Alcohol exclusion provisions and alcohol-related insurance claim denials in the United States: A narrative review.
Year: 2026
Type: review
Abstract: BACKGROUND AND OBJECTIVES: Alcohol exclusion provisions (AEPs) in the Uniform Accident and Sickness Policy Provision Law (UPPL) allow insurers to deny claims for alcohol-related injuries. Although many states have repealed AEPs, some enacted explicit prohibitions on intoxication-based claim denials while others did not. This review documents the evolution and current legal landscape of AEPs and evaluates how prior studies have classified these policies. METHODS: Data were obtained from the Alcohol Policy Information System (APIS) accessed in December 2025 and verified using Westlaw and Nexis Uni. Targeted reviews of the literature on AEPs were conducted. RESULTS: As of 2024, 21 states retain AEPs. Fourteen states and the District of Columbia explicitly prohibit intoxication-based claim denials, 13 states have no UPPL-related provisions, four states limit AEP applicability to disability insurance, and two states maintain policy-specific exceptions. Prior studies frequently overlook these distinctions. CONCLUSIONS: Legal heterogeneity remains substantial and may contribute to policy misclassification and biased estimates in empirical evaluations of AEPs. SCIENTIFIC SIGNIFICANCE: By providing a comprehensive legal mapping of AEP regimes and identifying common methodological shortcomings in the literature, this review offers a framework for improving future research on alcohol-related insurance policies, alcohol screening practices, treatment utilization, and related health outcomes.
Source: PubMed
DOI: 10.1111/ajad.70186
Author: Barış K Yörük
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7168359963