Life Insurance Lawyer Delaware

Our Delaware life insurance lawyers are here to help. We serve all states. Free consultation. No fee unless settlement.

Is a fall a basis for denial of a life insurance claim?
A fall alone is generally not a basis for denial of a life insurance claim. However, if the cause of the fall was due to engaging in hazardous activities or under the influence of drugs or alcohol, it could potentially lead to a denial of the claim. It ultimately depends on the specific circumstances surrounding the fall and the terms of the life insurance policy.
What are unusual examples of accidental death and dismemberment claims being denied with respect to a life insurance policy claim?
There are many unusual examples of accidental death and dismemberment (AD&D) claims being denied by life insurance companies. Some examples include:
  1. Death resulting from an animal attack that was not specifically listed as covered under the AD&D policy.

  2. Injuries sustained while participating in a sport or activity that was not covered under the AD&D policy.

  3. Injuries or death resulting from a natural disaster or act of terrorism, which were not covered under the AD&D policy.

  4. Death resulting from a medical condition or illness, rather than a direct accidental injury.

  5. Injuries sustained while under the influence of drugs or alcohol, which may be excluded from coverage under the AD&D policy.

  6. Injuries or death resulting from a criminal act or involvement in illegal activities.

  7. Injuries or death resulting from a pre-existing medical condition that was not disclosed on the application for coverage.

It is important to carefully review the terms and exclusions of an AD&D policy to understand what activities and circumstances are covered and to ensure that any medical conditions are disclosed on the application for coverage.

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Life Insurance Beneficiary Rules and Disputes Delaware

Life insurance beneficiary disputes can arise in various scenarios, often leading to complex legal battles and emotional distress among the parties involved. Here are three detailed examples:

  1. Last-Minute Beneficiary Change: Scenario: John, a terminally ill individual, decides to update his life insurance policy beneficiaries shortly before his passing. His original beneficiaries were his wife and children. However, in his final days, influenced by a new friend or advisor, he changes the beneficiaries to distant relatives or a charity organization. Dispute: After John's death, his family discovers the beneficiary change and contests it, claiming John was not of sound mind or was unduly influenced at the time of the alteration. They argue that the last-minute change doesn't accurately reflect John's true wishes. Resolution: Resolving such a dispute may involve gathering evidence of John's mental state and intentions at the time of the change. This could include medical records, witness testimonies, and documentation of any suspicious circumstances surrounding the alteration. The court may decide based on the evidence whether to uphold the last-minute change or revert to the original beneficiaries. Our top life insurance law firm won a $2,300,000 denied life insurance case involving Mutual of Omaha.

  2. Beneficiary Changed by Caregiver: Scenario: Sarah, an elderly woman suffering from dementia, relies heavily on her caregiver, Jane, for assistance with daily tasks. Sarah had designated her children as beneficiaries of her life insurance policy. However, Jane convinces Sarah to change the beneficiaries to herself, promising to take care of her. Dispute: After Sarah's passing, her children discover the beneficiary change and suspect undue influence by Jane. They believe Sarah was not fully aware of the consequences of the change due to her mental condition and argue that it goes against Sarah's long-standing intentions. Resolution: Resolving this dispute would involve an investigation into the circumstances surrounding the beneficiary change. This may include assessing Sarah's mental capacity at the time of the alteration, examining any evidence of coercion or manipulation by Jane, and considering Sarah's prior wishes as documented in legal records. If the court determines that Sarah was not competent to make such decisions or that she was unduly influenced, they may invalidate the beneficiary change. Our life insurance lawyers won a case with Globe Life Insurance on these facts.

  3. Beneficiary Ex-Spouse Cut: Scenario: Mark and Lisa were married for many years, during which Mark designated Lisa as the primary beneficiary of his life insurance policy. After their divorce, Mark remarries and updates his beneficiary designation, excluding Lisa and naming his new spouse instead. Dispute: When Mark passes away, Lisa discovers that she was no longer listed as a beneficiary of his life insurance policy. She believes that the change was made in retaliation for the divorce and argues that she is entitled to the proceeds as per their divorce settlement or based on state laws governing divorce and life insurance. Resolution: Resolving this dispute would involve interpreting the divorce settlement agreement, if any, regarding the disposition of life insurance benefits. Additionally, state laws may dictate whether divorce automatically revokes a former spouse's designation as a beneficiary. If there are ambiguities or conflicts in the documentation, the court may intervene to determine the rightful beneficiary based on the intent of the parties involved and relevant legal principles. Our life insurance attorneys fought a case involving a $900,000 Protective Life Insurance policy and successfully resolved it.

