Articles Tagged with: Cause of death denials

Post-Claim Underwriting in Life Insurance Explained

Life insurance companies commonly employ “post-claim underwriting” if a policyholder dies within the first two years of coverage. 

What is post-claim underwriting? Can life insurance companies use post-claim underwriting to deny my claim? How can a beneficiary contest a claim denied due to what the life insurance company discovered during post-claim underwriting?

Distinguished life insurance lawyer Chad G. Boonswang explains what post-claim underwriting is, how life insurance companies use post-claim underwriting to deny beneficiaries’ claims for material misrepresentation, and what to do if post-claim underwriting results in claim denial.

If the life insurance company won’t pay due to policy rescission for alleged misrepresentation, call us for help. Remember, life insurance companies only make money when they collect premiums and deny claims, so they take any opportunity to unfairly deny valid claims. Don’t take no for an answer! We have gotten many claims like this paid after we investigate. Call us today to discuss your claim.

What is Post-Claim Underwriting in Life Insurance?

“Underwriting” is the term used to describe the process by which a life insurance company calculates the risk an applicant for life insurance will die within the coverage term. Risk factors include medical history, current health, lifestyle habits, age, gender, weight, occupation, marital status, criminal history, and zip code. Those at greater risk of dying within the policy term pay more in premiums than those at less risk.

Under a life insurance policy’s incontestability clause, if a policyholder dies in the first two years of coverage the life insurance company has the right to look for false information on their application for life insurance and medical questionnaire. They look for this false information during the process of post-claim underwriting, which takes place after a policyholder dies and their beneficiaries submit their claim along with a copy of a death certificate.

If the life insurance company finds errors or omissions during post-claim underwriting, they rescind coverage for misrepresentation and deny claims for death benefits.

Is Post-Claim Underwriting Legal?

Technically, yes. Some laws have been passed in an attempt to stop it but the reality is that it still happens. State and federal law allow life insurance companies to employ post-claim underwriting to discover mistakes or omissions on a policyholder’s initial application for coverage. If they find false information or omissions, they rescind the policy and deny beneficiaries’ claims for death benefits.

This policy is meant to deter applicants for life insurance coverage from lying on their application to get lower premiums, but in practice, it results in many valid life insurance claims getting denied.

Post-Claim Underwriting in Life Insurance Claim Denials

During the contestability period, life insurance companies deny claims if the policyholder hid or falsified information on their initial application, even if that hidden or false information had nothing to do with the policyholder’s cause of death. 

Life insurance companies discover lies, mistakes, and omissions by performing post-claim underwriting, meaning that after a beneficiary files a claim they investigate the truth of the policyholder’s initial submissions. 

How Life Insurance Companies Do Post-Claim Underwriting

When a policyholder dies within the contestability period, the life insurance company reviews their application and medical questionnaire for any indication of misrepresentation. Often the information recorded on the death certificate reveals instances of misrepresentation, such as:

  • Failing to disclose smoking habit: dies of lung cancer from smoking
  • Failing to disclose heavy alcohol use: dies of cirrhosis of the liver
  • Fails to disclose dangerous sports: dies from a fall while rock climbing
  • Fails to disclose marijuana use: dies with marijuana in system
  • Fails to disclose high blood pressure: dies of heart attack or stroke
  • Lying about age: age younger on application than on death certificate
  • Lying about marital status: listed as “single” on death certificate

How to Protect Yourself Against Post-Claim Underwriting

An experienced life insurance attorney can help you get your payout in many instances of alleged misrepresentation. For example, the life insurance lawyers at Boonswang Law have gotten beneficiaries paid on denied claims after we investigated and found:

  • the policyholder made an innocent mistake without the intent to defraud the life insurance company;
  • the policyholder was unaware of the underlying condition that caused their death;
  • the life insurance agent made the mistake or omitted information;
  • the life insurance company or agent failed to question further when there were clear indications of a health condition;
  • a question on the application or medical questionnaire was confusing or ambiguous.

