IF you have a bit too much to drink this Christmas, spare a thought for Dee Elliott, who is battling with two insurers after her husband was run over by a car after a night out with colleagues.

Robin, who worked for the Ministry of Defence, was killed in October 2005 on a work trip to Wakefield. Although the actual events are unclear, it appears he left his hotel after a night of drinking with colleagues, stumbled onto a road and was hit by a car. When the emergency services arrived he was already dead.

Dee was devastated but believed she would be financially secure because Robin had taken the precaution of buying accident insurance. He had three policies, which were supposed to pay out a total of £145,000 to cover mortgage payments and other debts - two with Stonebridge International Insurance, an offshoot of Aegon, the other with Genworth Financial.

All three claims were rejected, though, because Robin, who was 57, was over the drink-drive limit when he was killed. This has left Dee struggling financially and she now faces the prospect of losing her home.

She said: “One by one the letters came back, each one refusing to pay out as Robin was over the drink-drive limit - even though he was a pedestrian. If they don’t pay out I could lose my home.”

The policies in question are a type of personal-accident insurance, held by hundreds of thousands of people. The insurance is supposed to pay out a lump sum in the event of an accident that causes permanent disability, hospitalisation or death. It is sold under various guises, including accidental-death plan and life-protection insurance, through banks, building societies and clubs. It is also marketed directly, making up a substantial portion of Britain’s junk-mail mountain.

While it can be cheap - providing cover for as little as £1 a week - most policies are riddled with exclusions which means a payout is far from guaranteed.

A standard feature of the policies is a clause that allows the insurer to wriggle out of a claim made when an accident arises under the influence of alcohol. This can come as a shock - as it did to Dee - as the exclusions are often not pointed out at the point of sale.

Kevin Carr at Lifesearch, an insurance broker, said: “Even though the alcohol exclusion is in the contract, it will surprise many that they could have a claim turned down after having a few drinks.”

Some policies are vaguely worded, implying that any amount of drinking is enough to invalidate a claim: “Using any type of alcohol or drugs unless under the advice of a doctor” is common wording.

Others are more specific: Stonebridge excludes claims where the person in question has a blood-alcohol level of 80mg of alcohol per 100ml of blood or higher, the drink-drive limit. Alcohol exclusions are a common feature of other types of insurance policies. Private medical insurers may refuse a payout for any condition related to “inappropriate drinking”. Being under the influence while on holiday is also a risk.

Peter Gerrard at Moneysupermarket, a comparison site, said: “It is a little-known fact that travel-insurance policies have a clause stating if you are under the influence of alcohol or drugs at the time of an incident your policy may be invalid.”

Life insurance will generally pay out even if a medical test shows you had alcohol in your blood when you died - although a claim may be rejected if you are a heavy drinker and failed to declare it.

Dee took her case to the Financial Ombudsman Service. Much to her disappointment, it upheld the insurers’ right to reject her claim. In his summing up in the case against Stonebridge, the ombudsman said: “The coroner’s report indicates, on the balance of probabilities, that Mr Elliott’s intoxication contributed to the accident that caused his death.”

Dee’s solicitor disagrees, arguing that the report does not suggest a link between Robin’s drinking and the accident. He also challenges Stonebridge’s exclusion based on the drink-drive limit arguing that it is too wide and could breach the unfair terms and conditions regulations.

Stonebridge and Genworth said this was a standard clause and they were committed to treating customers fairly.

It is worth complaining because on average the ombudsman said it upholds more cases in favour of the consumer where alcohol is involved.

A spokesman for the Financial Ombudsman Service said: “Where an insurer seeks to rely on an absolute exclusion for alcohol we would want to know that this had been very clearly brought to the attention of the consumer.”

INSURERS’ RULES ON DRINKING

FOR policies designed to pay out if you have an accident, some reserve the right to reject a claim for any drinking. “Using any type of alcohol or drugs unless under the advice of a doctor” is common wording.

Others exclude claims where the subject is over the drink-drive limit.

Private medical insurers may refuse a payout over “inappropriate drinking”. Being under the influence on holiday is a risk. Life insurance generally will pay out even if a test shows alcohol in blood at death.

Times Recommends

• How to sell your home in a downturn
• How to boost your spending power
• Unemployment benefits explained