Category: Life Insurance Claims
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Contesting Life insurance Beneficiary Last-Minute Changes

While almost any life insurance policyholder has the power to change their beneficiary designation at any time, a last-minute beneficiary change may indicate fraud, duress, or lack of competence. That the beneficiary change was made shortly before the death of the insured should raise suspicions that the new beneficiary may have made the change, the new beneficiary may have pressured the insured into making the change, or the insured did not understand what they were signing due to Alzheimer’s or dementia.

This is a horrible situation for the intended beneficiary or beneficiaries because you will have to fight an uphill battle to show that the beneficiary designation was changed due to fraud, duress, coercion, or lack of competence. Our life insurance claim attorneys have helped many families get to the bottom of a last-minute beneficiary change and prove that the change is invalid. 

Let our life insurance lawyers help you get paid the benefits that the insured always intended that you receive, not someone else. Contact us to schedule your free, no-obligation case evaluation. We will represent you on a contingent basis, meaning we do not get paid unless you do. You have nothing to lose and everything to gain!

How Our Life Insurance Attorneys Contest a Last-Minute Beneficiary Designation

We’ve seen fraudulent beneficiary changes all too often. A frail elderly person is convinced to hand over power over finances and other decision-making to a new love interest, a caretaker, or a relative who then changes the life insurance beneficiary to themselves. We have also had cases where the insured was susceptible to coercion and was manipulated into making the beneficiary change. 

You want to challenge a last-minute beneficiary designation change. Our life insurance lawyers can help you. First, know that every life insurance company does things differently. Next, know that state law governing these matters varies. For example, the life insurance beneficiary rules in NY differ from the life insurance beneficiary rules in Florida, the life insurance beneficiary rules in Texas, and the life insurance beneficiary rules in California

Our life insurance beneficiary lawyers have helped beneficiaries of life insurance policies across the country get paid, and we can help you too.

Our Life Insurance Lawyers Find Witnesses to the Beneficiary Change

Most beneficiary designation changes are required to be witnessed. We investigate to see if this change was indeed witnessed. 

If not, the change is invalid. If so, we can then depose those witnesses and get information under oath about the circumstances surrounding the change.

Our Life Insurance Legal Team Inspects the Beneficiary Change Forms

Life insurance companies have their own forms, procedures, and requirements for making a beneficiary change. If a beneficiary designation form was completed incorrectly or contained a mistake, that can invalidate the change. If the requirements were not met or the insured did not follow the procedure in submitting the last-minute beneficiary change, that can also invalidate the change. 

Common problems that invalidate the insured’s beneficiary change include:

  • Mistakes on the beneficiary change forms;
  • Misspelling of a beneficiary’s name or other errors in personal information;
  • Beneficiary change forms not witnessed or notarized;
  • Beneficiary change forms not sent to the correct address;
  • Beneficiary change forms not received by the life insurance company before the insured’s death.

Our Life Insurance Attorneys Represent You in the Interpleader

An “interpleader” is a legal action that is initiated by the life insurance company when the new beneficiary and the removed beneficiary file a claim for the same death benefits, and the removed beneficiary challenges the change in designation. 

The purpose of an interpleader is to determine who is the rightful beneficiary, and that is why an interpleader is commonly called a “life insurance beneficiary dispute.” 

Both the new beneficiary and the removed beneficiary should have experienced life insurance beneficiaries representing them in the interpleader. The law is nuanced, and it can be difficult to prove that the insured did not have the requisite competence to change beneficiaries or that the insured was under duress or threatened or coerced to make the change. 

Revocable vs. Irrevocable Life Insurance Beneficiaries

Most policyholders have a “revocable” beneficiary designation, which means they have the power to change their beneficiary designation at will and at any time. The only policyholders who are unable to change their beneficiary designation are those under a court order or an “irrevocable” beneficiary designation.

For example, as part of the property settlement agreement between divorcing parties, a family law judge might order that the support obligor maintain life insurance and name the support obligees as beneficiaries in order to guarantee that income stream. In some cases, the judge will order that the insured designate the support obligees as “irrevocable beneficiaries,” meaning that the obligor cannot “revoke” or change the beneficiary designation.

If the insured changed beneficiaries at the last minute and one of these circumstances applies, our life insurance lawyers can likely have that designation overturned.

Contact Our Life Insurance Attorneys Today for Your Free Consultation Regarding the Last-Minute Beneficiary Change

Are you considering contesting a life insurance beneficiary designation? Are you defending in a beneficiary dispute?

Our life insurance beneficiary lawyers have helped clients across the nation recover millions of dollars in death benefits to date. Let us help you. Whether you are the removed beneficiary or the new beneficiary, we will fight vigorously for your right to the death benefits. Contact us today.

3 small money bags in hand

Life Insurance Company Not Paying Full Amount?

This article will explain the common ways in which life insurance companies underpay valid beneficiary claims for death benefits and the reasons why.

If your claim is denied for a valid reason, there may be a way to negotiate a settlement for part of the claim depending upon the reason that the claim was denied. In some instances, settling for a portion of the death benefit is better than getting no payout at all.

If your claim is delayed, you may be entitled to interest. Do not let the life insurance company make money from keeping you waiting for your payout. Get your entire payout, including claim interest.

Our life insurance attorneys can help you if your life insurance claim is delayed or denied. If you are a life insurance beneficiary anywhere in the United States, we can help you get paid. Call us for your free, no-obligation case evaluation. We do not get paid unless you do.

Life Insurance Companies Only Make Money When They Don’t Pay Life Insurance Claims

Life insurance companies are like any other company – they are responsible to their shareholders to make a profit and provide dividends on their investment.

For this reason, life insurance companies will use any excuse to deny or delay paying a life insurance claim for death benefits. Life insurance companies hope that beneficiaries are unaware that they can fight the delay or denial, and will just take no for an answer.

We get beneficiaries’ claims paid every day. Call us for help, and we may be able to get you paid, too.

A Life Insurance Company May Initially Deny a Life Insurance Claim Due to Lapse or Termination, But You May Be Entitled to All or Part of the Death Benefit.

If your life insurance claim was denied because the insured failed to pay premiums and the policy lapsed or terminated, you may still be able to get paid.

Why? Because often the reason that the life insurance policy lapsed or terminated was not the fault of the insured. For example, if the insured was hospitalized and never received the mandated notices of lapse from the life insurance company, the policy may still pay out less the premiums that the insured was responsible for paying. 

Lapse When the Insured Should Have Had Disability Waiver of Premium

If a life insurance policy lapses due to nonpayment of premiums, the insured was entitled to a waiver of premiums due to disability, and the insurance company did not approve the waiver, a beneficiary may be entitled to the full amount of the death benefit.

