Life Insurance Lawyer Nebraska
Whether you reside in: Grand Island; Bellevue; Lincoln or Omaha; our life insurance attorneys who live and work here in Nebraska are here to help resolve your delayed or denied life insurance claim.
COVID-19 UPDATE: Our Nebraska life insurance attorneys are now handling numerous COVID-19 Coronavirus denied life insurance claims.
The depths of denial – when life insurance companies stretch the limits to deny valid claims
Our firm specializes in contesting the wrongful denial of life insurance claims. As such, we have come to know the life insurance industry inside and out. We can tell you, for example, that not all life insurance companies are out to exploit innocent policyholders or their beneficiaries. There are actually quite a few reputable life insurers out there that tend to honor valid claims made by beneficiaries.
Unfortunately, there are also some life insurance companies that take advantage of the power disparity between the company and the beneficiaries who are simply seeking the death payouts their loved ones intended for them.
How do they do this? Well, for one thing, they sell as many life insurance policies to as many people as possible. They then collect as steep premiums from those policyholders. Finally, when it comes time to pay death benefits, they come up with baseless justifications for denying completely valid claims. They do all this, of course, hoping that grieving beneficiaries won’t know that they have the right to contest those claim denials.
Every once in a while, we come across a case that illustrates the subversive maneuvers of these shady life insurance companies perfectly. This article discusses one such case.
The policy at issue
The case involved a gentleman named David. David was 54 years old and gainfully employed as a corrections officer. As part of his employment package, David received the option to purchase a life insurance policy. The insurance company also offered an accidental death rider for an additional premium.
David chose to purchase a $100,000 policy with a $300,000 accidental death rider. He named his adult daughter Maria as the sole beneficiary. The policy contained a two year contestability period. That means, among other things, that if David passed away within two years of the policy’s issuance, the insurance company could avoid payment if David’s cause of death came within a series of exclusions, including suicide.
The accidental death rider provided that the insurer would pay $300,000 above the policy payout if David’s death was “solely and exclusively caused by an accident and not the direct result of disease, infirmity, or any illegal activity on the part of the insured.” David was confident in purchasing the rider because he was a very healthy individual and, as a corrections officer, he was the antithesis of someone who would ever die while engaged in an illegal act.
David’s policy became effective on March 1, 2012 and he faithfully paid all of his premiums from that point forward.
Any reason to avoid paying a valid claim
On the evening of December 13, 2013, David was driving home from his job at the federal prison located some 30 miles from his house. It was a foggy night and, as usual, David had to navigate some winding, back country roads leading away from the prison. Unfortunately, David would never make it home that night.
In the early morning hours of December 14, David’s car was found crashed into a large oak tree. The force of the accident was so great that David’s small SUV was nearly unrecognizable. When emergency responders arrived, they declared David dead at the scene. A police department’s traffic forensics team was called to the crash site and officers performed a thorough investigation. David’s body was transported to the local coroner’s office for an autopsy.
The eventual police report revealed there were no brake marks on the roadway near the accident. That meant David’s vehicle hit the tree going full speed. Additionally, the autopsy report showed that David had suffered a small brain aneurysm at some time shortly before the accident. Nonetheless, the severe trauma to David’s body from the accident led the coroner to rule David’s official cause of death as “accidental death.”
Devastated by her father’s passing, yet also fearful of losing the financial support he had provided to her, Maria filed a claim with David’s life insurance company. She submitted all the required paperwork, which included a death certificate, the police report, and the coroner’s report. At the time, she had no reason to believe her claim would be denied.
Just weeks later, however, she received a outright denial letter in the mail. According to the insurer, it was denying the claim under David’s general policy on the grounds that he committed suicide within the first two years of the policy. According to the adjuster, the fact that no brake marks were found at the scene indicated that David intentionally rammed his car into the tree. The insurer also denied coverage the accidental death rider on two grounds: (1) David’s death was a suicide; and (2) even if it was not a suicide, his death was the result of his brain aneurysm and not a motor vehicle accident.
Luckily, Maria had a friend who was a lawyer specializing in the wrongful denial of life insurance claims. The lawyer took one look at Maria’s case and knew instantly that the insurer was simply trying to skirt its obligations. With Maria’s consent, the lawyer sued the insurance company for wrongful denial of claim.
Ultimately, the court agreed that the denial was wrongful. Taking all of the facts into consideration, the court found that David’s failure to brake may have resulted from the aneurysm, but that did not make that medical condition the “direct result” of David’s death. Additionally, the court noted that there was absolutely no evidence to suggest David was suicidal at any time prior to the crash. To the contrary, witnesses testified that he was a happy-go-lucky guy who never had a negative word to say about anything. In light of all this, the court awarded Maria the full $400,000 policy benefits, with interest.
This case underscores the lengths shady insurance companies will go to in order to avoid claim payouts. If you believe you have received a wrongful life insurance claim denial, please call us today. We contest faulty denials every day and we would be happy to assist you in getting the benefit you deserve.
- 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.