Our client was the beneficiary of an ERISA life insurance policy that the decedent had taken out through his employer. Tragically, the decedent was killed in a motor vehicle accident, and cocaine was detected in his system. The life insurance policy contained an exclusion for deaths if a person is "under the influence of narcotics." The life insurance claim was denied based on this exclusion.
We were successful in forcing the insurance company to pay the life insurance proceeds based on two simple grounds. First, cocaine is not a narcotic. We retained an expert pharmacologist who testified that narcotics are a derivative of opium, and are a depressant to the system; while cocaine is derives from the coca plant, and is a stimulant to the system. In fact, they are pharmacologically opposites.
Second, there is no level over which a person is considered "under the influence" of cocaine. Thus, we argued that the ERISA insurer could not carry its burden of proof on this element of its exclusion.
We filed suit on this case, but the insurer settled shortly after receiving our Motion for Summary Judgment.