Lapse Due to Employer’s Improper Administration of Group Life Insurance

If the insured maintained group life insurance through an employer, there are several ways you can get paid the death benefits despite lapse or termination:

  • Employer failed to provide mandated notices for conversion to private policy;
  • Employer failed to provide mandated premium waiver application if the insured became disabled; and/or
  • Employer stopped paying premiums for any improper reason.

Beneficiary problems with employer group life insurance are common. In these cases, a beneficiary may be entitled to the full amount of the death benefit payout.

A Life Insurance Company May Initially Deny a Claim for Death Benefits Due to Misrepresentation, But You May Be Entitled to All or Part of Your Claim.

A life insurance company will deny a claim if there is any indication that the insured misrepresented themselves on the initial application or medical questionnaire, even if the alleged misrepresentation had nothing to do with the cause of death. 

However, there are circumstances under which the beneficiary can get the death benefit minus what the insured would have paid in premiums if the life insurance company knew of the missing fact.

Common mistakes or omissions that a life insurance company will call a misrepresentation include:

  • Misstating year of birth;
  • Misstating address;
  • Misstating employment;
  • Misstating marital status;
  • Omitting a health condition of which the insured was unaware;
  • Omitting any medical condition because the question on the application was unclear;
  • Failing to disclose a past medical condition because the question was unclear.

These are all examples of information that factor in an insurance adjuster’s assessment of the risk that the insured will die within the policy term, and policy premiums are calculated accordingly. 

Those at greater risk of dying within the policy term will pay higher premiums than those at less risk. For example, if an insured misstated their year of birth, such as transposing digits from 1967 to 1976, they will pay less in premiums than if the adjuster knew their real age because someone born nine (9) years later is less likely to die within the policy term. 

In this case, as long as there is no indication that the insured intended to commit fraud, a top life insurance law firm can help you negotiate with the insurance company to be paid the death benefit minus the amount in premiums that the insured would have paid if the insurance company knew their real age.

If Agent Mistake or Negligence Caused the Alleged Misrepresentation, You May Be Entitled to the Entire Death Benefit

It is common for an insurance agent to fill out an application for the insured when the insured visits the agent’s office or the agent comes to the insured’s home to sell a policy. The agent will typically access the life insurance company’s online application, ask the insured questions, and type in the answer.

Under these circumstances, mistakes or omissions are not the fault of the insured and do not constitute misrepresentation:

  • The agent makes a mistake;
  • The agent fails to ask a question and answers it themselves;
  • The agent receives a truthful answer from the insured but inserts a different answer;
  • The agent coaches the insured to answer incorrectly;
  • The agent fails to ask about obvious medical conditions, such as the insured being in a wheelchair, having a cast on their arm, or needing a respirator to help breath;
  • The agent fails to ask follow-up questions if the insured answers in such a way as to indicate there is an underlying medical condition (for example, if the insured takes insulin) but has not disclosed that the person has diabetes.

An experienced life insurance beneficiary attorney can investigate the alleged misrepresentation, and if any of these circumstances apply, you may still be paid a portion or the entire death benefit.

An Insurance Company May Delay Paying a Life Insurance Claim – You Are Entitled to Interest!

Common Reasons Why a Life Insurance Company Will Delay Payout

Life insurance companies must pay claims within a “reasonable” time, otherwise they must pay the beneficiary interest on the death benefit. Typically that means insurance companies will pay valid claims within 30-60 days, but if they delay paying a claim any longer, contact us. We can help you get paid your entire life insurance claim, which could include interest.

Don’t Take No For An Answer! Our Experienced Life Insurance Lawyers Can Help You Get Paid.

If your life insurance claim has been delayed or denied, we can help. You may still be entitled to partial death benefits, the entire death benefit, or the entire death benefit plus interest. Know that if we take your case, we expect to win! Call to schedule your free, no-obligation case evaluation as soon as you get the sense that you are not getting paid on a life insurance policy.

drugs

Can a Life Insurance Claim Be Denied Due to Drug Use?

The short answer is yes, a life insurance claim may be denied due to drug use, but you can fight it! Whether your denied claim for death benefits can be paid eventually will depend upon the factors explained in this article.

We have helped many beneficiaries across the nation get death benefits when the life insurance company initially denied their claims because illegal or prescription drugs were involved. If your life insurance claim was denied due to drug use or for any other reason, give us a call. We can help.

What If the Insurance Company Claims the Drug Overdose Was a Suicide?

Most life insurance policies are subject to the 2-year contestability period, during which life insurance companies can deny beneficiaries’ claims for a number of reasons, including when the evidence suggests that the insured committed suicide. This policy is in place to keep people who intend to commit suicide from taking out life insurance policies just before their death.

Group life insurance policies from one’s employer are governed under ERISA, and in recent years the federal courts have ruled in favor of life insurance beneficiaries when the insured died of a drug overdose, deeming that the death a payable accident. In the courts’ views, the insured intended to ingest the prescribed or illicit drug, but did not intend to fatally overdose, therefore the insured did not intend to commit suicide.

Whether this theory applies in non-ERISA policies is being determined now in states across the nation. As the most experienced life insurance attorneys, we often use these and other arguments to get our clients paid. 

Case Study #1

We got clients in Kansas paid when the insured died from a Fentanyl overdose. The autopsy report stated that the cause of death was “accidental.” The insured was prescribed Fentanyl patches and took them daily for several years, yet the life insurance claim was denied based on the drug use exclusion. Because the Fentynol was prescribed, and the overdose was deemed accidental, we were able to get our clients paid. 

Claims of Misrepresentations on the Life Insurance Application

If the insured used drugs and did not disclose that on their life insurance application and medical questionnaire, beneficiaries’ claims are denied due to the insured’s misrepresentation. This is the case whether the death of the insured was drug-related or not, and whether the insured died using drugs that were prescribed or illicit drugs.

Case Study #2

We recently got clients in Georgia paid when the insured, in response to the question “In the past three months, have you consulted a doctor or had treatment, medication, or diagnostic tests of any type?”  answered “Yes” and added, “Taking Nexium 40mg for Acid Reflux.” 

New York Life denied her beneficiaries’ claim due to alleged misrepresentations, asserting that the insured was diagnosed with dyspepsia, gastroesophageal reflux disease with esophagitis, gastritis, and helicobacter pylori, weight loss, was taking Nexium, Biaxin, Zantac, and Flagyl, and was recommended to have an upper endoscopy. 

We successfully argued that the life insurance company was on notice from day one that the insured had a condition that should be investigated further before writing a policy, but the insurer failed to do so, and so waived their defense of misrepresentation. 

What If the Cause of Death Was Unrelated to Drug Use?

If a toxicology report shows the insured took prescription drugs they did not disclose, or took illicit drugs triggering the policy’s drug exclusion, the insurance company will most likely deny claims for death benefits initially. However, if the cause of death had nothing to do with drugs, we may be able to get the beneficiary paid.

