In the recent case of American Heritage Life Insurance Co. v. Morales, Florida’s Third District Court of Appeals weighed a claim for accidental death benefits claimed by the estate of an insured who was killed after a drunken jet ski crash.

The insurer denied payment of the claim, citing the alcohol exclusion provision of the policy.

SONY DSCFlorida is one of 29 states that allow for alcohol exclusion provisions by insurance companies, and this one in particular was in line with what most companies offer. The provision excluded coverage of any loss incurred as a result of any injury sustained while insured was under the influence of alcohol or any narcotic, unless administered upon a doctor’s advice.

The investigative report from the Florida Fish & Wildlife Conservation Commission indicated cause of death was multiple blunt force trauma injuries sustained by a front-end collision with a fixed object. Decedent, whose body was found ten hours after he was last seen alive, had a blood-alcohol level of 0.10 percent, above the legal limit of 0.08 percent.

An expert for the estate argued that while insured may have been impaired, that did not necessarily mean alcohol was the cause of the accident, and that any such assertion was “pure speculation.”

Trial court agreed and granted estate’s motion for summary judgment and ordered insurer to pay. Appellate court reversed, and ordered summary judgment favoring insurer, meaning benefits would not be paid.

The National Highway Traffic Safety Administration has long encouraged states to re-examine the existence of alcohol exclusions in insurance policies and to introduce/support laws that eliminate barriers to drug/alcohol testing of injured persons – including those who have been involved in car accidents.

While alcohol exclusions may make sense when we’re only talking about denial of life insurance benefits to the drunk operator/driver, the consequences can extend far beyond. Alcohol exclusion provisions allow insurers to deny reimbursement to hospitals for treatment to those who are injured while impaired by alcohol or illegally-consumed drugs. The idea is to discourage reckless drunkenness and save insurers money. The problem is these laws have the unintended consequence of reducing treating physicians’ incentives to test the blood-alcohol level of those who may have been drinking and driving at the time of the crash.

Between 2001 and 2008, a total of 12 states repealed or amended their laws pertaining to the Alcohol Exclusion Law, which is embedded in the Uniform Accident and Sickness Policy Provision Law (UPPL). Florida has not been one of them.

For victims of drunk driving accidents, such provisions may ultimately deprive them of the opportunity to recover full damages if the at-fault driver is not tested for alcohol.

Fort Myers car accident lawyers recognize the bottom line is persons who choose to drink and drive are effectively driving without insurance to cover their own injuries, should that be the deemed the cause of any subsequent accident. But victims could potentially suffer as well.

We are dedicated to taking insurance companies to task on issues of coverage for injuries sustained in drunk driving crashes.
If you have been a victim of a traffic accident, call Chalik & Chalik at (954) 476-1000 or 1 (800) 873-9040.

Additional Resources:

American Heritage Life Insurance Co. v. Morales, Jan. 21, 2015, Florida’s Third District Court of Appeal

More Blog Entries:

McIntosh v. Progressive Design & Engineering et al. – Troubling Traffic Engineering, Jan. 18, 2015, Fort Myers Crash Lawyer Blog