Life insurance companies do not like suicide. And it’s not for the same reasons the rest of us do. While normal people see suicide as a tragic cause of death, life insurance companies simply view it as a policyholder forcing them to pay out on a claim early. The earlier they have to pay out on a policy, the less money they make off that policy. Life insurance is just business to them. Learn about accidental life insurance claim denied.
Contrary to popular belief, death by suicide is not excluded in many life insurance policies. Indeed, most only contain language relieving the insurer from paying a death claim if the policyholder dies from suicide during the first two years of the policy. You better believe that when an insured does die during those early days of the policy, the life insurance companies will go to great lengths to make that death look like suicide. They do this, of course, simply to avoid payment.
As lawyers who specialize in the wrongful denial of life insurance claims, however, we have seen life insurers go to great lengths to label a death a suicide, even when all external evidence suggests otherwise. In doing this, the insurers hope not only to avoid making a policy payout, but also to so demoralize the surviving beneficiary such that they give up the fight for the monies they’re owed. It’s our job to make sure that doesn’t happen.
This article explores a fairly typical scenario where a life insurance company jumped at the chance to label a suspicious death as a suicide just to avoid making payment.
Death by poisoning
John was an interesting person. By his late forties, he was an accomplished songwriter and musician. John made a good living and was able to provide for his wife Suzanne and their two children.
Because Suzanne did not work outside the home, the couple did extensive estate planning in the event John predeceased his wife. One of the planning assets they chose was a lucrative life insurance policy on John’s life, which the couple obtained in June 2001. Among other things, the policy provided that if John were to commit suicide before July 2003, the life insurer would be under no obligation to make a policy payout.
One notable thing about John was his love of adventure travel. For example, in 2002, John traveled to Pakistan, notwithstanding the grave unrest in the Middle East at that time. It was on that trip that John met an unfortunate fate. The facts surrounding his death were as follows.
John was excited to travel to Pakistan to meet with a local musician who was going to teach him a style of music unknown to Westerners. The trip was to be a short one – just five days – after which John was to return to the United States to begin collaboration on the score for a major motion picture. Although John had written for other films in the past, this one was projected to be a blockbuster. It was the type of project that could launch his career to a whole new level. To say he was excited was an understatement.
Unfortunately, none of that ever happened. On his second night in Pakistan, John went to dinner with friends. By all accounts, he was feeling fine and was laughing and joking with his companions throughout the meal. After dinner, John retired to his room. The next morning, the hotel housekeeper found John dead on the floor of his hotel room. Hotel staff called the authorities, including the American Embassy. They arranged for John’s body to be autopsied by U.S. military doctors.
The autopsy revealed the presence of a lethal poison in John’s body. None of the poisonous substance was found in John’s room or in any of his personal effects. The military doctor ruled that his death was due to poisoning, but did not state whether the poisoning was due to suicide, homicide, or accident.
The insurer decides it was suicide
Despite her grief, Suzanne filed a claim under John’s life insurance policy. That process involved submitting all of the paperwork and reports from Pakistani authorities, as well as the military doctors who performed the autopsy. Despite the suspicious nature of John’s death, it never even entered Suzanne’s mind that he might have committed suicide.
John’s life insurance company saw things differently. They issued a claim denial letter stating that John’s death fell within the two-year suicide exclusion. As such, they refused to pay out any portion of the claim. The letter only compounded Suzanne’s grief. She was about to walk away from the money when a friend implored her to call a lawyer specializing in life insurance claim denials.
The lawyer met with Suzanne, talked at length about John and the circumstances of his death, and reviewed all the documents she had submitted with her claim. He instantly recognized what the insurer was doing.
Within days, the lawyer filed a claim denial appeal with the insurance company’s internal review board. In it, the attorney submitted additional evidence that wasn’t called for or provided with the initial claim documents. In particular, he presented sworn statements from several of John’s friends about his overall happiness and excitement about life. He also submitted John’s contract to score the major motion picture, and several emails John had written regarding his extreme excitement about that project. This was not a guy who wanted to die.
Ultimately, the appeals board recognized that such evidence would prove convincing to a court if the lawyer were to sue the company. They therefore overturned the claim denial and paid Suzanne all monies owed.
This case is a good example of why policy beneficiaries shouldn’t just give up upon receiving a claim denial. If you are facing a situation like this one, please feel free to call our firm today. We contest claim denials like this one day in and day out. We would be honored to evaluate your case and help in any way we can. Call us today.