FW: Darnell Ward Beneficiary Claim
Elaine Ward
To: Elaine Ward From: Imperial General Insurance Subject: Darnell Ward Beneficiary Claim 2945.10.27.011:13SET
Dear Elaine Ward,
As you know, I have been investigating your beneficiary claim resulting from the loss of Darnell Ward. We are sorry to inform you that after careful consideration and review, our investigation has revealed the cause of loss is not covered by the employee policy provided by Covalex Shipping.
Personal Life Policy 02107 02012000 notes the following exclusions under which benefits will not be paid if the loss:
(A) results from the Insured's alcoholism or addiction to drugs or narcotics; but not addiction which results from the administration of those substances in accordance with the advice and written instructions of a Licensed Health Care Practitioner. (B) results from the Insured's participation in a felony, riot or insurrection, or involvement in an illegal occupation.
The preponderance of the evidence collected at Covalex Gundo Station and witness statements indicate that the insured was intoxicated to the point they he lost normal control of his mental and physical facilities and that this intoxication was a contributing cause of the accident.
It is against the law and considered a felony for an individual to cause the death of another by the operation of devices while under the influence of intoxicants. Even if there may be intervening factors between the fact of operation and the death of another. Felony exclusion makes no benefits payable.
Since your claim was denied, you have the right to an internal appeal. You may request one by filling out a DCR-90 form. If you have questions regarding the information contained in this letter, please feel free to contact our claims department.
Sincerely,
Jessie Holzburg
Claims Adjuster Imperial General Insurance
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