In many cases, we get our client paid in full. In others, we are able to settle for the amount of the death benefit minus what the policyholder would have paid in premiums had the life insurance company written the policy knowing the policyholder’s true condition.

Talk with a Life Insurance Lawyer About Your Claim Denial

Unfortunately, many valid life insurance claims get denied due to alleged misrepresentation. Luckily, there is growing awareness of life insurance companies’ practice of denying claims when they find any indication of possible fraud during post-claim underwriting. 

If your life insurance claim was denied due to policy rescission after post-claim underwriting, call us today for your free, no-obligation case review. We  appeal your denied life insurance claim or sue the life insurance company and get you paid if at all possible.

Life Insurance Claims & Pending Death Certificates

Life insurance companies often delay payment on claims for death benefits if the policyholder’s cause of death is listed as “pending” on the death certificate. Is this legal?

The answer depends on how long the life insurance policy was in effect, what state law applies, and how long the delay is. Find out from leading life insurance lawyer Chad G. Boonswang how life insurance companies use death certificates, when life insurance companies delay a payout due to pending cause of death, and when beneficiaries might be entitled to interest on a delayed life insurance claim.

If your life insurance claim is delayed due to a pending cause of death or for any other reason, call the experienced life insurance lawyers at Boonswang Law for help getting your payout. We take cases on a contingency basis, meaning, we do not get paid unless and until you do. Call today for your free, no-obligation case consultation.

How Death Certificates Interact with Life Insurance Claims

Life insurance companies confirm a policyholder’s death with a certified copy of a death certificate identifying the policyholder as deceased and providing other details such as when they died, where they died, and what caused their death.

A coroner or medical examiner lists the cause of death as “pending” if they have yet to ascertain the cause of death. Another reason for the cause of death to be recorded as pending is if law enforcement is investigating the death and that investigation is incomplete.

Can You Collect Life Insurance Without a Death Certificate?

No. Life insurance companies require legal proof the policyholder died to avoid fraudulent payouts, or paying death benefits when the policyholder faked their own death. In fact, when a policyholder dies overseas, a foreign death certificate may delay payment on a life insurance claim because it lacks the information given on U.S. death certificates and the life insurance company deems it insufficient proof of death.

Delays in Life Insurance Claims Payments Due to Pending Cause of Death

Life insurance companies may only delay payments on claims for death benefits if the delay is reasonable. What is “reasonable” depends upon the situation and the governing law. These are the situations where a pending cause of death may cause a delay in payment of claims.

The Policyholder Died within the Contestability Period

If the policyholder died within the first two years of life insurance coverage, the incontestability clause allows a life insurance company to look into the policyholder’s submissions on their initial application and medical questionnaire. If there were any omissions or misstatements, the life insurance company will rescind the policy due to the policyholder’s alleged misrepresentation and deny beneficiaries’ claims.

A Life Insurance Policy Exclusion May Apply

If the policyholder’s cause of death may have been excluded from life insurance coverage, the life insurance company may delay payments on claims for death benefits until the cause of death gets determined. 

A life insurance company denies claims for death benefits after delaying payment if the policyholder died due to any of these common policy exclusions:

Police are Investigating the Policyholder’s Death

If the policyholder’s cause of death is under investigation by law enforcement, the life insurance company may delay payment until the cause of death is determined and the beneficiaries are cleared of wrongdoing.

How a Life Insurance Lawyer Helps Your Claim

A life insurance lawyer helps beneficiaries get paid by investigating their claim, corresponding with the life insurance company, and suing the life insurance company if they won’t pay.

If your claim is delayed due to a pending cause of death or for any other reason, call us for help. If the delay is unreasonable, you may be entitled to interest on the amount of the death benefit. We’re happy to discuss your claim.

Life Insurance Payouts & Murder

Many causes of death are excluded from coverage in life insurance. Is murder one of them?

Acclaimed national life insurance attorney Chad G. Boonswang discusses what happens to the death benefit if the policyholder is murdered. Murder is not an exclusion, and what happens to the death benefit depends upon whether the beneficiaries have any involvement in the policyholder’s death.

