Life insurance companies perform an important function in our society. They allow people of varying means to provide for loved ones after they pass away. They do this by allowing consumers to pay relatively modest monthly premiums. In exchange, the insurance company will make a significant lump-sum payout to a policyholder’s beneficiaries after the policyholder dies. Sounds like a great deal, right? If only things were that simple. Learn how to appeal a denied life insurance claim.
You see, life insurance companies don’t get rich by simply paying out on every claim they receive. To the contrary, life insurers go to great lengths in order to deny claims. In some instances, this means that they will perform their own thorough investigation into a policyholder’s death in order to fit that death within a policy exclusion. In other instances, it means they won’t perform any investigation whatsoever – so long as a death initially appears to fall within one of those exclusions. This is true even when the underlying death makes absolutely no sense.
This article explores one such case. The policy at issue – like many life insurance policies – contained an exclusion that relieved the insurance company from making a policy payout if the policyholder died while committing a felony. The case is a perfect example of the old adage, “Things are not always as they seem.” It is also a great example of why we fight day in and day out to contest the wrongful denial of life insurance claims.
A most unusual crime
This highly unusual case involved a man named Ben. By all accounts, Ben was happy, if not a little bit boring. He was an accountant, a father, and a husband. He coached his son’s little league team. He was an elder at his church. He volunteered regularly. Ben was a gentle soul, to be sure, but not a guy you’d ever expect to see on the local news.
Then, one day in September, security cameras kept close watch as Ben calmly walked into a bank, held a gun to a teller’s head, demanded all the cash on hand, gathered bags of the cash, and walked out of the bank. As Ben slowly loaded the bags into his car, outdoor security cameras captured the arrival of the police. They appeared with sirens blazing and guns drawn. With a terrifying ease, Ben raised his gun toward officers. They immediately shot and killed him.
As news of the incident spread, there was not a single person who had known Ben who could believe what he did. That said, the security footage was clear. Ben was an armed bank robber. It made no sense.
Out of everyone, Ben’s wife Sarah was probably the most shocked by the circumstances of her husband’s death. They talked about everything and there was zero indication that anything was different or wrong in his life. Their finances were fine. The whole thing was baffling.
Despite her grief and confusion, Sarah was compelled to file a claim with Ben’s life insurance company. Even though she doubted they would pay out under the circumstances, something told her to file the claim anyway.
A predictable denial
It came as no surprise when the denial letter came in the mail. Sarah knew the policy contained an exclusion in the event the policyholder died during the commission of a felony. By all indications, her husband had inexplicably committed a grand felony.
Sarah was about to give up on the life insurance claim all together when she got a call from the police department. The results of Ben’s autopsy had come in. As it turned out, Ben had high doses of a drug called scopolamine in his system at the time of his death.
Among other things, scopolamine is a drug that is used as a truth serum. After ingesting it, a person becomes unyieldingly subject to suggestion. It is very easy to administer. For example, a fine powder form of the drug can be blown into someone’s face or slipped into food or drink. It is imperceptibly ingested and within moments, the victim is under complete control of the perpetrator. For example, other victims have been told to empty their own bank accounts and then hand all of their money over to a thief. They do so willingly because they have no control over their own behavior and, typically, no memory of the event when the drug wears off.
After Sarah learned about the scopolamine, she contacted the life insurance company. They told her they weren’t interested in the information and that the claim denial would remain in effect.
Thereafter, Sarah got in touch with an attorney specializing in the wrongful denial of life insurance claims. He was fascinated by the story and undertook his own inquiry into the status of the police investigation. As it turned out, there had been a rash of scopolamine-related crimes in a three-county area over the past year. All indications were that Ben was a victim, not a perpetrator.
The attorney combined that information with several sworn statements regarding Ben’s life and personality prior to the incident. He presented it to the life insurance company’s appeal board who reluctantly agreed to reopen Sarah’s claim, pending further internal investigation.
Within a month, the police caught the group of criminals who had been using scopolamine to make innocent victims commit crimes. In exchange for a lesser sentence, one of them admitted Ben had been one of their victims. The lawyer presented that information to the appeals board, who agreed that was final piece of evidence necessary to overturn the claim denial. Though the process was gut-wrenching, Sarah was grateful she had hired a specialized attorney to contest the claim on her behalf.While this case presents a highly unusual situation, the life insurer’s actions are not atypical. They are in the business of denying claims and are not interested when beneficiaries provide additional information to support their claims. If you have experienced this sort of behavior from a life insurance company, please don’t hesitate to contact our firm today. We’re here to help.