2023-2024 Life Insurance Claims in Delaware Recently Settled

  • ERIE Life drug exclusion denial $20,000.00
  • Gerber Life fall death heart attack $65,000.00
  • Great Southern autoerotic asphyxiation $304,000.00
  • Chubb smoking in medical records $13,000.00
  • OneAmerica coronavirus denial $50,000.00
  • New York Life prescription drugs $105,200.00
  • MassMutual COVID-19 exclusion $200,000.00
  • Primerica felony gun exclusion $71,000.00
  • Denied AD&D claim Delaware $180,000.00
  • Accidental Death & Dismemberment $700,000.00
  • Liberty Mutual emergency room record $25,000.00
  • Denied SGLI claim beneficiaries $400,000.00
  • Veterans beneficiary dispute $205,000.00
  • AAA shooting downtown Wilmington $15,000.00
  • Bankers Life interpleader claim $325,000.00
  • FEGLI denied claim lawsuit $274,000.00
  • United Home self-inflicted injury $110,000.00
  • North American pneumonia death $103,000.00
  • Nassau RE coronavirus denial that we won $103,000.00
  • Prudential AD&D policy death not accidental $515,300.00
  • ERISA life insurance claim $137,000.00
  • AAA spouse versus ex-spouse dispute $321,400.00
  • Centerville dispute wife and caregiver $1,070,450.00
  • Denied FEGLI claim resolved very fast $280,900.00
  • Milford long delay of policy benefits obtained $108,000.00
  • Baltimore Life long delay of benefits we got $202,000.00
  • River source interpleader lawsuit plaintiff $253,200.00
  • Banner exclusion for alcohol settlement $119,000.00
  • Greenville Delaware denied life insurance claim $2,550,000.00
  • Wilton RE life sickness exclusion we won $288,000.00
  • AIG self-inflicted injury denial $247,000.00
  • Denied SGLI claim beneficiaries $405,730.00
  • Delaware denied life insurance claim $1,000,000.00
  • John Hancock misrepresentation application $125,000.00
  • SGLI change of beneficiary dispute $400,000.00
  • Newark Delaware dangerous activity $350,000.00
  • Country Financial denied claim won $10,000.00
  • Dover bad faith life insurance claim $124,000.00
  • Denied AD&D claim poisoning claim $829,000.00
  • Smyrna ambiguous language won $101,500.00
  • Milford divorce court orders settlement $440,000.00
  • Physicians Life prescription drug denial $273,000.00
  • Massachusetts Mutual suicide exclusion $303,200.00
  • VGLI competing beneficiaries resolved $400,000.00
  • Denied life insurance claim Wilmington, Delaware $750,000.00
  • Milford accidental death and dismemberment $200,000.00
  • Travelers Life divorce dispute settlement $430,000.00

Interpleader Lawyer Delaware

Delaware Life Insurance Law

If you place ownership of your life insurance policies in a trust, be sure you can trust the trustee

Most people understand the basics of life insurance. A policyholder pays premiums to an insurance company in exchange for a life insurance policy. That policy names one or more beneficiaries who will receive a death benefit payout when the policyholder passes away. In most instances, it is a relatively simple transaction.

In other cases, however, the mechanics of the insurance relationship can be a little more difficult. A perfect example of this complexity arose in a recent court case out of Nebraska. This article discusses the details of that case, and serves as a good reminder that sometimes complexity is not the best course for estate planning.

A life insurance policy held in trust

In the case at issue, a 38 year-old woman named Marilyn lived with her three children, all of whom were under the age of 10. Despite her youth, Marilyn felt it was extremely important to engage in some thoughtful estate planning given that her husband had unexpectedly passed away a few years earlier at the age of 36.

Marilyn knew that a sound life insurance policy would be the best way to financially protect her children should something happen to her. Because her kids were so young, however, Marilyn had reservations about obtaining a life insurance policy that named her minor children as direct beneficiaries.

After speaking with her insurance broker, Marilyn obtained a life insurance policy worth $3 million. She paid the premiums on that policy but transfered ownership of the policy to a trust. Not knowing many people in town, Marilyn appointed a friend’s accountant as the trustee of the trust.

Among other things, the trustee was charged with making sure the policy remained in good standing. He was also responsible for administering the life insurance proceeds to Marilyn’s children if she were to die before they were 18. This all seemed to make sense to Marilyn given that she really had no one else to look out for her children’s best interests.

An untrustworthy trustee

Marilyn remained responsible for paying the policy premiums during her lifetime. Always diligent, Marilyn had her computer remind her each time the annual premium of $150,000 came due. At that time, she would mail a check for the premium amount to the trustee. He would then make payments to the life insurance company on behalf of the trust.

This all worked well for a couple of years. Marilyn made payments to the trustee and he paid the insurance company. In the third year of the policy, the trustee was undergoing personal financial difficulties. When he received Marilyn’s premium payment check that year, he deposited it in his personal account, just as he had done in the past. Rather than immediately turning around and making a like payment to the life insurer, however, the trustee instead held on to the funds for his own use.

