19 May Sam was insured under a life insurance contract policy tha
Sam was insured under a life insurance contract policy that excluded death due to suicide. The policy had a face amount of $1 million. Two weeks after taking out the policy, Sam was driving home from his promotion party while intoxicated. He lost control of his car and was killed when the car hit a utility pole. There was no one else involved in the accident. The weather was clear and the road was in good shape and well lighted. Sam’s insurance company refused to pay and Sam’s wife sued the company to force payment. The Trial Testimony at the trial proved conclusively that Sam was legally intoxicated when he left the party. There was also proof that there was nothing in the policy about lack of coverage in the event of an accident due to intoxication. The Arguments at Trial The insurance company’s attorneys argued that benefit provisions apply only to death due to accidents – unintended and unavoidable mishaps – and that, although Sam appeared to have been in an accident, his death was due to his being intoxicated and therefore not an accident. They further argued that this concept was so logical that it did not need spelling out in the insurance policy. The estate’s attorneys argued that because the policy was silent about accidents due to intoxication, the benefit provision should apply regardless of the cause of the accident. The parties had a contract and all exclusions must be spelled out in the contract in order to be effective. Questions to Discuss Who do you think has the stronger argument, the insurance company or Sam’s estate? Why? If you were the jury hearing this case, how would you decide? Why? What do you think the rule regarding coverage of accidents due to use of drugs or excessive alcohol should be?
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