Our life insurance lawyers in Massachusetts handle delayed and denied life insurance claims, AD&D claims, beneficiary disputes and Massachusetts interpleader lawsuits.
Deaths involving boats, commercial fishing, or work in harbors can lead to denied life insurance claims in various scenarios, depending on the circumstances, the terms of the insurance policy, and the findings of the insurance company’s investigation. Here are some scenarios in which a life insurance claim related to such situations might be denied:
Exclusion Clauses: Life insurance policies often contain exclusions for high-risk activities, including specific water-related activities such as deep-sea diving, commercial fishing, or piloting vessels. If the insured’s death occurs while participating in an excluded activity, the claim may be denied based on the policy’s terms.
Intentional or Criminal Acts: If the death results from intentional acts or criminal behavior on the part of the insured, such as reckless or illegal actions while operating a boat, the insurance company may deny the claim based on the policy’s exclusions for unlawful or self-inflicted deaths.
Underreporting Risky Activities: Failing to accurately disclose participation in high-risk maritime or fishing activities during the policy application process can be considered material misrepresentation. If the insurance company discovers such misrepresentations, they may deny the claim for providing false information.
Lack of Required Certifications: Some life insurance policies may require individuals engaging in specific water-related occupations or activities to hold certain certifications, licenses, or training. If the insured lacks the necessary qualifications or training, and their death is connected to their work, the claim may be denied.
Intoxication or Substance Abuse: If the insured was operating a boat or involved in maritime activities while under the influence of alcohol or drugs, and this contributed to the death, the claim may be denied based on policy exclusions related to intoxication.
Suicide or Self-Harm: If the death was ruled a suicide or was the result of deliberate self-harm while aboard a vessel or engaged in work in harbors, the policy’s suicide exclusion may come into play, potentially leading to a denied claim.
Violation of Safety Regulations: If the insured’s death is linked to a violation of safety regulations or procedures in the maritime or fishing industry, the insurance company may investigate and potentially deny the claim.
Occupational Hazard Exclusions: Some policies may include exclusions specific to certain occupational hazards, including those related to working in the fishing or maritime industries. If the insured’s death is a direct result of these hazards, the claim could be denied.
Delay in Reporting: Insurance policies often require that deaths be reported promptly. If there is a significant delay in notifying the insurance company of the death, it may raise questions about the validity of the claim.
Criminal Activity or Non-Disclosure: If the insured’s death is linked to criminal activities such as drug trafficking, smuggling, or other illegal maritime operations, or if the insured failed to disclose such activities during the policy application, the claim may be denied.
Non-Disclosure of Medical Conditions: If the insured had undisclosed medical conditions that contributed to their death, and these conditions were relevant to the risk assessment, the claim may be denied based on material misrepresentation.
It is essential for policyholders to thoroughly understand their insurance policies, accurately disclose relevant information during the application process, and ensure they meet any specific requirements related to their occupation or activities.