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California Court Awards Accidental Death and Dismemberment Benefits and Finds Unum was Wrong to Invoke a Crime Exception

A California District Court awards Accidental Death and Dismemberment (“AD&D”) benefits to a beneficiary and found Unum was wrong to invoke a crime exception under the life insurance policy at issue.


In 2019, Lilly Miller received grave news that her son was killed in a motorcycle accident. Ms. Miller was the beneficiary of her son’s life insurance policies. She filed a claim for $50,000 in life insurance benefits and $50,000 of AD&D benefits.

Unum paid the life insurance benefits but denied the AD&D benefits claiming that a crime exclusion (he was speeding at the time of the accident) precluded AD&D benefits. So, Ms. Miller filed a lawsuit against Unum in pursuit of the AD&D benefits.

The Crime Exclusion Policy

The life insurance policy included an exclusion for:

Accidental losses caused by, contributed to by, or resulting from. . . an attempt to commit or commission of a crime

The Court’s Decision

Unum argued that the crime exclusion was proper for the following reasons:

  1. Speeding is a crime under California Law; and
  1. Dictionaries define crime as any illegal act for which someone can be punished by the government

Ms. Miller argued that the statutory definition of crime does not control and instead the court must determine whether the insured person of average intelligence would consider speeding a crime.

The court agreed with Ms. Miller and made the following findings:

  1. The policy failed to define “crime” and its meaning is amenable to different interpretations; and
  1. Unum was not entitled to rely on California statute to define the term crime; and
  1. The dictionary has several definitions of the term crime proving it is ambiguous

In other words, the court found the term “crime” to be ambiguous. Because of this ambiguity, the court held that it is uncertain whether the crime exclusion should apply to speeding. Under the law, the court must construe the ambiguity against the insurer who drafted the policy.

Insurance Companies Have Lawyers. Shouldn’t You?

Because this law firm was created to focus on disability insurance, we have developed expertise in this complex area of the law.

Our expertise in long-term disability and life insurance claims means our clients have the backing of a law firm that has attorneys who:

  1. are experts in disability claims;
  2. fought all major disability insurance companies and know their tactics;
  3. a track record of success;
  4. won major disability lawsuits that created good law; and
  5. recovered millions of dollars in disability benefits.

All our lawyers commit every day of their legal career to helping people get disability benefits from UNUM, MetLife, Prudential, Northwestern Mutual, Hartford, CIGNA, and others.

Because federal law applies to most disability and life insurance claims, we do not have to be located in your state to help. We help clients nationwide.

Call to get experienced disability lawyers on your side with:

Call us at (800) 969-0488 or send us your information for a free consultation with a disability attorney. No fees or costs until you get paid.