Case Study #3

The insured was in a motorcycle accident, sustained severe injuries, and was hospitalized with a DNR for one month until he died. His beneficiary’s claim was denied based on “acute amphetamine intoxication” and benzodiazepine use, both of which were indicated in the toxicity report. No autopsy was performed, and the medical examiner never viewed the body. 

We successfully argued that the insured did not die from an overdose but from injuries sustained in the accident, and we got our clients paid.

Case Study #4

The life insurance company denied our client beneficiaries’ claims due to misrepresentation on the part of the insured. However, the alleged misrepresentation was not material to the insured’s death, which was from natural causes. We got those clients paid, too. 

Drug Exclusions in the Rider

Most accidental death insurance policies include exemptions for death by drug overdose. The rub is that while death by prescription drug overdose is commonly deemed to be accidental, these insurance policy claims get denied. Even if the death certificate lists the cause of death as “accidental” when someone dies of a drug overdose, insurance companies will deny those claims. 

The insurance company will often use an autopsy report or toxicology report to determine whether a life insurance claim should be paid, but the mere presence of a drug in the insured’s system does not mean that the death was not accidental. Did the insured know they were taking a drug, or that the drug they took had a fatal interaction with another drug they take? Was the insured mistaken as to the dose? Was there perhaps medical malpractice in prescribing too large of a dose, or in prescribing a drug that could have fatal interaction with a drug the insured was already taking?

We investigate the death of the insured when the insurer uses drugs as an excuse to deny your claim for death benefits. We get to the truth!

What You’ll Need to Fight Your Life Insurance Claim Denial

If your claim for death benefits was denied due to alleged drug use, talk with us. When you have your no-cost, no-obligation consultation with us, we will tell you in advance what documents you should provide. They may include:

  • A copy of the life insurance policy
  • A toxicology report
  • An autopsy report
  • A death certificate
  • The names of any doctors seen by the insured
  • The name, dose, and date of any prescription drugs that the insured may have been taking.

We Fight Back When Life Insurance Companies Use Drug Use as an Excuse Not to Pay You

While we cannot guarantee the result of any case, and cannot promise the same results as the case studies in this article, we can promise you that your case will get the full attention that it deserves. We take beneficiary cases on contingency, meaning that we never get paid unless you do. If you retain us to fight on your behalf, know that we expect to win! Contact us immediately to talk about your death benefit claim denial.

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What is “Material Misrepresentation” in Life Insurance?

Life Insurance Misrepresentation defined by a national life insurance beneficiary attorney.

Material misrepresentation is an untrue statement or omission that affects an insurer’s decision whether to issue a life insurance policy, and if issuing the policy, what premium the insured will pay. Usually the omission or untrue statement is meant to work in the insured’s favor, making the insured seem like less of a risk to the insurance company..

The two year period after the insurer issues a life insurance policy is called the “contestability period.” During the contestability period, the insurer has the right to rescind a life insurance policy if, after an investigation, it finds that the insured made a mistake or lied on the initial application and medical questionnaire. 

In virtually every state in the U.S., our attorneys have been very successful in getting clients’ claims paid when they were initially denied due to alleged misrepresentation on a life insurance application or medical questionnaire. Call us at 1-855-865-4335 to discuss your case. We don’t get paid unless you do!

What is Rescission in Life Insurance?

When insurers deny a beneficiary’s claim due to alleged misrepresentation on the part of the insured, they are exercising their right to “rescind” the policy, meaning, they never would have written the policy but for the insured’s untrue statement or omission. The policy is deemed void ab initio, which means it is treated as invalid from the outset.

When Can an Insurer Rescind a Life Insurance Policy?

An insurer can rescind a life insurance policy when the insurer can show any material misrepresentation on the part of the insured. The insurer’s burden of proof varies by state.

Some common defenses to an allegation of material misrepresentation are:

What if there was No Intent to Deceive on the Part of the Insured?

It depends where the insured took out the policy. Many states allow an insurer to rescind a life insurance policy and deny the claim even if there was no intent to deceive on the part of the insured. Those states do not differentiate between an honest mistake and a lie, and rescission can happen whether the death occurred within the contestability period or not.

Case Study: in South Carolina, a death benefit claim was denied for misrepresentation about COPD, however, the insured was never diagnosed with COPD.  South Carolina law requires proof that (1) the insured’s statement was false; (2) the falsity was known to the insured; (3) the falsity was material to the risk; (4) the falsity was made with the intent to defraud the insurer; (5) the false statement was relied on by the insurer. False answers made to the best of insured’s knowledge and belief does not satisfy the element of intent. We got our client beneficiary paid.

Case Study: in Illinois, an insured disclosed all medical information, including a hospital trip and follow up visits. The agent prepared the application. When the insured died, the insurer denied the claim for death benefits because the agent had neglected to record the insured’s disclosures completely. Under Illinois law, misrepresentation requires actual intent to defraud. Because the insurer cannot use fraudulent, careless, negligent, or mistaken actions of an agent to avoid payment, we got our client paid.

What if the Alleged Misrepresentation Had Nothing to Do with the Cause of Death?

In some states, an insurer will rescind the policy even if the alleged misrepresentation had nothing to do with the cause of death, even if the contestability period expired. We have gotten our beneficiary clients’ claims paid when the alleged misrepresentation was not “material” to the cause of death.

Case Study: in Kansas, an insured died of natural causes but the insurer tried to rescind the policy due to incorrectly-answered questions on the questionnaire. Under Kansas law, an insurer can only rescind a policy if it proves that the insured made an untrue statement or omission of material fact with the intent to deceive. In order for a misrepresentation to be material, it must have directly contributed to the insured’s death. Because the insured died due to natural causes, we got our beneficiary client paid.

Case Study: in Maryland, an insured and his fiance completed a life insurance application via agent with five people present and the insured was never asked about drug abuse. Insured was later murdered. An insurer has the burden to prove fraud and materiality of misrepresentation. Although the insured did not disclose drug use, he was not asked about it and did not receive medical treatment for it. Because the drug use was not material to the death and the insured was not asked about it, we got our client paid. 

Wondering if drug overdose is an accidental death covered by life insurance? It can be. Call us if your life insurance claim was denied because of drug overdose.

What if the Life Insurance Agent Made the Misrepresentation?

We have seen many, many cases where the agent or broker completed the application and medical questionnaire for the insured, and either made a mistake or intentionally omitted a fact.

In these cases, we have argued successfully that knowledge of the disputed fact is imputed to the insurer through the actions of its agent, and that there was no intent to deceive on the part of the insured.

Case Study: in Georgia, a life insurance agent completed the application for the insured indicating that the insured had no material medical history at all, although the insured was confined to a wheelchair and visibly had an amputation of lower extremities. Because actual knowledge of the agent’s incorrect statements in the application is imputed to the insurer, we got our beneficiary client paid.

