Life Insurance Lawyer Missouri

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What to do about unclear life insurance beneficiary designations

If you’ve ever worked in or around the life insurance industry, you know that it is a profession rife with lawyers. Insurers have lawyers tasked with writing confusing and long winded policy language. They have other lawyers who are charged with dreaming up policy exclusions. Still other lawyers are employed for the sole purpose of concocting reasons for claim denials each time a claim for benefits is received.

There’s a good reason why life insurance companies pay so much money to employ so many lawyers. Denying valid claims is big business. The more they can deny claims by policy beneficiaries, the more money they keep in their own coffers and the happier investors and executives are at the end of the year.

Unfortunately, a lot of innocent people get hurt as a result of the insurance companies’ greed. Many times, life insurance policy proceeds are intended to give financial security to a loved one when a key wage earner passes away. Without those dollars, beneficiaries can lose their homes, possessions, and personal security.

Such was the case for one policy beneficiary in Florida who experienced a confounding and unbelievable claim denial. This article explores the facts of her case and serves as a cautionary tale in two respects. First, policyholders need to be exceedingly clear when designating beneficiaries to their life insurance policies. Second, beneficiaries need to be vigilant in retaining specialized lawyers to help contest bogus claim denials.

The cloud of love

This case involves a gentleman in his 60s named Harold. Harold had been in the mining industry for his entire life and had amassed a great deal of wealth. He had hundreds of friends in his Florida community and was well-liked by all. What Harold lacked, however, was his true love. Harold’s first wife, Margaret, had passed away when the couple was in their 30s and he had never remarried, even though he was terribly lonely.

In the fall of his 64th year, however, Harold met a younger woman who went by the name of Marie Rodriguez. Harold was instantly smitten by Marie, if not slightly amused by her name. Harold had a large extended family and had two distant nieces who were named Maria Rodriguez and Marie Rodriguez, respectively. In light of this, Harold almost immediately began calling his new girlfriend by the nickname “Merry.”

The romance between Harold and Merry was fast and furious. Within a few months’ time, Harold had made Merry a joint owner of several of his properties and had titled most of his cars and boats in her name. He also changed his $5 million life insurance policy to name “Merry Marie Rodriguez” as his sole beneficiary. Because the couple spent nearly every second of every day together, Merry was fully aware of the change Harold had made to his life insurance policy. She was flattered, of course, but hoped the policy wouldn’t be needed for many years to come.

In the flurry of new romance, it never occurred to Merry that she hadn’t ever told Harold her true name. In fact, she wasn’t very fond of the name and avoided using it for most of her adult life. Indeed, few people outside those involved in issuing her driver’s license and passport knew that her real name was Guadalupe Maria Elizabeth Rodriguez. She had simply gone by Marie or, as Harold called her, Merry.

An unexpected death and subsequent confusion

About a year after Merry and Harold started seeing each other, Harold passed away suddenly from a massive heart attack. The whole community was grief-stricken but Merry was particularly despondent. In fact, one of Harold’s lawyers had to remind her to make a claim against his life insurance policy. She finally got around to doing so some six months after his death. As part of the claim process, she had to submit a copy of her driver’s license in order to prove she was the intended beneficiary.

When the life insurance company received the form, its adjusters were quickly confused. The policy named Merry Marie Rodriquez as the beneficiary, yet the person claiming a right to the policy proceeds was named Guadalupe Maria Elizabeth Rodriguez. To complicate matters, the policyholder had two relatives whose names more closely aligned to Harold’s stated beneficiary. None of the women, however, had the formal name of “Merry.”

In light of all this, the insurance company simply denied Merry’s claim. Its stated reason for the denial was that there was no clear beneficiary designation in the policy. Stunned by the news, Merry reached out to Harold’s former attorney. He referred her to a lawyer who specialized in the denial of life insurance claims.

After reviewing the facts of the case and interviewing several witnesses, the attorney put together an evidence packet for the life insurance company. It included several letters Harold had written to “Merry,” pictures of the couple together, statements from witnesses familiar with Harold’s pet name for his girlfriend, and evidence of all Harold’s property transfers to Merry Marie Rodriguez. He also obtained a statement from Harold’s personal attorney regarding his understanding of Harold’s intentions. Merry’s attorney threatened to sue the insurance company if it did not pay Merry on the claim or if it attempted to pay the proceeds to one of Harold’s nieces.

All of the effort eventually paid off. They insurance company ended up paying the $5 million death benefit directly to Merry, just as Harold had intended. While the outcome of this case was a positive one, it does underscore the importance of naming a clear beneficiary in your life insurance paperwork. It also illustrates just how important a specialized lawyer can be for protecting your rights.

As lawyers who practice solely in the area of life insurance claim denials, we see cases of unclear beneficiaries all the time. We know insurance companies use them as a poor excuse for denying valid claims and we don’t stand for it. If you are facing this or a similar situation, call us today. We’re here to help.

