There are very few things in life that are harder than losing someone that you love. With any death, there is the emotional pain that must be dealt with. If you lose a spouse or partner, however, there are also several administrative tasks that you must undertake while you are in the midst of your grief. Learn about a denied accidental death claim here.
One of those tasks is dealing with the deceased’s life insurance company. In a perfect world, you could notify the insurance company of the loss and they would simply pay you the money that is owed under the policy terms (assuming you are the beneficiary). In reality, things often aren’t that easy.
After all, life insurance companies are for-profit businesses. What that means from a practical standpoint is that the more claims they can deny, the higher their profits at the end of each fiscal year. As a consequence of this reality, each year, hundreds of deserving beneficiaries are denied the payouts intended for them. Life insurance employees know that if they issue a claim denial, most people will not have the wherewithal to contest that denial.
This is especially true if they attach some “shameful” justification to their denial letter. Reasons why life insurance claims are denied. This article discusses one such case.
Definitely not suicide
Don and Shirley had been married for 52 years. The couple was very religious – some would call them fundamentalist Christians – and they tried to live their lives according to the instructions in the Bible. As the couple aged, they began to have difficult discussions about end-of-life issues. Both had “Do Not Resuscitate” (DNR) orders on file with the local hospital. They also instructed family and friends that if either of them became incapacitated, they did NOT want anyone to take measures to hasten their death. According to the couple, to leave such instructions would be akin to suicide, which was an act they both believed was contrary to God’s law.
Sadly, Don was diagnosed with a very aggressive form of cancer. It caused large tumors to grow in his abdomen and he was in extreme pain most of the time. The doctors prescribed him heavy doses of narcotics but he tried to take them as little as possible because he wanted to remain mentally lucid as long as he could.
Almost a year after Don’s diagnosis, Shirley brought her husband home from the hospital for the last time. He wanted to die in his own bed and doctors warned them that the end was near. One day, Shirley ran out just for a moment to buy some groceries. By the time she returned, Don had passed away in his recliner. Not knowing exactly what to do, Shirley called the police and they arrived on the scene within moments.
The police made a report of the scene. It noted that Don had died in his recliner and that there were several bottles of heavy narcotics on the table next to him. The report also noted that a total of 25 pills were missing from the various prescription bottles.
The coroner’s report concluded that Don died as the result of his advanced disease. It also noted the presence of narcotics in his bloodstream, but made no conclusions regarding the type or amount.
No one who knew Don thought he had taken an excessive amount of pills to end his life. He had had many hard discussions with the people who were close to him and they all knew suicide was not an option for him.
The life insurance company made a horrible assumption
Shortly after Don’s death, Shirley filed a claim for life insurance benefits as Don’s electrical workers’ union retirement benefits provided a $500,000 policy. The couple had planned on this sum providing comfort for Shirley in her remaining years. As instructed by the insurer, Shirley submitted a claim form along with copies of Don’s death certificate, the police report, and the coroner’s report.
Just three weeks after filing the claim, however, Shirley received a letter in the mail from the life insurance company. In it, the claims adjuster explained that Don’s death was “suspicious” and that circumstances warranted further investigation since the company believed Don had committed suicide and the policy included a suicide exclusion.
Shirley was incensed. In her mind, there was no way Don would have brought shame to their family by taking his own life. Fortunately, a neighbor was at her house when the letter arrived. That neighbor’s brother Ken was a lawyer who specialized in the wrongful denial of life insurance claims. The neighbor called Ken immediately.
Within the hour, Ken was at Shirley’s house. He explained that the best time for him to contact the insurer was before they issued a formal claim denial. Once a denial letter was issued, he explained, he would have to jump through several time-consuming procedural hoops in order to get Shirley the money she was owed.
After speaking with Shirley about Don, the attorney obtained sworn witness statements from the couple’s pastor, several relatives, and a few close friends. All of them attested to Don’s strong faith and all recounted him saying that suicide was directly against the teachings of Jesus and therefore he would never do it. Ken also got a sworn statement from Don’s doctor, stating that he had prescribed all of those narcotics for Don some two months prior to his death and given the man’s level of pain, it was a miracle Don had only taken 25 of the pills in two months.
After submitting all of this evidence to the claims adjuster, the life insurer paid Shirley’s claim quickly. In fact, she had the money in her bank account within a week’s time. The case is a perfect example of why it is so important to engage a specialized attorney the moment a life insurance company indicates that they are going to do anything other than just pay the full claim amount.
Our firm is focused on battling life insurance companies that have denied claims or are delaying decisions on a claim. If you are in a situation similar to Shirley’s, please call us today. We’re here to help.