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What are ways to fight an accidental gunshot life insurance claim denial?
An accidental gunshot can be a traumatic event, and if it results in the death of an insured person, their beneficiaries may file a claim for life insurance benefits. However, if the insurance company denies the claim, the beneficiaries may need to take action to fight the denial. Here are some ways to fight an accidental gunshot life insurance claim denial:
  1. Review the policy: The first step is to carefully review the life insurance policy to determine if the accidental gunshot is covered. Some policies may have specific exclusions for accidental death, or may require that the death occur within a certain period of time after the accidental injury. Understanding the terms and provisions of the policy is critical to determining whether the claim should be covered.

  2. Gather evidence: If the claim is denied, it may be necessary to gather evidence to support the claim. This could include police reports, witness statements, medical records, and any other evidence that demonstrates the insured person died as a result of an accidental gunshot. The beneficiaries may also need to obtain a death certificate that lists the cause of death as accidental.

  3. Consult an attorney: If the claim is denied, it may be helpful to consult with an attorney who has experience in handling life insurance claims. An attorney can review the policy and the evidence, and can advise the beneficiaries on their legal options.

  4. File an appeal: If the claim is denied, the beneficiaries may have the right to file an appeal with the insurance company. The appeal should include a detailed explanation of why the claim should be covered, along with any supporting evidence. It is important to follow the appeal process outlined in the policy, which may include specific deadlines and procedures.

  5. File a lawsuit: If the appeal is unsuccessful, the beneficiaries may need to file a lawsuit against the insurance company. This can be a complex and time-consuming process, and it is important to have an experienced attorney to guide the beneficiaries through the litigation process.

In summary, fighting an accidental gunshot life insurance claim denial may involve reviewing the policy, gathering evidence, consulting an attorney, filing an appeal, and potentially filing a lawsuit. It is important to understand the terms and provisions of the policy, and to follow the proper procedures for appealing a denial or filing a lawsuit.

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Life Insurance Beneficiary Rules and Disputes Maine

2023-2024 Life Insurance Claims in Maine Recently Settled

  • Mutual Security Life coronavirus denial $203,000.00
  • Mass shooting death denial $150,000.00
  • Inter-American Life COVID-19 denied $105,000.00
  • Denied SGLI claim change in beneficiary $406,400.00
  • Ameriprise wrong age on application $30,000.00
  • Executive Life power of attorney change $77,000.00
  • First Capital Life felony exclusion claim $128,000.00
  • Iowa Farm Life suicide gun accident won $175,000.00
  • American Standard Life alcohol exclusion $202,500.00
  • FG Life lapse of policy two month time $31,000.00
  • NEA Life chronic illness exclusion won $10,000.00
  • Globe denial material misrepresentation $109,250.00
  • Iowa Farm Life denial of benefits resolved $502,000.00
  • SGLI claim wife and ex dispute won $400,000.00
  • American General suicide exclusion $213,800.00
  • Equitable nonpayment of premium $103,000.00
  • Denial of FEGLI claim benefits won $409,300.00
  • Lewiston interpleader lawsuit resolved $740,000.00
  • Maine denied life insurance claim $921,500.00
  • FEGLI appeal resolved in three weeks $154,000.00
  • Denied AD&D claim suicide case won $920,000.00
  • Biddeford long delay of benefits obtained $950,000.00
  • Auburn Maine material misrepresentation $821,000.00
  • AIG divorce ex-spouse against spouse $319,300.00
  • Accidental Death & Dismemberment $750,000.00
  • Hartford drug exclusion opioid death $204,650.00
  • Bangor divorce settlement court order $350,000.00
  • AIG interpleader beneficiary dispute $560,000.00
  • Prudential denial of AD&D policy $526,000.00
  • ERISA appeal life insurance benefits $144,000.00
  • Denied life insurance claim Maine $815,300.00
  • New Jersey Life denial of benefits $270,000.00
  • USAA Life dispute among family $720,000.00
  • Standard autoerotic asphyxiation $320,000.00
  • Reliance Standard sickness exclusion $210,000.00
  • Maine divorce settlement life insurance $500,000.00
  • Portland ambiguous language resolved $911,000.00
  • Gerber denial felony exclusion $106,000.00

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Maine Life Insurance Law

There are few more dangerous forces in business than greed. Unfortunately, however, greed can strike almost any industry and can wreak havoc for the unsuspecting. The life insurance industry is rife with greed.