Case Study: in New Mexico, an insured had cancer 15 years earlier and disclosed to the insurance agent that she visited an oncologist every six months. The agent did not disclose this on the application for life insurance. When the insured died, the insurer tried to rescind the policy due to misrepresentation, but we got our beneficiary client paid because information conveyed to the agent is imputed to the insurer.

Case Study: in Oklahoma, an employer switched the company’s group policy to another insurer, and the insured was asked only if she wanted the same coverage, which she did. After she died, the new insurer claimed misrepresentation because the insured did not disclose her full medical history. However, the new insurer did not require the insured to complete an updated medical questionnaire at the time. We got our client beneficiary paid.

Case Study: in New York, an applicant who was blind and had diabetes had an agent fill out the life insurance application. The agent marked “No” for both conditions. When the insured died, the insurer sought to rescind the policy for misrepresentation, but because the insured was blind she could not have seen the application. We got our beneficiary client paid.

When the Insured Would Have Paid More in Premiums but for the Alleged Misrepresentation. 

People who are older or who have existing medical conditions or previous surgeries will pay more in premiums because they present more of a risk of loss to an insurer. If a person lies about age or medical history on their application, the insurer will charge less in premiums but may have the right to rescind the policy if they discover the misrepresentation.

Case Study: the application listed the insured’s age as seven (7) years younger than he was. When he died, the insurer tried to rescind the policy due to misstatement of age. This policy was governed by Delaware law, and the solution was to settle for most of the death benefit amount by calculating what premiums the insured would have paid if the insurer knew his correct age, and subtracting that amount from the death benefit.

Ambiguous Questions on the Questionnaire Resulted in Misrepresentation.

If a question on a medical questionnaire is ambiguous, it and the insured’s response can be construed against the insured. Often a question will prompt an incomplete answer or an answer that puts the insurer on notice that there may be more to the story.

Case Study: In response to  “In the past 3 months, have you consulted a doctor or had treatment, medication or diagnostic tests of any type?” the insured answered “Yes.” Underneath the question, the insured added, “Taking Nexium 40mg for Acid Reflux.” When she passed, the insurer denied the beneficiary’s claim due to alleged misrepresentations, asserting that insured was diagnosed with dyspepsia, gastroesophageal reflux disease with esophagitis, gastritis and helicobacter pylori, weight loss, was taking Nexium, Biaxin, Zantac and Flagyl, and was recommended to have an upper endoscopy.

Under Georgia law, the existence of circumstances from which constructive knowledge of material information may be imputed to the insurer will estop the insurer from relying upon the falsity of such answers in seeking to avoid liability under the policy. The insured made no further inquiry, therefore it was no failure of the insured to disclose. Also, under Georgia law, courts have consistently found that compound questions to be answered with a “Yes” or “No” are ambiguous by law, and ambiguities are always be construed in favor of the insured.

Case Study: in New Hampshire, a family took out a life insurance policy. The application had room for five names, but only two doctor’s names, so it was unclear to the parents whether the medical questions applied to the children or not. Questions are ambiguous when there are two reasonable interpretations, and because ambiguous questions are interpreted in favor of the insured, we got our client paid.

Case Study: in Arizona, an agent prepared a life insurance application for an insured and her son. She only spoke Spanish, and several questions on the application were ambiguous in that it was not clear whether facts or an opinion regarding the son’s health were sought. The son later died. Because in Arizona an insurer must prove actual fraud to rescind a policy for misrepresentation, we got our client paid.

What if the Insured’s Answers Should Have Triggered Investigation by the Insurer?

In some states, an insurer has a duty to investigate if any answers on the insured’s application or medical questionnaire indicate there may be more to the story.

Case Study: in New Mexico, an agent completed an application for the insured and the insured stated that she reviewed the application and approved it. Although she did not disclose any medical conditions, that day she was using an oxygen tank and, in fact, had been diagnosed with congestive heart failure, atrial fibrillation, and diabetes. The agent failed to take note of this and his failure to disclose facts that may affect the insured’s interest makes him liable for the loss. The insurer has a duty to investigate when an applicant gives sufficient information to alert the insurer to a medical condition. Because the agent failed to warn the insurer of an observable health condition, the insurer could not rescind the policy and we got our client beneficiary paid.

If Your Claim Has Been Denied Due to Material Misrepresentation, Talk with us – our lawyers are among the Best Life Insurance Beneficiary Attorneys in the United States.As you have read, in many states beneficiaries can successfully defend against insurance companies’ allegations of material misrepresentation. Regardless of where you live or what state law controls, you need vigorous representation to get paid. Contact us for a free case evaluation.  You pay no fee unless we get you paid. 
Corona virus

Life Insurance Not Paying for COVID-Related Death?

If you are the beneficiary of a life insurance policy, and your life insurance claim was denied in COVID-related death, don’t take no for an answer. The life insurance attorneys at Boonswang Law have helped thousands of beneficiaries fight insurance companies. Let us help you get paid the money you are owed!

Life Insurance Companies Have No Incentive to Pay You—Even If COVID-19 Was the Cause of Death.

Life insurance is supposed to work like this:

  1. The insured fills out an application and medical questionnaire.
  2. The insurance company writes a policy for the insured that specifies the term of coverage and the coverage amount.
  3. The insured pays life insurance premiums as they come due.
  4. The insured dies within the policy term.
  5. The insurance company pays the death benefit to the named beneficiary or beneficiaries.

However, life insurance companies only make money for their shareholders when they don’t pay beneficiaries’ claims for death benefits. For this reason, insurance companies will find any possible way to deny a claim or delay payment on a claim.

Unfortunately, life insurance companies are now denying and delaying payouts on life insurance claims when the insured died from the coronavirus (COVID -19). Social media is rife with stories about insurance companies::

  • Requiring beneficiaries to send and resend paperwork;
  • Requiring beneficiaries to send extra documentation;
  • Delaying payout because the death is being investigated;
  • Delaying responses to beneficiaries’ inquiries.

Contact Boonswang Law if the life insurance company is treating you this way, or if your claim is in any other way being delayed, or if your claim was denied. Not only can we help you get your life insurance claim paid, but we can also force the insurance company to pay you interest on the death benefits if the delay in paying your claim was unreasonable.

Should Life Insurance Pay When the Insured Dies from the Coronavirus (COVID-19)?

Yes. COVID life insurance coverage should not be in question. While newly-written policies may have a pandemic exclusion, there was no life insurance exclusion for COVID in the first nine months of 2020, during which, presumably, the insured died. 

However, life insurance companies are taking advantage of the medical community’s relative ignorance regarding coronavirus and alleging that the insured’s cause of death was an undisclosed pre-existing condition or an undisclosed lifestyle habit. Life insurance companies will also take any opportunity to deny a claim during the first two years of a policy, called the contestability period, if there were any mistakes or omissions on the insured’s application or medical questionnaire. 

