FREQUENTLY ASKED QUESTIONS

Imagine the following scenario: Your spouse is the sole provider for you and your child. He has a life insurance policy, and he unexpectedly perishes. You assume that the policy will issue you – the beneficiary – the death benefit after he passes away. However, while your spouse was young and relatively healthy, to your dismay, an autopsy reveals that the cause of his death was a drug overdose and refuses to pay the death benefit.

In addition to your world being turned upside-down because your spouse has passed away, you are even further shaken to learn that you do not have access to the financial stability that you thought his life insurance would offer because he overdosed on drugs. You can’t help but wonder if the company that issued your husband’s life insurance has the right to deny the claim.

Life Insurance and Drug Overdose

life insurance drug overdoseDoes life insurance cover drug overdoses? Sometimes, but not always.

There are a number of factors that are taken into consideration to determine if a life insurance company will pay a death benefit for someone who has overdosed on drugs. These factors include:

  • The type of drug that the insured overdosed on
  • Whether or not the insured was honest about his or her drug use when applying for life insurance
  • Whether the drug overdose was intentional or on accident

It used to be that insurance providers excluded coverage for people who engaged in risky behaviors. These behaviors included things like scuba diving, mountain climbing, and skydiving, as well as drug use. However, today, many life insurance providers have become less stringent with their exclusions. But, with that said, it is still necessary for insured individuals to disclose with the provider any dangerous or risky behaviors that they engaged prior to receiving coverage. If the insured does not disclose this information, there is a chance that the policy will be void if the individual perishes as a result of engaging in a risky activity, such as drug use.

If the policyholder isn’t forthright with information regarding risky behavior, the insurance company has the right to deny the claim. If a claim is filed on the insured’s life insurance, there is what is known as an incontestability period. During this period, the insurance provider can dispute a claim, stating that the policyholder provided them with incorrect information.

Drug use is considered risky behavior, and an insurance provider may or may not issue a death benefit for a drug overdose.

When can an Insurance Company Deny a Drug Overdose?

If the drug overdose was deemed intentional, a life insurance provider can deny the claim and refuse to payout the death benefit. This is especially true if the life insurance policy was just taken out and the insured died as a result of a drug overdose shortly after the policy was issued. In this case, it would likely be determined that the insured took the policy out as a way to provide his or her family with financial stability – even if it meant ending a life.

If, however, the drug overdose was unintentional, there is a chance that the insurance company will cover the claim and pay out the death benefit; however, this type of situation is still tricky. Why? – Because drug use, as mentioned, is considered risky behavior. If the insured was not honest with the insurance provider while applying for life insurance coverage and had a long history of drug use, coverage may not be granted. But, that’s not always the case. For example, if the person was not using drugs at the time the policy was issued and recently started using them, or only tried them one time and overdosed, the insurance company may cover the claim and issue a death benefit to the beneficiary.

In short, drug overdoses require lengthy investigations before an insurance agency will agree to issue a payout to the named beneficiary. Based on what the insurance provider finds during the investigation, they may cover the claim, or they may deny it.

Is there a Difference between Illegal and Prescription Drugs?

Just like it depends on the nature of the drug overdose, it also depends on what type of drug the insured overdosed on.

An overdose of an illicit drug, such as cocaine, heroin, or meth, the insurance company could argue that the insured knew the dangers of using the drug, and therefore, the overdose was non-accidental and a claim could be denied. An overdose on a prescription drug, however, may be deemed accidental, because prescription drugs are prescribed by licensed physicians. For example, if someone overdoses on Oxycontin that was prescribed by a doctor, the death may be ruled accidental and the life insurance company would likely pay the death benefit.

Will a life insurance company deny a claim for a drug overdose? In short, there is no definitive answer. It depends on the circumstances and the insurance provider.

18 Comments

  1. I will never take my own life so that diane will not lose any of my benefits. i deal with so much pain. I need help but have just about given up on this issue. I need help help but know none will be forthcoming.

    1. Hi Robert. Pain and addiction are not easy obstacles to overcome. If you do, it will be a true accomplishment that you can very proud of, but it can be done. Remember that no one can do it alone. Insurance, including Medicare, can pay for rehabilitation services and counseling. This is the national helpline from the US Department of Health and Human Services https://www.samhsa.gov/find-help/national-helpline. This can be a good place to start on the road to recovery. I wish you and your family the best on your journey to recovery.