Once the premium payments were past due, the life insurance company began sending delinquency notices. At first, these were simple overdue reminders. Next, the insurer began to warn that the policy would be cancelled if payment was not received within 30 days. When no payment was forthcoming, the insurer issued a notice of termination giving the insured the opportunity to reinstate the policy by making the account current within 60 days.

Unfortunately, all of these notices were sent to a P.O. Box that had been set up by the trustee for the sole purpose of administering Marilyn’s trust. Once the trustee started embezzling funds from the trust, however, he also stopped checking the mail that came into that address. The life insurer even sent some of the correspondence via certified mail but none of it was ever signed for or picked up from the post office.

A coverage conundrum

Tragically, Marilyn was killed in a car accident during what would have been the fourth year of the policy term. Her children, now without parents, were placed in the care of a distant relative named Tony. Fortunately, Tony had the foresight to search Marilyn’s effects for evidence of a life insurance policy or other funds that might assist with raising Marilyn’s three children.

Not surprisingly, Tony found evidence of Marilyn’s life insurance policy among her papers. He quickly contacted the insurance company to inquire about making a claim. That’s when he learned that the policy had been cancelled due to nonpayment of premiums. He also learned of the arrangement with the trustee at that time. The insurance company outright refused to entertain any claim for death benefits that Tony might submit. He had no idea what to do.

At that time, Tony contacted an attorney who specializes in the denial of life insurance claims. After reviewing all of the evidence at hand, the attorney decided Tony, on behalf of Marilyn’s minor children, should sue the trustee and the insurance company. The theory of the case against the insurance company was that it had constructive knowledge that no one was receiving the delinquency notices regarding the policy given that its certified letters on that issue were never picked up.

After a prolonged trial, the court sided with Tony and returned a verdict against the trustee and the insurance company. Although that was a great outcome for Tony and for Marilyn’s children, the case was not an easy one to win and very easily could have been decided in the insurance company’s favor.

The moral of this story is twofold. First, if your estate is so complex that documents such as life insurance trusts need to be created, you must make sure you can trust the people charged with administering the estate. Additionally, any time you receive a life insurance claim denial, it is best to contact an attorney who specializes in those matters. Our firm does just that day in and day out. If you have a claim denial that needs to be sorted out, call us today. We’re here to help.

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Alcohol Exclusion Life Insurance Denial

In the United States alone, it is estimated that nearly 30 people die every day in an alcohol-related auto accident. If they planned ahead, their loved ones will be entitled to the death benefit from some sort of life insurance policy. More often than not, however, when those loved ones go to make a claim on the policy, that claim is denied outright due to the involvement of alcohol in the insured’s death.

In fact, we’ve seen insurance companies deny such claims without doing any sort of substantive investigation whatsoever. It’s as if their claims manual simply says “Alcohol involved in death? Deny claim.” This is largely because most life insurance policies contain a provision saying that if you die while committing a crime, your beneficiaries are automatically disqualified from receiving your death benefit.

Driving under the influence, of course, is a crime. Thus, for the insurance company, these cases seem like a slam dunk. If you’ve been denied a death benefit payout on this basis, you need to know that claim denials in these situations are not that automatic. Indeed, there are several reasons why the beneficiaries may still be entitled to receive the payout.

For example, while the insured may have driven after consuming alcohol, his blood alcohol level may not have been at or above the legal limit at the time of death. In that case, his act of driving was not a crime, and the policy exclusion should not kick in. There are other exceptions that may apply but if you’re facing a denial on this basis, you really need to speak with an attorney specializing in life insurance claim denials.

Dangerous Behavior Exclusion Life Insurance Denial

In other cases, the insured’s death is due to a car crash that occurred while the insured was exceeding the speed limit. This is another frequent reason that life insurance companies deny claims. Almost without fail, however, their reasons for doing so are on shaky grounds at best.

We’ve seen insurers deny these claims on the grounds that speeding is a “reckless” or dangerous behavior. Many policies contain exclusions for deaths that occur while the deceased was acting recklessly. As you might imagine, there is a lot of wiggle room in that definition and a claim denied on this basis should be contested immediately.

We’ve also seen life insurance companies deny these claims because the act of speeding constitutes a crime, thus triggering the crime exclusion detailed above. This is where having a lawyer on your side to contest the denial is critical. In most states, exceeding the speed limit is considered an “infraction,” not a crime. Legally speaking, there is a significant difference between the two. Be sure you have someone on your side who can fight this fight.

Drug Exclusion Exclusion Life Insurance Denial

Finally, we’ve also seen instances where the life insurance claim was denied because the insured had drugs in his/her system, either prescription or illegal.

Life Insurance Contestability Period Delaware

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We can fight any drug exclusion life insurance claim denial.