Insurance companies will also delay payment on a claim if they have to investigate the cause of death. While some coroners will record the cause of death as “complications from COVID-19,” others will specify the particular complication, such as pneumonia, respiratory failure, multi-organ failure, or septic shock.

If the insurance company is delaying payment on your COVID life insurance claim, be sure to review the death certificate and confirm that COVID-19 is cited as the cause of death. Why? So that the insurance company can’t deny your claim alleging that the cause of death was something other than COVID-19.

The Reasons Life Insurance Claims Are Denied for COVID   

Claim Denied Due to Alleged Misrepresentation by the Insured Who Had Covid

If the insured omitted or lied about having a medical condition or lifestyle habit that could affect the insured’s ability to survive contracting the coronavirus, the insurance company will seize on this as a reason to deny your claim.

Underlying conditions such as diabetes, heart disease, and chronic lung disease render someone more vulnerable to COVID-19. Smokers are also more vulnerable to COVID-19.

If the insured did not disclose something on their initial application or medical questionnaire, the insurance company will allege that the death was due to a non-disclosed condition or habit and  can and will deny your claim.

Claim Denied Because the Insured Died From Coronavirus During the Life Insurance Contestability Period

During the two-year period following the purchase of a life insurance policy, the insurance company will deny a claim for death benefits if the insured made even a small mistake on their initial application or medical questionnaire. Your claim will likely be denied even if the cause of death had nothing to do with the mistake.

Common errors or omissions that the insurance company will claim is misrepresentation include:

  • Wrong date of birth or age;
  • Failure to disclose past or present disease, illnesses, or conditions; 
  • Failure to disclose past or present injuries, surgeries, or disabilities;
  • Failure to disclose past or current smoking, or alcohol or drug abuse;
  • Failure to disclose engaging in risky activities or hobbies;
  • Failure to disclose travel to a high-risk destination.

This means that even if the insured’s alleged misrepresentation had nothing to do with COVID-19, your claim will be denied on a technicality during the contestability period. Fortunately, in many instances where the mistake had nothing to do with the insured’s cause of death, we’ve been able to litigate a full payout or settlement with the insurance company. 

Call us if your claim was denied due to alleged misrepresentation, and the insured had the coronavirus. Let us help you fight back and get paid.

Claim Denied Because the Insured Died of Coronavirus After the Policy Lapsed Due to Nonpayment of Premiums

An insurance company is required to pay death benefits to the beneficiaries if the insured dies within the policy term and has paid all of their premium payments. If the insured does not pay premiums when due, their life insurance policy lapses or terminates. An insurance company will deny a claim for death benefits on a lapsed or terminated policy. 

It is very common for policies to lapse due to circumstances outside the insured’s control. We have gotten thousands of claims paid in those instances. 

For example, if an insured was hospitalized and did not receive the required lapse notices from the insurance company, we have litigated those cases and gotten the claim paid. If an insured had group life insurance through an employer, and the employer allowed the policy to lapse or failed to provide the insured with the required paperwork to transfer to an individual policy, we can get that claim paid. If the insurance company or employer failed to send the notices required by state statute, we can get that claim paid. If the insured was disabled and eligible for a premium waiver, but did not receive a premium waiver and the policy lapsed due to non-payment, we can get that claim paid.

Did the insured die from COVID-19, and your claim was denied because the policy lapsed? Call us. We can determine whether the lapse was the insured’s fault, or the fault of the insurer.

The Life Insurance Beneficiary Lawyers at Boonswang Law Can Help You with Life Insurance COVID Claims.

If your claim is delayed or has been denied, do not give up! We know all of the insurance companies’ tricks and how to fight them. Gather the paperwork you’ve received, your claim application, the insured’s death certificate, and schedule your free case evaluation. We can get claims paid when the insured died after having contracted the coronavirus. Our experienced life insurance attorneys will review your case and discuss your options with you at no cost. Let us help you fight the insurance company.

shots of alcohol

Life Insurance Claim Denied Due to Alcohol Consumption?

Can the life insurance company deny your claim because the insured used alcohol? The short answer is yes, claims for death benefits are frequently denied unfairly when alcohol is involved.

Was your claim for death benefits denied because the insured used alcohol? Was the insured’s death from complications from alcohol abuse? Was the insured intoxicated when they died, but their death had nothing to do with alcohol use or abuse?

In many cases where the life insurance company denied beneficiaries’ claims due to the insured’s alcohol use, we can help you get your claim paid. Let the experienced life insurance beneficiary attorneys at Boonswang Law fight for you. There is no cost unless we win.

Why Insurance Companies Routinely Deny Life Insurance Claims Due to Alcohol Consumption.

Insurance companies make money for their shareholders when they deny life insurance claims. For this reason, they will grasp at any reason, however unlikely, to deny your claim initially.

Does Alcohol Affect Life Insurance?

Yes, alcohol consumption can affect whether a life insurance policy is paid, or whether an applicant for insurance can get coverage.  

If an insured discloses on their initial application for life insurance that they use alcohol, the insurance adjuster will take that into consideration when writing the policy. Life insurance companies often justify their life insurance claim denials by arguing that alcohol use can affect the amount in premiums an insured will pay, and may even result in denial of their application.

Will Life Insurance Pay Out for an Alcohol-Related Death?

In some cases, life insurance will pay out after the death of an insured who suffered from alcoholism. If the insured died of causes wholly unrelated to alcohol use or abuse, it is often possible for an attorney to get that life insurance claim paid.

What Can Be the Reasons for Rejection of a Death Claim Due to Alcohol?

Here are the types of death not covered by life insurance when alcohol is involved:

The Policy has an Alcohol Intoxication Exclusion

In about half of all states in the U.S., life insurance companies are permitted to add an exclusion to policies to exclude deaths directly or indirectly related to alcohol use from coverage. If the insured is intoxicated and dies for any reason, the insurance company will deny your claim under this exclusion.

Misrepresentation on the Initial Application and Medical Questionnaire

If the insured omits mention of alcohol use, or fails to disclose past or current alcoholism, and the death of the insured was in any way related to alcohol use, the insurer will likely deny your life insurance claim for death benefits because of alleged misrepresentation on the part of the insured.

We can sometimes resolve these claims for the amount of the death benefit minus the amount the insured would have paid in premiums had the underwriter known that the insured used alcohol.

The Insured Died During the Contestability Period

If the insured dies within two years of purchasing the policy, the insurer will grasp at any reason to deny your life insurance claim, even if that reason has absolutely nothing to do with the cause of death. 

For example, if the insured failed to disclose that they used alcohol socially, and then dies of something having nothing to do with alcohol use, such as mesothelioma, the insurer may allege that the insured misrepresented himself and deny your life insurance claim.

