Insurance refuses to cover woman’s $54K bill because of alcohol use

This is an archived article and the information in the article may be outdated. Please look at the time stamp on the story to see when it was last updated.

LOVELAND, Colo. — There’s nothing illegal about having a few drinks in one’s own home – but when a Colorado woman tripped and fell on her face, that’s when her problems began.

Carol Mullins, of Loveland, says her insurance company refused to cover her medical bills because she was legally drunk. Now Mullins has a $54,000 medical bill for a fractured cheekbone.


“These insurance companies, they take and take and take and as soon as you have a claim, sorry can’t help you,” complained Mullins.


The 55-year-old said she tripped on her front porch on the evening of March 28, after her grandchildren left a sled partially hidden behind a chair.

“I’m 100-percent sure I would not have fallen if the sled would not have been there,” insisted Mullins, denying that the several glasses of wine she drank earlier that night were to blame.

But her insurance company, Tokio Marine HCC, sent her a denial of coverage letter stating, “Injury sustained that is due wholly or partially to the effects of intoxication or drugs is excluded under this policy.”

Carol remembered her reaction upon reading the letter, “I wanted to throw up because I couldn’t believe it because I knew we were in the $50,000s (of medical bills).”

insurance-denialMullins said the fall would’ve happened if she had been stone cold sober and feels insurance is for accidents.

“I was in my own home,” Mullins said. “I wasn’t out driving. Since when can’t you have a couple of glasses of wine in your own home?”


An attorney for Carol’s insurance company told the FOX31 Problem Solvers the policy speaks for itself but suggested Mullins file an appeal.  Vincent Plymell, the Communications Manager for Colorado’s Division of Insurance, suggested Mullins file a complaint with the Department of Regulatory Agencies because his office had never heard of such an exclusion.  Plymell said it might be legal for an HMO to deny such a claim but he’s unaware of an HMO ever doing it, and it’s not clear that Tokio Marine HCC qualifies as an HMO in Colorado.

If you’ve had a similar situation, you can file a complaint with the Department of Regulatory Agencies by calling 303-894-7490 / 800-930-3745 (outside the Denver metro area) or emailing

Copyright 2021 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


Police Theft Prevention - Shannon LaNier

Showers not producing much rainfall - Star Harvey

Astros played coldest game ever - Adam Krueger

Track Severe Weather on the new CW39 app - Adam Krueger

Happy Earth Compost

ABC13 9PM News EVERY night on CW39 Houston

Severe Forecast Friday - Adam Krueger

CW39 Houston headlines - Sharron Melton

LIVE in Minneapolis - Craig Treadway

Verdict reaction - Shannon LaNier

Star Harvey with Amber Wheeler CW39 8-9am

Bus stop, 7-Day, & Carwash forecasts - Star Harvey

Reaction to Chauvin Conviction - Sharron Melton

Chauvin verdict reaction in Houston - Shannon LaNier

Frost Advisory, Freeze Advisory, Fire Weather Warning - Adam Krueger



Mars "Ingenuity" Helicopter Reaction Follow w/ Jim Reuter

DC Rep. Bush - Chauvin Verdict Reaction

DC Rep Bass - Chauvin Verdict Reaction


More Featured



More Crime

Local Headlines

More Local

Don't Miss