If your life insurance claim gets denied or your payout is delayed because the policyholder was murdered, call Boonswang Law for help. We have helped life insurance beneficiaries across the nation get their payout after their claim got denied or delayed by filing a life insurance claim denial appeal, an interpleader action, or by suing the life insurance company

Does Life Insurance Pay If the Policyholder is Murdered?

Yes, as long as the person who murdered the policyholder is not the beneficiary. This is called the “Slayer Rule.” Under the Slayer Rule, no beneficiary can have anything to do with the policyholder’s death, such as hiring someone to murder the policyholder or murdering the policyholder when their beneficiary is their spouse or someone else close to them. 

The Slayer Rule is in place to keep beneficiaries from benefiting from having a hand in the policyholder’s death.

Accidental Death & Murder in Life Insurance

Accidental Death life insurance coverage, called an AD&D policy or an AD&D rider, covers the policyholder if they die for any reason other than natural causes such as disease or old age. Murder qualifies as accidental death for the purposes of AD&D coverage, and the beneficiaries should get the death benefit if the policyholder is murdered.

If your AD&D claim was denied because the policyholder was murdered, call us for help getting your Accidental Death & Dismemberment payout. We take life insurance cases on a contingency basis, meaning we do not get paid unless and until you do. Call us today for your free case review.

Reasons Life Insurance Benefits Get Denied for Murder Victims

Beneficiary or Beneficiaries Are Found Guilty of the Murder

If the beneficiary murdered the policyholder, they will not receive a payout under the Slayer Rule. This will likely be the case even if the death is ruled manslaughter instead of homicide, or the policyholder died due to the beneficiary’s self defense.

Policyholder is Murdered While Involved in Criminal Activity

If the policyholder is murdered while doing something illegal, their beneficiaries’ claims get denied. You may think of illegal acts as breaking and entering or assault, but life insurance companies also exclude deaths during minor infractions of the law from coverage. 

For example, if the policyholder was trespassing and is murdered, their beneficiaries’ claims get denied. If the policyholder was driving the wrong way down a one way street and murdered in a carjacking, their beneficiaries’ claims get denied. If the policyholder was high on an illicit drug and murdered, their beneficiaries’ claims get denied.

Life Insurance Fraud & Murder

If the beneficiary participated in a plot to kill the policyholder, even if they are not the person committing the act, they will not get a payout. If the policyholder conspires with their family to plot their own death, that is insurance fraud and their beneficiaries will not get a payout.

Reasons Life Insurance Benefits are Delayed if the Policyholder is Murdered

When a life insurance policyholder is murdered, the life insurance company waits until the police investigation is complete and exonerates the beneficiary or beneficiaries before paying death benefits. This can take months or even years. 

Life insurance companies must pay claims within a reasonable time. If the homicide investigation concludes, the life insurance company may owe you interest if they delay your payout further.

Talk with a Life Insurance Lawyer if Your Claim is Denied Due to Murder

If your claim gets denied due to the policyholder’s murder, you have a right to know why. The life insurance company must give you the basis for claim denial. You then have the right to appeal, file an interpleader action, or sue the insurance company.

If your claim is delayed by a murder investigation or if the life insurance company delays your payout unreasonably, you may be entitled to interest on the death benefit.

In either case, our life insurance lawyers help you get your payout. Call today for your free, no-obligation consultation.

Life Insurance Companies & Your Medical Records

You would think that because you pay life insurance premiums, your beneficiaries will automatically get their payout if you die within the policy term. It is rarely that simple. 

Life insurance companies only make money when they collect premiums and don’t pay death benefits, so they look for ways to deny your beneficiaries’ claims. They may investigate your medical history to find out if you had any undisclosed illnesses, conditions, medications, or surgeries they can use to rescind your policy due to alleged misrepresentation. If the policy is rescinded, the life insurance company won’t pay.