We are frequently able to get these claims paid, especially if the death was unrelated to alcohol use or abuse.

The Insured Died While Doing Something Illegal

If the insured died while doing something illegal – for example, drinking and driving – the insurer will deny your life insurance claim under the illegal act exclusion. If the insured had a few drinks at a friend’s dinner party, mistakenly trespassed on a neighbor’s yard on the way home, and was struck by a falling branch and killed, the insurer may use the few drinks to deny your life insurance claim.

Let the Life Insurance Beneficiary Attorneys at Boonswang Law Fight for You!

If your claim has been denied for an alcohol-related reason, do not give up! There are many circumstances under which we can get that claim paid or even negotiate a settlement for you.  Keep in mind that we take cases on a contingency basis, meaning that we do not get paid unless we win. Contact us for your free, no-obligation consultation. Let us help you fight the life insurance company.

smoke

Life Insurance Claim Denied Due to Smoking?

Unfortunately, one of the most common reasons insurance companies refuse to pay a life insurance claim is because the insured smoked, but did not disclose their past or current smoking habit on their initial life insurance application and medical questionnaire.

If your claim was denied due to smoking, we can help. Often it is a matter of showing that there was no fraudulent intent on the part of the insured, or that a past smoking habit had nothing to do with the insured’s cause of death. 

Don’t take no for an answer if payment was denied because the insured allegedly lied about smoking. The experienced life insurance lawyers at Boonswang Law have helped thousands of beneficiaries get paid when the insured was a smoker. Contact us for your free, no-obligation case evaluation. We don’t get paid unless we win, so let us help you.

Claim Denied Due to Death within the Contestability Period

The two-year period following the date of purchase of the life insurance policy is called the contestability period. During the contestability period, an insurer can deny beneficiaries’ claims for any mistake or omission they made on the initial life insurance application or medical questionnaire, even if the mistake or omission had nothing to do with the insured’s death.

For example, if the insured did not disclose that they had a smoking habit years ago, and quit, then died of injuries sustained in a car accident during the contestability period, the insurer can deny your claim. If the insured failed to disclose that they currently smoke, and was shot and killed in a hunting accident, the insurer can still deny your claim.

When the alleged misrepresentation is not “material” to the insured’s cause of death, we can often get your claim paid.

Claim Denied Due to Misrepresentation

If the insured died outside the contestability but the cause of death could be linked to undisclosed smoking, your life insurance claim will likely be denied due to misrepresentation. The reason insurers are permitted to deny such claims is that as a matter of public policy, people applying for life insurance should be dissuaded from lying about their health or lifestyle habits just to get a lower premium payment.

We have gotten many such claims paid because we can show that the insured did not act with fraudulent intent in failing to disclose smoking. We have also gotten claims paid when the insured’s smoking habit had nothing to do with the cause of death.

Case Study – If No Intent to Deceive, No Misrepresentation

Where an insured died of natural causes but the insurer denied the claim because questions on the initial application were not answered correctly, we were able to get that claim paid because those answers did not show that the insured acted with the intent to deceive, and the answers were not material to the insured’s cause of death.

Claim Denied Due to Agent Mistake or Negligence

It is all too common for an insurance agent to complete an application and medical questionnaire on behalf of the insured, to make a mistake that the insured does not find or know about, and then for the insurer to deny beneficiaries’ claims due to alleged misrepresentation on the part of the insured.

Case Study – Settling for the Death Benefits Minus the Increase in Premiums the Insured Would Have Paid.

An agent made a mistake that recorded the applicant’s age as seven years younger than he was. We were able to get our beneficiary client paid the death benefits minus the amount the insured would have paid in premiums had his age been recorded correctly. This same theory might apply to get you paid when the insured smoked, but did not disclose it on the application. 

Case Study – Agent Negligence or Mistake.

An insured disclosed to his agent that he used to smoke but quit a few months prior. His agent responded that the question about smoking did not apply because the insured had recently quit. The agent also did not record related information about the applicant’s COPD and Hepatitis C. The insured signed the application verbally and did not have a chance to proofread the agent’s work.

Although the insured died from smoking-related complications, the agent knew about past smoking and present related conditions yet did not record them. We got our client beneficiary paid because the insurance agent’s knowledge is imputed to the insurance company.

Don’t Take No For An Answer! We Can Help Get You Paid When the Insured Smoked

The life insurance beneficiary lawyers at Boonswang Law have dealt with thousands of claim denials over the years, and smoking has figured prominently among the reasons for denying a claim. What might seem like a cut-and-dried case of lying on the part of the insured may be an innocent mistake, a mistake or negligence by the insurance agent, or have nothing to do with the cause of death. In any case, we will find out and help you fight back. 

Have questions about life insurance claims being denied due to vaping or occasional cigar smoking? We can help you with that too.

Insurance claim denied graphic

Life Insurance Company Won’t Pay Claim? Here’s What to Do When Your Claim is Denied

Here’s an explanation of the most common reasons a life insurance company refuses to pay a claim, how you can prevent your beneficiaries’ claims from being denied, and what to do if the life insurance company denies your claim, from the noted life insurance lawyers at Boonswang Law.

Why Do Life Insurance Companies Deny Claims?

Life insurance companies seize any opportunity to deny claims because they only make money for their shareholders when they don’t pay out. This means that many, many claims are denied in bad faith, for the flimsiest of reasons.

5 Common Reasons for Life Insurance Claim Denials or Delays

Death During the Contestability Period

The two years after the day that the insured purchases a life insurance policy is called the contestability period. During the contestability period, the insurance company can deny a claim for death benefits due to any mistake or omission on the insured’s initial application and medical questionnaire, even if the mistake has nothing to do with the cause of death.

Suicide during the contestability period will also result in claim denial. This is to dissuade those contemplating suicide from taking out life insurance policies to benefit their loved ones, knowing they will die soon.

Misrepresentation on the Application or Medical Questionnaire

If the insured intentionally or mistakenly omits or misstates information of any kind during the contestability period, the insurer will deny your claim. This is also true if the omission or misstatement was made by an insurance agent preparing the insured’s application and medical questionnaire.

Insurance companies will also deny claims outside of the contestability period for alleged misrepresentation, whether or not the alleged misrepresentation had anything to do with the insured’s cause of death. These denials can frequently be overturned!

Death Excluded from Coverage

Common exclusions include:

  • Suicide (often if within 2 years of taking out the policy)
  • Death during an illegal act
  • Death by drug overdose
  • Death by alcohol poisoning
  • Death occurring while visiting a high-risk travel destination
  • Death due to an Act of War

Lapsed Policy Due to Non-Payment of Premiums

If a beneficiary is told that the claim is denied due to policy lapse or termination, the inquiry should not stop there. It is common for policies to lapse due to no fault of the insured. 

