyholders. As such, U.S. lawmakers are pushing through legislation that could potentially permit Holocaust survivors, and their families, the ability to sue for breach of contract, and other viable claims, and seek the full payment of amounts due and owing to the families of the many Holocaust victims and to others who may have viable claims.
Our Miami insurance dispute lawyers handle insurance claims for homeowners. Our attorneys represented insurance companies before 2006, when we opened a firm dedicated to fighting for the rights of consumers. We understand how insurance companies work. And we have the knowledge and experience necessary to represent homeowners in disputes over an insurance claim.

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