Noted national life insurance lawyer Chad Boonswang explains how this happens and what to do about it in this comprehensive article. If your life insurance claim was denied due to misrepresentation, call the life insurance lawyers at Boonswang Law for help with your life insurance claim denial appeal. We have helped life insurance beneficiaries across the nation get the death benefits they deserve. Call us today to discuss your case.

Do Life Insurance Companies Check Medical Records Following a Policyholder’s Death?

The short answer is yes, they can. As part of most life insurance contracts, the policyholder agrees that their representative provides the life insurance company with medical records if requested. The clause may also state the circumstances under which the life insurance company will request medical records, such as:

Life insurance companies are supposed to check medical records before issuing a policy when a policyholder’s answers on the initial application and medical questionnaire indicate there may be further medical issues, or if the life insurance company needs more information about the policyholder’s health before underwriting a policy.  In reality, they rarely do so.

Do Life Insurance Companies Need Permission to Obtain Medical Records?

Yes. Under the Access to Medical Reports Act (1988) and the Data Protection Act (2018), the policyholder’s executor or other representative must provide the life insurance company with the policyholder’s medical records. The life insurance company cannot obtain medical records on their own without a representative’s consent.

That said, there are private services which provide life insurance companies with prescription histories and lab test results for a fee, without your permission. Also, life insurance companies can obtain anything in the public record, such as a DUI or a bankruptcy filing. 

Life insurance companies are motivated to collect all information possible to assess the risk a policyholder will die within the policy term and they charge premiums according to that risk. They may subscribe to a service such as the Medical Information Bureau (MIB) for this purpose.

Life insurance companies are also motivated to investigate a policyholder’s cause of death if the policyholder dies within the contestability period or of undisclosed illness, disease, lifestyle habit, or condition. Obtaining the policyholder’s medical records is part of that investigation.

How Many Years of Medical Records Can Life Insurance Companies Check?

When initially underwriting a life insurance policy, life insurance companies sometimes check up to 10 years of an applicant’s medical records. If a policyholder dies under suspicious circumstances, the life insurance company looks at the medical record they have and the record generated by the policyholder from the date that they applied for life insurance coverage to the date that they died.

Why Life Insurance Companies Want to Check Medical Records

Life insurance companies look at medical records to ascertain whether the policyholder died of an undisclosed injury, illness, disease, condition, or lifestyle habit. If the policyholder failed to disclose what eventually caused their death, the life insurance company denies their beneficiaries’ claims due to misrepresentation.

Life Insurance Companies Demanding Medical Records

Life insurance beneficiaries rarely have a choice – they must provide the life insurance companies with the medical records they demand to have their claim for death benefits processed and paid. 

If the life insurance company is asking for consent to view medical records, they are probably looking for something to give them cause to allege the policyholder lied on their application and  rescind the policy and deny your claim due to misrepresentation.

Life Insurance Company Asking for Health Care Providers of Policyholders

Most policyholders must provide life insurance companies with the name and contact information of their primary care physician as well as any medical provider they regularly see, or they’ve seen in recent years. This facilitates gathering medical information on the policyholder before issuing the policy as well as after death.

Talk with a Life Insurance Lawyer for Help

If your life insurance claim was denied due to misrepresentation and policy rescission, call us for help. We discuss your case with you free of charge.

Know that many claims which get denied due to misrepresentation are paid after we look into it and show the policyholder did disclose everything they knew or the policyholder made an innocent mistake. Don’t take no for an answer. Call us to get your life insurance claim paid.

smoke

Denied Life Insurance Claims Due to Marijuana Use

Most life insurance policies exclude death related to illicit drug use from coverage and deny beneficiaries’ claims if the policyholder died from drug overdose. 

What about medicinal marijuana use? What about recreational use of marijuana in states where that is legal? 

Find out from noted life insurance lawyer Chad G. Boonswang, Esquire what happens when a policyholder dies with marijuana in their system, what a life insurance company considers in deciding to pay or deny a claim for death benefits, what a policyholder must do if they use marijuana, and what to do if your life insurance claim was denied due to marijuana use.

