Accidental Death Claims in Florida
Accidental death policies will allow coverage of a claim when the insured dies from an accident. To put it as plainly as possible, an “accidental death” usually occurs when the insured died from causes which are not natural. Case law, for example, has defined “accidental” as something that is “fortuitous, contingent, or happening by chance.”
Stated another way, death may be “accidental” if it is physically caused by events and conditions that are external to the body.
When you think of an accidental death, you might think of someone dying in a vehicle crash or drowning in a body of water. These are events which are not natural causing.
Why will an accidental death claim be denied?
An accidental death benefit claim is commonly denied on the basis of a policy exclusion. Accidental death policies will usually exclude coverage if the insured died a “natural” death. A natural death signifies death from sickness or the normal aging process. Often times, the critical issue in an accidental case is whether the insured died from an “accident” or from “sickness”. This issue can, of course, turn on rather contested factual questions.
What if the insured dies from suicide? Is that an accidental death?
As a general matter, accidental death policies do not provide coverage if death is due to suicide. (The attorney should always review the policy before making a legal conclusion
on the matter of coverage). However, suicide cases present their own unique issues. A potential key issue in a suicide case is whether the decedent took his or her life, or
actually died from an accident.
Florida case law provides a favorable presumption against suicide. This means that if
the insurance company asserts that the insured died from suicide, and denies coverage,
nevertheless, from an evidentiary point of view, the court will apply a presumption that
the insured did not commit suicide. However, the legal presumption against suicide can
be overcome if the insurance carrier is able to produce evidence against suicide. If the
evidence turns out to be fairly conflicting, it could result in a triable case.