If the policyholder fails to disclose the outcomes of a genetic test indicating a heightened risk of a disease or condition, and the insurer uncovers this after the death, it may be deemed a breach of contract or fraudulent behavior. Most life insurance policies mandate applicants to furnish precise and comprehensive health information, encompassing any identified genetic risks. Neglecting to divulge pertinent details may result in the rejection of the claim.
Should the policyholder succumb to a disease or condition linked to a genetic mutation expressly excluded in the policy, the claim might be disallowed. Certain life insurance policies delineate exclusions for specific hereditary conditions like particular cancers or cardiovascular diseases. It is imperative for policyholders to meticulously scrutinize policy terms and conditions, comprehending the coverage scope and any predefined exclusions.
If the policyholder's genetic test results are not disclosed, and the information becomes known to the insurer during a routine review or investigation, leading to policy cancellation, any subsequent claims might be denied due to the lapsed coverage.
If the policyholder provides inaccurate information about their genetic history during the application process, and this misinformation is discovered after death, the insurer may have grounds to deny the claim based on misrepresentation.
If the policyholder undergoes genetic testing after obtaining the policy and discovers a high-risk condition, failing to inform the insurer promptly may lead to claim denial, as prompt notification is typically required for material changes in health status.
Understanding policy terms, adhering to disclosure requirements, and staying informed about any policy-related genetic testing provisions are vital to ensuring a smoother claims process in the event of an unforeseen circumstance.
What is scary is the prospect of life insurance companies obtaining genetic information on policyholders, and then intentionally canceling the policies of high risk individuals.
In any event, our top life insurance lawyers fight all denied and delayed life insurance claims. Our life insurance lawyers handle FEGLI claim denials as well as SGLI claim denials. The life insurance claim attorneys at our firm handle beneficiary disputes and life insurance interpleader lawsuits.