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.

COVID-19 UPDATE: Our Mississippi life insurance attorneys are now handling numerous COVID-19 Coronavirus denied life insurance claims.

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.

Mississippi denied life insurance claims are nothing new. Existing for many years, life insurance policies have been used to safeguard families and friends alike in case emergencies or accidents come unexpectedly. Unfortunately, denials of life insurance claims, as well as delays, are commonplace.
Our life insurance lawyers who live and work in Mississippi can help, whether you are in: Jackson; Gulfport; Southaven; Hattiesburg; Biloxi; Meridian; or anywhere in the state of Mississippi, we will get you the benefits to which you are entitled.
Mississippi Life Insurance Law
Policies through work are governed under ERISA. The primary regulating force here in Mississippi is Title 83 of the Mississippi, and oversight is provided by the Mississippi Insurance Department.
Most Common Reasons for a Denied Life Insurance Claim in Mississippi
  • 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.
Why life insurance companies are watching social media
Fraud investigation teams spend all day every day scouring social media sites
Life insurance companies are in business for one reason and one reason only – to make money. Let’s be honest, they wouldn’t make much money if they indiscriminately paid out on every claim submitted by a beneficiary. Indeed, to the extent they can come up with a reason – any reason – to deny a claim, they will do so. They would much rather invest the $500,000 they owe to beneficiaries in the stock market than pay it out as they’re supposed to.
Consequently, for as long as there have been life insurance policies, life insurers have undertaken investigations into each and every policyholder death that comes their way. In the past, that meant they did things like review police reports, autopsy reports, and other official documents concerning an insured’s death.
Today, however, they have a whole new arsenal when it comes to investigations – it’s called social media and they’re using it every day. As lawyers who specialize in the wrongful denial of life insurance claims, we come across this new phenomenon all the time. Insurance companies will scour social media sites in an effort to deny perfectly valid claims. Here are just a few of the uses – and misuses – of social media by life insurance companies.
Sad social media posts as a means for denying claims
Many life insurance policies contain an exclusion in the event the insured’s death comes by way of suicide. Insurance companies love this exclusion. In fact, they often determine that an insured’s death was a suicide, even if all evidence (including the coroner’s report) points to a contrary conclusion.
These days, they’re using social media as a hunting ground for indicia of suicide. If a policyholder made posts that indicated some sadness in the weeks or months leading up to their death, they may claim that person’s death was “obviously” a suicide and deny a valid claim.
Failure to disclose a significant medical condition can also be the basis for denial of a claim for death benefits. Thus, life insurance companies also use sad social media posts to claim the insured suffered from undisclosed depression. In legal terms, the failure to disclose significant information is known as a “material misrepresentation.”
The insurance company’s reasoning goes like this: (a) the policyholder had an obligation to reveal his depression during the application process; (b) if he had revealed his depression, we (the insurer) wouldn’t have granted him a policy; (c) because we relied on a false application, the policy should be rescinded and the death benefit should not be paid.
This line of reasoning may sound far-fetched, but it happens all the time. Life insurance companies treat social media like it is a gold mine for denying claims in circumstances like this.
Proof the insured engaged in “inherently dangerous” activities
In most instances, life insurance applications also require policyholders to reveal whether they engage in certain risky hobbies. These include things like car racing, motorcycle riding, sky diving and SCUBA diving. They do this because if a person regularly engages in a sport or hobby deemed to be “inherently dangerous,” the life insurer can charge higher premiums or deny coverage all together.
Let’s use SCUBA diving as an example here. If an insured dies in a SCUBA diving accident, the first thing the life insurer will do upon receiving a claim is go back and look at the policy application. The application typically asks questions like: “Do you regularly engage in any of the following inherently risky activities: SCUBA diving, sky diving, car racing, motorcycle racing?” If the deceased answered “no,” yet died while SCUBA diving, the insurance company will instantly deny the claim.
So, what does all of this have to do with social media? Often, in response to such denials, beneficiaries will claim that the underlying policy application was truthful – that the insured did not “regularly” SCUBA dive, but rather died one of the only times he ever tried the sport. In these instances, the life insurance investigators will immediately take to social media. Of course, they’re looking for posts, pictures, or membership in online groups that suggest the insured was more than the occasional SCUBA diver. If they can find evidence to support their theory that SCUBA diving was a “regular” hobby, they will renew their denial of claim.
Other material misrepresentations
Life insurance companies are becoming very aggressive in their use of social media to prove that a policyholder made material representations in their insurance application. This is especially true where the application process did not involve a physical examination and relied solely on the insured’s answers to written questions.
As discussed above, if an insurance company can prove an insured made a material misrepresentation in applying for the policy, it may be able to rescind the policy and deny a claim for death benefits. Thus the insurer will investigate social media posts for things like:
• Pictures of a policyholder who claimed to be a non-smoker smoking cigarettes;
• Pictures of a policyholder who claimed to be a non-drinker sipping a cocktail;
• Pictures of a policyholder who claimed to be average weight when they are actually medically obese;
• Pictures of a person who claimed to have no medical conditions getting chemo treatment.
The possibilities are endless but insurance companies now know they can use social media to their advantage.
Of course, claim denials based on social media posts are often unwarranted. If you are a policy beneficiary who has received a denial on this – or any – basis, give us a call. Our firm is specialized in the wrongful denial of life insurance claims. We know the tricks insurance companies use to deny benefits intended for the policyholder’s loved ones. Our business is to successfully contest those claim denials and our track record suggests we’re darned good at it.
If you need advice or assistance with a life insurance claim denial, call us today. We’re here to help.