Cuyamaca College Insurance Covers Questions

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Tom was insured under a life insurance contract policy that excluded death due to suicide. The policy had a face amount of $1 million. Two weeks after taking out the policy, Tom stopped at a local bar to have a “few” as he had gotten a promotion that day and his family was depending on that promotion to save their home. Tom left the bar, driving while intoxicated. He was speeding and lost control of his car which hit a utility pole.  He was killed immediately.  There was no one else involved in the accident.  The weather was clear and the road was in good shape and well lighted.  Tom’s insurance company refused to pay and Tom’s wife sued the company to force payment.

The Trial

Testimony at the trial proved conclusively that Tom was legally intoxicated when he left the party. There was also proof that there was nothing in the policy about lack of coverage in the event of an accident due to intoxication.

The Arguments at Trial

The insurance company’s attorneys argued that benefit provisions apply only to death due to accidents and that, although Tom appeared to have been in an accident, his death was due to his being intoxicated and therefore not an accident. They further argued that this concept was so logical that it did not need spelling out in the insurance policy. The estate’s attorneys argued that because the policy was silent about accidents due to intoxication, the benefit provision should apply regardless of the cause of the accident;  the parties had a contract and all exclusions must be spelled out in the contract in order to be effective.

Questions to Discuss

  1. Who do you think has the stronger argument, the insurance company or Tom’s estate? Why?
  2. If you were the jury hearing this case, how would you decide? Why?
  3. What do you think the rule regarding coverage of accidents due to use of drugs or excessive alcohol should be?

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