Life Insurance Lawyer Mississippi
Whether you reside in: Meridian; Biloxi; Hattiesburg; Southaven; Gulfport or Jackson; our life insurance attorneys who live and work here in Mississippi are here to help resolve your delayed or denied life insurance claim.
When an innocent death looks like a little like suicide
Most people have a loose understanding of the interplay between life insurance and suicide. Generally speaking, a person cannot obtain a life insurance policy with a large death payout then kill themselves in an effort to get a windfall for their surviving beneficiaries. Indeed, nearly all life insurance policies contain a suicide exclusion for at least the first two years of the policy.
Unfortunately, life insurance companies grasp onto the suicide exclusion as an excuse to deny perfectly valid claims. In fact, life insurance companies can decide – simply for purposes of the policy – that a death was due to suicide even when the authorities reach a different result.
They do this because denying claims is big business for life insurers. They don’t generate profits by simply paying out on every claim that is submitted. To the contrary, they make the most money when they collect premiums then come up with excuses to deny claims. Indeed, life insurance companies keep plenty of attorneys on the payroll whose sole job is to come up with reasons to deny valid claims.
Such was the case with one family who suffered an unfortunate loss while vacationing in the Grand Canyon. This article explores their fateful plight, the battle they raged against the insurance company, and the way they finally managed to get the life insurance payout their patriarch intended for them.
A family vacation gone terribly wrong
In the fall of 2015, the Jones family set out on a trip that would be shared by literally thousands of other Americans that year. Specifically, they decided to hike the Grand Canyon. Steve Jones and his wife Alice believed that their two children, ages 13 and 15, were finally old enough to handle the trip and to thoroughly enjoy it.
The family started the eight mile descent into the canyon at approximately 8 am. Steve was particularly giddy that morning because he had just purchased his first smartphone and was excited to document the entire trip through a series of photographs and videos that he would take with his phone. In fact, for his 45th birthday two weeks earlier, Alice had bought Steve a “selfie stick” that would allow him to take self-portraits at greater than an arm’s length distance.
About half-way down the trail, the family stopped to marvel at all the splendor of the canyon from a particularly precarious perch. While the rest of the family was hesitant to approach the edge, Steve decided it was a perfect place to take a selfie. He told the family he wanted the shot to look like he was floating on air in the middle of the canyon. Other tourists on the trail that day would later recount how happy and carefree Steve seemed to be in that moment.
Unfortunately, as Steve positioned himself for the perfect shot, he took one step too far toward the edge. In an instant, he lost his footing and, to the great horror of his family and other tourists, fell to his death in the canyon below. In a heartbeat, the Jones family was without a father.
An infuriating life insurance claim denial
When Steve died, Alice was not only overwhelmed with grief, but also with intense fear. Steve, a physician, had been the family’s only wage earner. In fact, Alice hadn’t had employment outside the home since Steve graduated from medical school some twenty years earlier. The only saving grace, as far as Alice could tell, was that Steve had taken out a life insurance policy naming her the sole beneficiary. The policy had a $1 million death benefit with a $3 million rider that would kick in if Steve were to die in an accident. Alice was positive that policy would keep her family from financial ruin while she got back on her feet.
Alice thus submitted a claim to the life insurance company. As required, she also submitted a copy of the police report regarding the incident, the coroner’s report, and a death certificate. Each listed the cause of death as an “accidental fall.” The police report described the incident in great detail and contained several witness statements regarding Steve’s positive attitude just before the fall.
Nonetheless, some four weeks later, Alice received a claim denial letter in the mail. According to the life insurance company, Steve’s death was a suicide. The insurer concluded from all of the claim paperwork that Steve had voluntarily jumped from the ledge and that, consequently, the suicide exclusion of his policy prevented a payout.
Alice was enraged. Having been married to Steve for nearly a quarter century, she knew how happy and carefree her husband was. She knew that the day of his death was one of his happiest. She was not going to take the claim denial lying down.
Alice contacted an attorney who specializes in the wrongful denial of life insurance claims. She provided him with the policy, her claim submission, and the denial letter. After careful consideration, the attorney could see the insurance company’s denial was just a ruse.
Alice formally retained the attorney and allowed him to handle all further communications with the insurance company. In fact, the attorney doggedly pursued the administrative appeal process offered by the insurance company. He not only provided additional witness statements about Steve’s state of mind that day, but also produced Steve’s personal journal which described how happy and content he was with his life. Importantly, the attorney also threatened to file a suit for, among other things, bad faith denial of claim if the insurance company did not reverse its decision.
That did the trick. In light of the overwhelming evidence that Steve was not depressed or suicidal, the insurance company agreed to pay the claim in full. This case simply reiterates how important it is to hire a specialized attorney if you are facing a life insurance claim denial. In fact, if you’re experiencing similar circumstances, please don’t hesitate to give us a call.
- Number one is a misrepresentation on the application. This typically involves failing to disclose a medical condition. However, we can get over this hurdle the majority of the time.
- A lapse of a life insurance policy is probably second most common. What happens is that the insured gets sick and misses a payment or two. These are tough, but often we can get these claims paid.
- Probably third is the type of death exclusion. This could be a suicide or it could be a self-inflicted injury. Murder is another exclusion. Health again can fall under this exclusion. We often win suicide exclusions as we cite case law that the death was actually accidental.
- A very common exclusion is the alcohol exclusion. The insured may have been killed in a car crash, but the autopsy revealed alcohol in the person’s system. We have many legal briefs to combat this exclusion.
- Heroin and opiates or illegal drug exclusion is one of the biggest now. With the opioid crisis, there are tens of thousands of deaths.
- Prescription drug overdose exclusion may involve an overdose of medicine or taken medicines that are contraindicated.
- An ex-spouse being cut off from life insurance benefits is a big one. We actually have a half dozen ways to get over this hurdle.
- Having a spouse not listed as a beneficiary is another reason for denial
- Having a child not listed as a beneficiary is one too.
- Having only a primary beneficiary who is deceased is another.
- On an AD&D (accidental death and dismemberment) life insurance policy, a fall not being considered an accident is extremely common.
- The insured’s age not being correct on the initial application is a reason for denial.
- Having the wrong social security number listed is common.
- An autoerotic asphyxiation exclusion is an easy one for us to beat.
- An omission on the application is a big reason for denying a life insurance claim, but we have legal briefs to this effect.
- Not providing the required documents to the insurance company after death is a reason.
- Information which is argued to not be correct is one.
- When there is a dispute between two or more beneficiaries, an interpleader may occur, and we always get these resolved quickly.
- A beneficiary not named is a reason for not paying it out.
- A life insurance policy may be transferred from one company to another by the employer which causes major problems.