If your life insurance claim was denied due to marijuana use, call the life insurance lawyers at Boonswang Law. We can help!

Drug Exclusions

Death from drug overdose is a common exclusion from life insurance coverage. Life insurance companies will deny beneficiaries’ claims for death benefits if the policyholder death was drug-related.

Marijuana is considered a drug, but how life insurance companies treat marijuana use depends upon the following factors:

  • Is recreational use of marijuana legal in that state?
  • If not, is marijuana use legal only if prescribed in that state?
  • If so, did the policyholder hold a prescription for medical marijuana?
  • Did the policyholder disclose recreational or medicinal marijuana use on their initial application and medical questionnaire?
  • Did the policyholder die within the contestability period?

If the policyholder had group life insurance coverage through their employer, federal ERISA law will apply. Know that federal law does not yet recognize legal cannabis use of any kind. 

If the policyholder died within the contestability period, the life insurance company has the power to comb through their initial application and medical questionnaire for inconsistencies. If they find any (i.e., if the policyholder did not disclose marijuana use), the life insurance company has the power to deny their beneficiaries claims – even if the marijuana use had nothing to do with the policyholder’s death.

Life Insurance Coverage Denials Due to Marijuana Use

If recreational use of marijuana use is still illegal in your state, or the policyholder did not have a prescription for medicinal use, the life insurance company will consider the policyholder’s use of marijuana as use of an illicit drug. 

Know that even if the policyholder’s death had nothing to do with marijuana, if marijuana was in their system, the life insurance company will deny beneficiaries’ claims outright during the two-year contestability period. 

Material Misrepresentation for Marijuana Use

Even if the two-year contestability period has expired, life insurance companies deny beneficiaries’ claims for material misrepresentation if the policyholder did not disclose marijuana use on their initial application and medical questionnaire.

What To Do If Your Claim Denied Due to Marijuana Use

If your life insurance claim was denied due to marjuana, do not take no for an answer. An experienced life insurance lawyer will fight for you and help you appeal the life insurance claim denial.

First, your life insurance lawyer investigates and finds out whether the marijuana use had anything to do with the cause of death. Next, your lawyer uses that information plus whether or not the policyholder’s marijuana use was legal to negotiate with the life insurance company. You may be entitled to a payout in the amount of the death benefit minus what the policyholder would have paid in premiums had the life insurance company known of the marijuana use.

Applying for Life Insurance

It is crucial that policyholders disclose recreational or medicinal marijuana use to the life insurance company. This way, the life insurance company views marijuana as a lifestyle choice or prescription drug, not as an illicit drug.

If you are a policyholder using marijuana medicinally, tell your life insurance company so that your beneficiaries’ claims will not be denied for drug use. If you are a beneficiary to a policy owned by someone using marijuana medicinally, advise them to disclose their marijuana use to their insurance company so that they are not paying premiums all those years only to have your claim denied.

Talk with a Life Insurance Lawyer

If your life insurance claim was denied due to marijuana, call our experienced life insurance lawyers for help. The law governing marijuana use is complex and how it interplays with the various state laws and federal ERISA law is still evolving. 

We stay on top of current marijuana law and how life insurance companies can treat marijuana use and can help you get your payout if at all possible. Call us now to discuss your case, free of charge.

Insurance claim denied graphic

Autoerotic Asphyxiation Life Insurance Claim Denied

Sometimes the way a loved one dies exacerbates the grief of friends and family members. Autoerotic asphyxiation can be one of those causes of death, but life insurance beneficiaries often have more problems to deal with than their embarrassment or shame when an insured dies that way. 

Was your life insurance claim denied when the insured died of autoerotic asphyxiation? Our life insurance attorneys can help. We’ve investigated these types of life insurance claims and helped beneficiaries in your circumstances appeal life insurance claim denial and get their life insurance payout. Let us help you during this difficult time.

Death by Autoerotic Asphyxiation Can Look Like Suicide

Because autoerotic asphyxiation involves strangling oneself, the circumstances of the death give the life insurance company the opportunity to deny a life insurance claim due to suicide

A life insurance company can deny a claim for death benefits due to suicide if the insured allegedly committed suicide during the contestability period or if suicide is expressly excluded from coverage in the life insurance policy.