      1. WHY does every one assume someone on prescription medication from a doctor needs rehab or as the above stated “a road to recovery”? PAIN IS A REAL ISSUE! And because so many people have abused the system those that are truly in pain, REAL PAIN, are the ones now being labeled and paying the price.

        1. Hi Kimberly, great point. There is a difference between using prescription drugs and abusing prescription drugs. The people who need help are abusers.

    2. Hey man dont know you at all,but bro,,hang in there.dont be like that,we only get one chance at life.its not over for you.make things around you better.head high,mind right.

  2. My grandson has been on a grow up insurance plan since he was born for 10,000. It will automatically double when he turns 21. He has recently been smoking Heroine and is now addicted. He will be 20 this month. Will his insurance pay out if he was to die of an overdose? Thanks. It’s Gerber life.

  3. My son died of an over dose at 32 years old I have unium insurance company for coverage it was ruled accidental will they pay out

    1. Yes, they should! As long as it is not during the contestability period of the policy and there were no riders or exclusions dealing exclusively with drug overdoses.

  4. My son is 26 and is an active drug user. Is there any life insurance policies I could purchase and that would pay out if he god forbid passed away so I could cover funeral costs?

    1. He will qualify for a guaranteed policy, if not a traditional policy.

  5. My husband passed away has life insurance it was deemed accidental there were drugs in his system but he hit his head will they pay out

    1. I don’t know for sure. Most likely yes if the death was not ruled the result of an overdose.

  6. My brother in law died in his sleep last month in his early 30s and we just heard from the coroner that they’re ruling it an od from fentanyl but it makes no sense as they only found fentanyl and nothing else in his system (such as cocaine, opiods, mdma, etc) which is not how fentanyl is sold on the streets (it’s way too powerful alone. Pushers aren’t stupid, they make their money from repeat customers). My sister is terrified that on top of losing her best friend she’s gonna be homeless bc she doesn’t think insurance pay out now. Can you direct me to any resources for challenging cause of death on a death certificate? I think with covid and the general feeling of chaos we’re all experiencing there was a mix up at the morgue or lab.

    1. Andrew @ LifeAnt

      Hi Red,
      First of all, you might not need to worry if the life insurance company will pay the claim anyways, so you should first go through the process of trying to get that claim paid. A lot will depend on how long your brother in law had a life insurance policy and which company it’s with. If they refuse due to their belief that your brother in law lied on his application and had a drug abuse problem, then at that point you might want to see about getting a second opinion on the autopsy. It will likely cost money to do so, however. You could start with this link here https://www.therestlesssleep.com/?page_id=382

  7. My 35 year old brother passed away in May, 2020. He had workplace accidental death coverage. The cause of death was cocaine and fentanyl with a history of drug usage. The coroner report said it was an accidental death.

    He also had a accidental death rider to a loan insurance policy. The insurance on the loan paid out to cover the loan and I received the proceeds from it as the beneficiary.

    Now I am waiting on the 2 different policies to determine if illegal drug use ruled an accidental death on a coroner report is indeed an accidental death for payout of insurance purposes.

  8. Hello

    My ex husband, my daughters father died from fentanyl toxicity. It was ruled an “accidental death” from the coroner. The life insurance company denied it even though he had a prescription and was on other medications, like Xanax, gabapentin….etc. we are trying to fight this.. any suggestions?

    Thank you
    Roselyn

    1. Hi Roselyn it depends on whether the company has a good justification or not. Life insurance companies are pretty conservative when it comes to decisions like this, meaning they are typically more likely to side with a client in order to avoid bad press or legal trouble. That doesn’t mean that they always act ethically though and you should hold them accountable if you are within your rights. You can report the matter to your State bureau of insurance if you do not get the outcome that you desire, and you can approach an attorney who specializes in matters like this to threaten a suit to the life insurance company if you want to apply more pressure. You may want to review the language in your actual life insurance contract to see if the life insurance company is acting within their rights. If they are, you may not be able to do much.

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