Intentional Self Inflicted Injury

Intentional self inflicted injury, simply put, is an injury that is caused by the person injured. While we purchase life and disability insurances to protect and cover ourselves in case of injury, the area of a self inflicted injury can be a bit of a gray area. Many injuries considered to be self inflicted will not be covered by any of the policies that cover accidents. This also includes workers compensation. Understand what constitutes an intentional self inflicted injury, and knowing about a waiver of a premium, in advance to avoid a surprise.

How it Works

Insurance policies are written to such a way to insure both the policy holder and the insurance company. While insurance companies offer insurance to their policy holders to protect them, they also look to minimize their risk. Accidental insurance policies are written in such a way that will exclude coverage to the policy holder if the injury was self inflicted. If you have a history of risky behavior or a track record of self inflicted injuries, your insurance coverage may be denied.

Language in a accidental insurance policy excluding coverage of intentional self inflicted injuries is more often found in individual plans. Since group plans cover lots of different people with different needs, it is more rare to see a group plan that excludes coverage of self inflicted injuries. Group plans cover a group that is too broad to include language for an intentional self inflicted injury clause in the policy.

Self Inflicted Injury Exceptions

There are some exceptions to the exclusion of coverage for self inflicted injuries. Many life insurance policies will now pay death benefits to the beneficiary of a policy holder if the policy holder commits suicide. In order for the beneficiary to receive benefits from the life insurance policy, the policy holder needs to have their life insurance policy for a minimum of two years at the time of their death. Self inflicted injuries that result from depression may also be covered. If you have a history of depression and injuring yourself, check the specifics of your policy or speak to your agent about coverage.

If injury occurs to the policy holder while breaking the law, the insurance companies will not pay benefits out. Your accidental insurance policy may contain language precluding benefits if the policy holder is injured while committing a crime or while under the influence of drugs or alcohol. Read your policy carefully to understand what would be covered, what absolutely would not be covered and what would be considered an intentional self inflicted injury.

What constitutes an intentional self inflicted injury may be up for debate between the insurance company and the injured party. If there is a conflict of opinion between the policy holder or beneficiaries and the insurance company about whether injuries suffered were self inflicted or not, it may end up being for the courts to decide. In some cases, the policy holder or beneficiary is able to prove in a court of law that an injury suffered was, in fact, not self inflicted. If they are able to prove the injury was not self inflicted, the insurance company could be forced to pay benefits to the policy holder.

For many, we may not have to worry about what sustaining an intentional self inflicted injury. It is, however, important to understand what would be covered and what wouldn't. Even if you don't engage in illegal or risky activities, you may still become injured at some point. It's important to understand these details while your are doing your research on policies that cover accidents so that you are not surprised should you become injured.

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