For example, if an employer fails to pay group life insurance premiums on the insured’s behalf and then fails to provide the required notices and conversion forms to the insured, the employer is at fault for the lapse in coverage and the claim can be paid.

If an insurance company cannot show that it sent the insured the required notices of impending lapse, the claim can be paid. If the insured was entitled to a waiver of premiums due to disability, but did not receive that waiver, the claim can be paid.

Beneficiary Dispute 

If the insured changed the beneficiary designation just before dying, or there is an allegation of fraud or undue influence related to a change of beneficiary, the insurer will not pay out until that is resolved.

If the insured is vague in the beneficiary designation, for example, designating “all my children” rather than naming each of the children, a beneficiary dispute may arise. Did he mean all of his children from all marriages? Did he intend to include children born outside of his marriages? Did he intend to include stepchildren? The insurer will not pay out until this is resolved.

If the insured’s named beneficiary cannot be found or has died, and there is no contingent beneficiary, the insurer will investigate and will eventually pay the death benefit to the insured’s estate.

How to Prevent Claim Rejection

An insured can take these three (3) steps to make sure their intended beneficiaries get the death benefit they’ve paid for.

  1. Disclose Medical History and Lifestyle Habits

The insured should disclose all past and current medical conditions, diseases, surgeries, and medication. The insured should also disclose all lifestyle habits, such as smoking and alcohol use. If the insured engages in any activities or hobbies considered dangerous by the insurer, the insured should disclose that as well.

If the insured hides any of these facts, they risk their beneficiary’s claim being denied for misrepresentation, especially if the insured dies within two years of purchasing the policy or the cause of death is related to the misrepresented fact.

  1. Proofread Application Prepared by Agent

Frequently, errors and omissions are the fault of an insurance agent who prepared the application and medical questionnaire on behalf of the insured. The insured should always proofread these documents carefully before signing them.

  1. Specify the Name of a Beneficiary and a Contingent Beneficiary

The most effective way to make sure the death benefit will pass to the intended parties is to specify primary and contingent beneficiaries by name. Do not name a minor child as a beneficiary, as this child cannot directly receive the death benefit and the court will appoint a receiver or trustee to manage the funds.

How Do I Deal with a Rejected Insurance Claim?

Contact the Insurance Company

Be sure to get the reason for denial in writing. Ask the claims agent if any additional information or documentation would overturn the denial. 

Contest the Denied Claim

By law, you must be given the forms to contest the claim denial. You must have reasons other than “the denial is wrong” or “the denial is unfair” to overturn the denial. 

Frequently, the reason for the claim denial seems iron-clad on its face, but the facts behind the reason show that there was no fault on the part of the insured. In those cases, the claim denial can be overturned entirely, or the life insurance company will settle for the death benefit amount minus what the insured would have paid in premiums.

When Does a Life Insurance Beneficiary Need an Attorney?

As soon as your claim is denied (or even if you think your claim is going to be denied), contact a life insurance beneficiary attorney. This will not cost you anything because beneficiary attorneys work on contingency, meaning they only get paid if they win. 

An experienced life insurance beneficiary attorney will investigate the facts behind the denial and the facts of the cause of death and will be able to uncover whether the policy legally lapsed, the insured was at fault for misrepresentation, or the death was indeed excluded from coverage. Often a claim that is initially denied is paid or settled once an attorney gets involved.

Let the Experienced Life Insurance Beneficiary Attorneys at Boonswang Law Help You Get Paid

Boonswang Law has helped thousands of beneficiaries just like you contest a claim denial and get paid. Contact us today for your free, no-obligation case evaluation. Remember, we don’t get paid unless you do!

Statue of Liberty

Life Insurance Beneficiary Rules in NY

How Does Life Insurance Work in New York State?

If you are the owner or a beneficiary of a life insurance policy issued in New York State, this guide will provide you with important information about how life insurance works there. While there are some federal laws governing life insurance nationwide, every state treats insurance laws differently, and in New York, there are things you need to know whether you are the insured or a life insurance beneficiary.

For well over two decades, the experienced life insurance attorneys at Boonswang Law have helped beneficiaries in cases where life insurance is not paying out. If you have questions about life insurance and you are a resident of New York State, contact us today to speak with an attorney. Your initial consultation is free of charge, and we don’t get paid unless we win!

Who Can Be a Life Insurance Beneficiary in New York?

People you are related to, people you are not related to, trusts, organizations, businesses, charities, your estate… you can designate any, some, or all of these as your life insurance beneficiaries in New York State. 

You can designate one or more people or entities and also designate the percentage of death benefits that will be allocated to each. You can also designate “secondary” or “contingent” beneficiaries that will receive the death benefit if the primary beneficiaries are not available.

Minor Children as Beneficiaries of Life Insurance in New York

Children under the age of 18 should not be named as beneficiaries in New York State. If they are, the court may appoint a guardian to receive and manage the funds in their name until they reach the age of majority. Technically, a child above the age of fourteen years and six months can receive death benefits, but counting on this technicality opens the door to possible dispute and litigation.

If an insured wants minor children to receive life insurance proceeds, he or she should create a trust for the benefit of those children and name the trust as beneficiary. In the alternative, the insured can name an adult custodian of the funds as beneficiary.

How Life Insurance Pays Death Benefits in New York

First, the insurance company will try to locate and pay the insured’s named beneficiary or beneficiaries. 

If the named beneficiary has died or the beneficiary designation is invalid for any reason, the insurance company will try to locate and pay the contingent or secondary beneficiary or beneficiaries

If the insurance company cannot locate either the named beneficiary or the contingent beneficiary, it will usually pay the death benefits to the estate of the insured. This is commonly provided for in the policy itself and not a matter of state law. The insurance proceeds are then subject to the will of the insured and are distributed among the heirs accordingly. 

In the case where there is no will, the insured has died “intestate” and the insurance proceeds will be distributed according to New York’s intestacy laws, which can be found here.

Will a Life Insurance Beneficiary Designation Naming a Spouse be Changed by Divorce in New York?

Yes.If the insured divorces the beneficiary of his or her policy, that beneficiary designation is automatically invalid under the New York revocation on divorce statute:

EPTL 5-1.4(a)(1) provides: 

Except as provided by the express terms of a governing instrument, a divorce .. revokes any revocable (1) disposition or appointment of property made by a divorced individual to, or for the benefit of, the former spouse, including, but not limited to, a disposition or appointment by will, by security registration in beneficiary form (TOD), by beneficiary designation in a life insurance policy …. 

If the insured wishes to retain the beneficiary designation after divorcee, he or she must reaffirm the designation of the ex-spouse as beneficiary after the divorce decree is entered. This is often desired the insured is paying spousal support or child support and is complying with family court orders to maintain life insurance to guarantee that income stream.  