Missouri 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 Missouri can help, whether you are in: Kansas City; St. Louis; Springfield; Columbia; Independence; Lee's Summit; or anywhere in the state of Missouri, we will get you the benefits to which you are entitled.
Missouri Life Insurance Law
Policies through work are governed under ERISA. The primary regulating force here in Missouri is Title 20 of the Missouri Code, and oversight is provided by the Missouri Department of Insurance.
Most Common Reasons for a Denied Life Insurance Claim in Missouri
  • 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.
When a life insurance company can’t make up its mind about a claim
If you’ve ever experienced the death of a spouse, you know just how difficult the experience can be. In addition to taking care of other family members, burying your best friend, and figuring out how to deal with the rest of your life, you also have to take care of some unpleasant tasks. One of those tasks is making a claim for death benefits against your deceased spouse’s life insurance policy.
That chore can be particularly upsetting as each communication with the insurance company only serves to remind you that your beloved spouse is gone. If your initial claim for death benefits is denied, the grieving process can be stretched further. Depending on the insurance company, you may have to pursue multiple administrative appeals or other formalities before you can ever pursue the wrongful claim denial in court. This process can take months, or even years.
For one woman living in Missouri, the gross incompetence of her husband’s life insurance company stretched the process out over 20 years. In this article, we’ll explore the real-life nightmare she endured in pursuing policy benefits. While the situation is harrowing to read, we hope it illustrates a point we try to communicate all the time: if you are the designated beneficiary under a life insurance policy and you receive a claim denial letter following the policyholder’s death, you need to contact an attorney immediately. Importantly, not just any attorney will do. You need to find an attorney who specializes in the denial of life insurance claims. The following case illustrates why.
The initial claim denial
The woman at the center of our case is named Susan. In 1985, Susan’s husband John purchased a life insurance policy worth $250,000 and named Susan as the sole beneficiary. At the time, neither Susan or John believed the policy would be needed for a long time. Nonetheless, John obtained the policy so that Susan would be cared for financially if the worst case scenario ever happened.
In 1986, that worst case scenario came true. John was killed unexpectedly in a car crash. As John had planned, Susan made a claim for death benefits under the policy. As life insurance companies often do, John’s insurer issued a quick and decisive claim denial, claiming that John’s policy coverage had lapsed prior to his death.
Unfortunately for Susan, she was the life insurance company’s ideal beneficiary – rather than contest the denial as she had a right to do, she simply went away. John and Susan had paid premiums on that policy for nothing. That’s a big win for the insurance company.
Media pressure forces scrutiny
By the 2000s, life insurance claim companies were all over the news. The industry was being heavily criticized for failing to notify beneficiaries of policies under which they were owed benefits. John’s insurance company, like many others at that time, sought to determine whether any of their policyholders had died without the company receiving a notice of death.
If an insurance company learned of a policyholder’s death for the first time during this process – no matter how long it had been since that person died – the insurance company undertook an effort to locate beneficiaries and pay valid claims. The insurers did this by searching for death records regarding their policyholders within the Social Security Administration death records. All of this effort was aimed at getting the media off the industry’s back. Thus, the process was often rushed and many mistakes were made.
Susan’s second go-around with the life insurer
In 2013, nearly 20 years after John’s death, his life insurance company contacted Susan. Company representatives claimed that in doing their retrospective review of policyholder deaths, they determined that John’s policy had not lapsed at the time he died. Rather, the insurer claimed that John’s policy had been in full force and effect for three months following his death. Consequently, they paid Susan the $250,000 policy benefit.
Susan was understandably upset, believing the company had robbed her of the financial security John had intended her to enjoy back in the 1980s. Thus, she demanded that the insurance company pay her 9% interest on the $250,000 for the period of time between John’s 1986 car accident and the 2013 policy payout. The insurance company refused to pay Susan any interest. She contacted the Missouri Department of Insurance (“MDOI”) and asked that agency to undertake an investigation.
Susan’s third go-around with the life insurer
As MDOI got further and further into its investigation, it discovered yet another mistake by the insurance company. Specifically, the agency determined that John’s policy had actually lapsed nine days before his death and that Susan had not been owed any payout under the policy terms.
In what can only be described as a life insurance nightmare, Susan and the life insurance company ended up in court. Susan sued the life insurance company based on its repeated errors. To make matters worse, the insurer cross-sued in an effort to get the $250,000 policy payout back.
In what was viewed by many as a cruel twist of fate, the insurance company prevailed in court. Citing a well-settled legal concept called “restitution,” the court said that someone who receives a payment by mistake should not be able to enjoy the windfall of that mistake. Instead, the court ruled, Susan had to pay back the entire $250,000.
Fortunately, Susan’s case presents a rare and extreme set of facts. We doubt there is a soul reading this who doesn’t feel bad for her. Nonetheless, her case illustrates the importance of retaining an attorney the minute you receive a claim denial letter. And not just any attorney – an attorney who specializes in the denial of life insurance claims.
It is our job to tackle the life insurance companies head-on. We watch out not only for their mistakes, but also for intentional actions they sometimes take to deny legitimate death benefit claims. If you’re facing the denial of a life insurance claim, call us today. We’re here to help.