Very often, people are told that life insurance will give a lump sum payout to the beneficiary should the insured person dies during the tenure. But, just like any pact, there are rules to follow and a few circumstances wherein a policy may not give a payout.
Insurance providers will brief you about the types of deaths that your policy will cover. However, some people may not be fully aware of those that are NOT funded by their policies. When it comes to coverage, how the insured person dies matters. Just as how essential it is to identify the covered cases, policyholders must also recognize the types of death which might be excluded from their policy coverage.
Whether you have a term life insurance or you are yet planning to purchase one, make sure you know whether or not a type of death is covered by your policy. Read on to learn the exceptional situations where insurers may withhold a death payout.
There are two types of possible scenarios for a policyholder’s death due to murder. Situation #1: If investigations reveal that the beneficiary has something to do with the policyholder’s death — involving themselves in the crime — the insurance provider will not settle the claim until the case resolution is in favor of the accused.
Situation #2: If the policyholder’s death is due to their own involvement in any criminal activity defined by the law, the insurance provider has the right to withhold the death benefit.
When it comes to suicidal death, the terms and conditions may vary depending on the insurance provider. Some insurers will not cover the policyholder’s death if he or she commits suicide within the first 12 months of the policy term, but will provide should the suicidal death occurs on the succeeding years of the policy tenure. In the case of linked policies, some insurers will pay 100% of the total death benefit even if the policyholder commits suicide during the initial year of policy commencement.
Then again, these are subject to the terms and conditions of the insurance provider, which is why it is crucial to review your policy to know the inclusions and exclusions before you even purchase it.
Under the Influence of Alcohol
Most insurers rarely accept applicants that are alcoholics and/or narcotic users in the first place. However, if the insured person had successfully availed a policy by lying and not disclosing his or her alcohol and narcotic habit, the beneficiaries cannot expect the insurer to provide a payout should the insured person dies in an accident due to driving under the influence of alcohol and other illegal narcotic substances.
Insurance providers are not obliged to honor the claim made by the beneficiary if the policyholder fails to disclose his or her regular participation in such hazardous activities. This is why pilots and crews have to opt-in for an aviation exclusion rider when availing a term life policy since flying is an activity that can pose a threat to their lives.
Depending on the company’s terms and conditions, some insurers may still provide the payout if the policyholder dies due to self-inflicting injuries. But, if the insurer finds out that your lifestyle poses enough risk by making these activities a regular hobby, they may exclude your case from the policy coverage.
Pre-existing Health Conditions
More often than not, insurance providers will not settle claims if the policyholder dies due to a health condition that existed prior to the application for the policy. This is why it is very important to be honest and thorough during the underwriting process in order to avoid difficulties of collecting the death benefit.
The types of health conditions may be subject to the terms and conditions of the policy but on top of these pre-existing illnesses are the sexually transmitted diseases such as HIV and AIDS.