Virginia-based BenGlassLaw represents life insurance claimants nationwide.
An Accidental Death While Kayaking on Lake Michigan
A 35-year-old father of two died while kayaking on Lake Michigan in June. At the time of his death, he had an ERISA-governed life insurance policy with The Standard insurance company.
The Standard Life Insurance Company Refused to Pay The Accidental Death Benefits
The Standard paid the death benefit, but refused to pay the accidental death benefit, citing a policy exclusion for “deaths caused or contributed to in any way by the voluntary consumption of drugs or alcohol.”
The refusal was based on the fact that at the time of his death, the decedent had a blood alcohol level of .13. An expert reviewer for The Standard, Richard Tovar, M.D., a toxicologist concluded that the decedent’s high BAC must have “at least contributed” to his drowning.
A toxicologist is a scientist who studies the effects of chemicals, drugs, and other substances on living organisms to determine their safety and potential risks to health. They analyze the impact of toxic materials and develop ways to minimize or prevent harmful exposure.
The Client’s Family Hired Us Due to Our Expertise in Handling Life Insurance Claims
We filed an extensive ERISA appeal. We argued that their expert was simply guessing. No one witnessed why or how the decedent had come out of his kayak and into the water. We provided information about the weather (the waters and wind were calm when he left the shore, but in the 90 minutes between the time he embarked and the time he drowned, the winds had picked up and the waves were 3 feet high).
Our Appeal was Full of Detail and Legal Arguments
We included the last know picture of the decedent alive (which showed that the water was very calm). We also included TV news reports (via YouTube video) that showed that Lake Michigan has a very high rate of drownings every year and had a reputation (unbeknownst to the decedent) of being a very dangerous lake for amateur kayakers.
We included a video like this one showing how dangerous Lake Michigan can be. We also included a report from an expert toxicologist that opined that even though the decedent’s BAC was high, it was impossible, in an unwitnessed drowning, to know whether intoxication played any role in the death.