Case study: we got our client beneficiary paid when the insured died of autoerotic asphyxiation. The insured was found in his hotel room, and the life insurance company denied the claim for death benefits, alleging the insured committed suicide. We investigated and were able to show that the insured intended to survive, as he had laid out his clothing for the next day.

Death by Autoerotic Asphyxiation During the Contestability Period

The life insurance contestability period is the two years following the purchase of a life insurance policy. During that period, the life insurance company has heightened power to deny claims for death benefits due to any errors or misrepresentation on the life insurance application, or if the insured allegedly committed suicide, even if the policy does not contain a suicide exclusion.

We have gotten beneficiaries paid when their claim was denied due to death during the contestability period, especially when the alleged misrepresentation had nothing to do with the cause of death. Call us for your free case evaluation.

Death by Autoerotic Asphyxiation When Suicide is an Exclusion

Every life insurance policy has “exclusions” that provide which causes of death are not covered by the policy. Typical exclusions are death by Act of War or Terrorism, suicide, and death while engaging in sports or activities that the life insurance company considers dangerous.

Death by autoerotic asphyxiation is usually an accident. We will thoroughly investigate the circumstances of the death of the insured and if we can show the death was accidental and not suicide, you will get your payout.

What is Autoerotic Asphyxiation?

Autoerotic asphyxiation is achieved when someone masturbates while cutting off oxygen to their brain, commonly using a noose around their neck, to enhance an orgasm. When the person passes out from lack of oxygen, they release their grip on the noose and it loosens, allowing them to breathe normally. Sometimes the noose fails to loosen and the person dies accidentally. 

What is Erotic Asphyxiation?

Erotic asphyxiation is the same practice as autoerotic asphyxiation but the choking is done by someone to their partner. That other person can be choking their partner manually or employing a noose. One would think that this would be a safer practice than autoerotic asphyxiation because one partner remains conscious and can ensure that the choked partner regains consciousness.  Sometimes, however, things go wrong and people die.

In these cases, if the insured dies of erotic asphyxiation, the life insurance company will likely delay paying the life insurance claim to investigate for homicide, especially if the insured’s partner was the beneficiary of the life insurance policy. This is especially the case if the insured’s partner is suspected of murder, accused of murder, or indicted for murder. 

Was your life insurance claim denied due to death by erotic asphyxiation? Call us for your free, no-obligation consultation. We help beneficiaries get paid.

Lawyer to Help with Life Insurance Claim Denied Autoerotic Asphyxiation

Most death by autoerotic asphyxiation is accidental, but life insurance companies will invariably take advantage of the opportunity to deny or delay your claim for death benefits, hoping you will be too embarrassed to fight back.

Don’t take no for an answer! Call us for your case evaluation and find out whether you can get your life insurance payout.

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 you appeal your life insurance claim denial.

If you or someone you know is abusing drugs or suffers from drug addiction, call the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline at 1-800-662-HELP (4357) for free and confidential help, 24 hours a day.

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. 

If you or someone you know is struggling with thoughts of suicide, call the National Suicide Prevention Hotline at 1-800-273-8255 to access their national network of local crisis centers that provide free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week.

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? Did the insured use marijuana legally or as a prescription, and your claim was denied?

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 appeal life insurance claim denial 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.

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.

If you or someone you know is abusing alcohol or drugs call the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline at 1-800-662-HELP (4357) for free and confidential help, 24 hours a day.

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 by appealing the life insurance claim denial. Let the experienced life insurance beneficiary attorneys at Boonswang Law fight for you. There is no cost unless we win.

If you or a loved one is struggling with alcohol abuse, call the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline at 1-800-662-HELP (4357) for free and confidential help, 24 hours a day.

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 by appealing the life insurance claim denial. 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. Call us and find out how to appeal your life insurance claim denial.

Call Us Now
Email Us Now