October 24, 2025
Life Claim represented the widow of a man who fell down the stairs at his home and broke his neck, which caused his death. However, while the medical examiner listed “blunt force injuries of the head and neck” as the cause of death, he also “acute and chronic substance abuse (including ethanol and benzodiazepines) and hypertensive atherosclerotic cardiovascular disease” as contributing factors. Additionally, a toxicology report indicated that a blood sample taken from the insured postmortem tested positive for alcohol in the amount of .182 g/100mL, which is equivalent to a BAC of 0.18%, or more than twice the legal limit in Texas.
Based on the Medical Examiner’s report and the toxicology report, Minnesota Life denied our client’s claim for two reasons. First, the company argued that it had not received sufficient proof that the loss resulted independently from all other causes because “[e]thanol at this concentration would impair one’s ability to ambulate safely and with coordination so death from a fall is no longer unforeseeable.” Second, the company argued that the policy’s “alcohol exclusion applies and precludes the payment of benefits.”
Faced with these obstacles, our forensic investigation team was able to obtain clarification from the Medical Examiner that he found no specific medical evidence to support that cardiovascular disease, alcohol intoxication, or benzodiazepine consumption actually caused or contributed to the fall. After submitting a comprehensive appeal, Minnesota Life reconsidered its decision and agreed to pay our client’s claim in full with interest.