Our firm specializes in contesting the wrongful denial of life insurance claims. Consequently, we know the industry better than most. In fact, because of our specialty, we view life insurers with a great deal more skepticism than the average consumer.
For example, many consumers view life insurance companies almost like charitable organizations. After all, when life insurance works the way it is supposed to, a death payout can be the difference between poverty and financial security for loved ones left behind. Additionally, even though that eventual payout can be quite large (sometimes in the hundreds of thousands, if not millions of dollars), many policyholders pay relatively modest monthly premiums. In other words, life insurance seems like a great deal to the average person.
Because we deal with these companies all the time, however, we know full well that they are far from charitable. In fact, they often stretch the interpretation of policy language with the specific intent of denying otherwise valid claims. Remember, life insurers are for-profit enterprises. They don’t get rich by indiscriminately paying out claims. They do get rich by routinely collecting premiums and then denying claims from grieving beneficiaries who are too bereft to fight for their rights.
That’s why we’re here. We’ll do the fighting for you when you need it. Until then, let us describe for you a recent case that illustrates the reality that life insurance companies are not your friend.
Difficulty submitting a claim
The case involved a life insurance policy worth $350,000 owned by a man named Dennis. Dennis named his younger brother Ryan as the sole beneficiary under the policy. In fact, he even went so far as to provide Ryan with a copy of the actual policy, which Ryan kept in a safe deposit box.
Dennis paid his premiums faithfully for over 15 years. When he was 67 years old, he passed away following a long battle with cancer. At the time, Ryan was 62. He was terribly shaken by his brother’s death. Additionally, Ryan had been fighting Lyme disease for a few years and a brain infection had taken a toll on his ability to process new or difficult information.
Nonetheless, a few weeks after Dennis passed away, Ryan retrieved his brother’s life insurance policy from the safe deposit box. He carefully turned to the section of the policy titled “How to file a claim.” In truth, the directions were unnecessarily convoluted, which made them terribly difficult to understand in Ryan’s condition.
For example, the policy first gave instructions for what to do if the policyholder died within the first two years of its issuance. It then gave instructions for what to do if the insured had paid for an Accidental Death & Dismemberment rider – although it gave no instructions regarding how a beneficiary could tell if such a rider was in place. Finally, it gave instructions for how to file a claim on a policy that had been in place for over two years.
Although the final category was the one Ryan needed to focus on, he had a difficult time understanding that information. Specifically, the claims in that category required submission of: (a) a signed and completed claim form; (b) a valid death certificate; and (c) an autopsy report, if one was prepared (if not, the claimant was supposed to submit a sworn statement saying there was no autopsy report in existence).
Ryan didn’t have any family members or friends in the vicinity who could help him process the claim. Thus, he did the best he could do on his own. Ultimately, he submitted: (a) a claim form that was about 90% complete, but unsigned; and (b) a death certificate. No autopsy had been ordered for his brother given the clear cause of death. Nonetheless, Ryan forgot to submit a sworn statement to that effect.
No help with the claim
Several weeks following Ryan’s submission of the claim, he realized he had not heard back from the life insurance company. Thus, he called a “help” line referenced in the policy documents. That number didn’t connect him to a real person. To the contrary, he was prompted to put in the policy number he was calling about. An automated voice system then informed him that the claim was “under review.”
For the next two months, Ryan heard nothing. No one from the life insurer ever contacted him to ask for the missing information. Eventually, he received a claim denial letter in the mail that simply read “claim file incomplete, claim denied.” Fortunately, Ryan had a caregiver at his house when the letter was delivered. The caregiver helped Ryan contact an attorney specializing in the wrongful denial of life insurance claims and even assisted Ryan with the initial consultation.
The attorney was horrified at what he heard. He immediately helped Ryan gather all of the information required to make a claim. He then contacted the insurer directly and submitted the full packet of information. He also informed the insurer in writing that he planned to file a lawsuit on Ryan’s behalf for, among other things, bad faith denial of claim (which carried the possibility that the insurer could be hit with punitive damages).
Within two weeks’ time, the life insurance company paid Ryan the full policy benefit, plus interest. Ryan and the insurer also entered into a settlement agreement whereby Ryan agreed not to sue for punitive damages. Ultimately, the outcome was the best thing for Ryan because it allowed him to focus on his life and his recovery.
Situations like this arise all the time. If you or a loved one have received a claim denial that doesn’t seem legitimate, please call our firm. We’ll provide a free evaluation and, if we believe your denial can be successfully contested, we’ll take on your case at no up-front cost to you. In fact, you won’t pay a dime unless and until you get some recovery from the life insurance company. Call today. We’re here to help.