Take, for example, the very manner in which life insurance companies conduct business. The goal of every life insurance company is to collect the greatest amount of premiums from the greatest amount of policyholders. That would be all fine and good if life insurers then routinely paid out death benefits when those premium-paying policyholders died.

That’s not always what happens. Instead, the insurance companies hire armies of lawyers whose sole job is to concoct phony reasons to deny valid claims against those policies. They do this because the fewer claims they have to pay out, the greater their profits. As lawyers who specialize in the wrongful denial of life insurance claims, we see insurance companies engage in these illicit tactics every day.

To add insult to injury, the greed doesn’t stop at the corporate level. Some life insurance agents, themselves motivated by greed and high pressure to sell policies, engage in tactics that are every bit as harmful to the consumer. This article explores the circumstances surrounding one such agent, and the disastrous impact he had on policyholders in his small town. While we typically like to report on cases where a policy beneficiary triumphed against a bogus claim denial by a life insurer, this article is more of a cautionary tale for those who may be in the process of obtaining insurance.

Handling the life insurance application process

With some limited exceptions, nearly all life insurance policies require the policyholder to undergo an application process before a policy can issue. While the thoroughness of that process varies from company to company (and policy to policy), it typically involves some level of investigation into the applicant’s health history. In most cases, that investigation involves a detailed health questionnaire, followed by a simple physical examination.

The requirement of truthfulness in the application process cannot be understated. A life insurance policy, at its core, is a legal contract. Contracts must be premised on the truth. Otherwise, the party who was lied to during contract negotiations may later be able to rescind the contract.

In the life insurance context, that means that a policy applicant must give the insurance company truthful information about his health history. If he does not, and later dies of an undisclosed medical condition, the insurer may be able to avoid its obligation to pay a death benefit to policy beneficiaries. Fortunately, most people understand this and are truthful in answering questions about their health.

Beware of answering life insurance policy questionnaires

As noted above, insurance agents can be under tremendous pressure to sell policies. This may be because they are paid a commission based on a percentage of premiums, or simply because they want to get ahead within their agency by selling more policies than anyone else. Regardless of the motivation, some life insurance agents play some pretty dirty tricks to meet their policy quotas.

Such was the case with one agent named Tim. Tim’s game was relatively simple. Every time he met a new client who wanted to purchase a life insurance policy, Tim would set up a phone call with that person to go over the extensive health questionnaire required by the insurance companies he represented. Tim asked each client to set aside one to two hours for the call. During that call, Tim would read each question on the application aloud to the client, and then record their answers on an application form that would be submitted to the insurance company. Tim touted this process as “gold standard customer service.”

The only problem was, Tim didn’t always record the client’s answers to the questions correctly. He knew, for example, that if a client reported a history of diabetes, heart disease, or cancer, the insurance company was unlikely to issue a policy. Consequently, Tim would not receive a commission for his work. Therefore, even if a client did report a serious medical condition to him during the call, Tim would purposefully fail to report it on the form, a policy would issue, and Tim would be credited for the sale.

A series of denied life insurance claims

This process worked very well for Tim until his clients started passing away. For example, Tim submitted an application for one client who admitted to him during the call that he had been under a doctor’s care for heart disease for over a year. Tim, however, never noted that information on the form that went to the insurer. When the client died of a heart attack just over a year after the policy issued, the insurance company undertook a medical investigation.

It didn’t take much for the insurance company to discover the client’s history of serious heart-related health problems. The insurance company filed a lawsuit to rescind the policy without paying the death benefit because, it argued, the policy had been issued based on fraudulent information. When the court granted that rescission, the policyholder’s beneficiaries lost out on the death benefit that was intended for them.

In short order, other similar cases arose involving this same agent. While we would like to report that the courts showed mercy on the unsuspecting beneficiaries, that was simply not the case. The court found that the policyholder was ultimately responsible for verifying the truth of the information it submitted to the insurance company. By failing to review Tim’s form, they failed to ensure the truthfulness of the application.

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The point of this story is simple: you must be in charge of your own life insurance application. Don’t let an agent or anyone else submit the application for you. If have questions about the application process or have had a claim denied in a manner you feel is wrongful, please call us today. We’re here to help.