ERISA Life Insurance Beneficiary Designation Rules and Ex-Spouse in New York

If a life insurance policy is acquired as a benefit of employment, it is likely governed by the Employee Retirement Income Security Act of 1974, known as “ERISA.”  In a life insurance claim dispute governed by ERISA, this federal law will supersede New York state law.

Under ERISA, the life insurance beneficiary designation is strictly observed regardless of whether the insured divorced the beneficiary or not. In other words, despite New York state law revoking an ex-spouse’s beneficiary designation, if an insured fails to change the named beneficiary after divorce, the ex-spouse will receive the death benefit. 

The bottom line is, if an insured has a policy through work that is governed by ERISA, and does not want his or her ex-spouse to receive the death benefit, he or she must change the beneficiary designation before they die.

Can You Contest a Life Insurance Beneficiary Designation in New York?

Yes. Here are two of the most common circumstances that prompt life insurance beneficiary disputes in New York State:

ATTEMPTED BENEFICIARY CHANGE BY THE INSURED

If the insured tried to change the beneficiary of his or her policy but did not do so correctly or completely, a court in New York will look at extrinsic evidence to determine what the intent of the insured was at the time he or she tried to change the beneficiary designation.

FRAUDULENT BENEFICIARY CHANGE 

If a formerly-named beneficiary alleges that the insured was coerced of forced to change a beneficiary designation, a New York court will look at evidence and testimony about the insured’s health, state of mind, and the role of the new beneficiary in the life of the insured at the time the beneficiary change took place.

What Happens when the Insured Designates Someone as Beneficiary on the Policy, and Names Someone Else as Beneficiary in his Will?

In New York, the terms of the policy will control the outcome of this dispute, rather than New York State law or federal law. You and your attorney will have to comb through the provisions of the policy documents to determine the answer to this question, as it will vary policy-to-policy.

I am the beneficiary of a New York life insurance policy and someone is contesting the beneficiary designation, what do I do?

You should defend for beneficiary designation by securing the representation of an experienced New York life insurance beneficiary attorney. Contact us to schedule an evaluation of your case.

Life insurance claim

COVID-19 & Life Insurance Payouts [GUIDE]

If your loved one died of COVID-19, and you are the named beneficiary of his or her life insurance policy, read this guide for problems to look out for and how you can solve them and get paid.

If your life insurance is not paying out, contact us for your free, no-obligation consultation. We have gotten many beneficiaries paid when the insured died of COVID-19, and we can help you as well. And, we don’t get paid unless you do!

Are Life Insurance Companies Denying Payouts for Deaths Related to COVID-19?

Yes, unfortunately. 

As a practical matter, know that insurance companies only make money for their shareholders when they don’t pay beneficiaries’ claims. For this reason, insurance companies will find any possible way to initially deny a claim, or delay payment on a claim.

Reports on social media have alerted us to the fact that the insurance companies are giving beneficiaries the runaround when it comes to COVID-19 deaths. Insurance companies have been employing the following tactics:

  • Requiring you to send and re-send paperwork, repeatedly;
  • Requiring you to send extra documentation;
  • Delaying responses to your inquiries;
  • Delaying payment on your claim.

Contact Boonswang Law any of this has happened or is happening to you. We can help you get your claim paid. And, if the delay in paying your claim was unreasonable, the insurance company may owe you interest! We can get that paid too.

Does Life Insurance Cover Death from the Coronavirus (COVID-19)?

Yes. As of this writing, there is no pandemic exclusion on life insurance policies. That may change in the future, however, right now an insured is covered for death by COVID-19.

Problems arise in determining and then recording the cause of death, because COVID-19 affects individuals in different ways. The most straightforward way to list cause of death is “complications from COVID-19” but some coroners will specify the complication, such as:

  • Pneumonia
  • Respiratory failure
  • Multi-organ failure
  • Septic shock

If the death was COVID-19 related, review the death certificate and be sure that COVID-19 is cited. Why? So that the insurance company can’t claim that the cause of death was something other than COVID-19, and potentially deny your claim.

The Most Common Reasons Life Insurance Claims are Denied   

Misrepresentation on the Application or Medical Questionnaire

If the insured failed to disclose any medical conditions or lifestyle habits that affect his or her ability to survive COVID-19, this provides a reason for the insurance company to deny your claim for death benefits.

For example, underlying conditions such as diabetes, heart disease, and chronic lung disease render an insured more vulnerable to COVID-19. The insurance company can and will deny your claim, citing the cause of death as a non-disclosed condition and voiding the policy due to misrepresentation.

Smokers are also more vulnerable to COVID-19. If the insured failed to disclose that he or she smokes or used to smoke, the insurance company will use that to deny your claim.

Contestability Period

During the two-year period following the purchase of a life insurance policy, an insurance company can deny beneficiaries’ claims if the insured made even the simplest mistake on his or her initial application or medical questionnaire. 

This means that even if the mistake had nothing to do with COVID-19, your claim can be denied on a technicality. Fortunately, where the mistake or error had nothing to do with the cause of death, we’ve been able to negotiate a settlement with the insurance company. 

Call us if your claim was denied because the insured died during the contestability period and  allegedly “misrepresented” himself or herself on the initial application or medical questionnaire.

Common Examples of Mistakes on an Application that Result in Claim Denial

  • Wrong date of birth or age;
  • Failure to disclose past or present disease, illnesses, or conditions, 
  • Failure to disclose past or present injuries, surgeries, or disabilities;
  • Failure to disclose past or present smoking, or alcohol or drug abuse;
  • Failure to disclose engaging in risky activities or hobbies;
  • Failure to disclose travel to a risky destination.

Lapsed Policy Due to Nonpayment of Premiums

If the insured failed to pay premiums, the life insurance policy will lapse or terminate. An insurance company will deny a claim for death benefits on a lapsed or terminated policy. However, it is common for policies to lapse due to circumstances outside of the control of the insured, and we have gotten hundreds of claims paid in those instances. 

For example, if an insured had group life insurance through an employer, and the employer allowed the policy to lapse or failed to provide the insured with the required paperwork to transfer the policy to an individual policy, we can get that claim paid.

If the insured was eligible for premium waiver due to disability and did not receive premium waiver, we can get that claim paid. If the insurance company failed to mail the required notices of lapse and termination to the insured, we can get that claim paid.

How Can a Life Insurance Lawyer Help?

With the legal team at Boonswang Law by your side, you can fight claim denial and you stand a great chance of getting paid. We know all of the insurance companies’ tricks and how to negotiate with them. Don’t give up! We know how to help.

First, gather your paperwork, such as your claim application, the death certificate, and any documents sent to you by the insurance company. Then schedule your free consultation, our skilled life insurance attorneys will review your case and discuss your options with you, at no cost to you. Let us help you get paid!

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