Life Insurance Lawyer New Hampshire

New Hampshire Denied Life Insurance Claims Recently Settled

MetLife policy purchased less than 2 years ago $328,500.00
Stonebridge illegal activity exclusion $202,860.00
AIG accidental death & dismemberment AD&D $407,000.00
Gerber ambiguous language policy $278,200.00
FEGLI dispute among beneficiaries $146,000.00
New Hampshire denied life insurance claim $1,500,000.00
ERISA appeal had to overcome 3 issues $139,000.00
Allstate material misrepresentation application $302,000.00
American General suspicious circumstances $204,000.00
New Hampshire denied AD&D claim won $1,00,000.00
Hartford autoerotic asphyxiation death $305,900.00
Globe lapse policy not in force $103,000.00
Transamerica alcohol drunk driving death $259,000.00
SGLI 2 issues first was beneficiary change $400,000.00
New Hampshire divorce and life insurance $731,000.00
Geico suicide or self-inflicted injury exclusion $114,200.00
Bankers issue with felony exclusion on policy $283,000.00
Genworth prescription drug exclusion issue $107,000.00

Life insurance incontestability clauses – 2 years isn’t always the limit

Anyone who is familiar with life insurance knows that many policies include a provision known as the “incontestability clause.” Generally speaking, incontestability clauses provide that if the policyholder dies within the first two years of the policy term, the life insurer can contest any of the representations made in the insurance application in an effort to void the policy.

Let’s say, for example, that a 45 year-old man, Jason, obtained a life insurance policy with a two-year incontestability clause on February 2, 2016. In his application, Jason stated that he had never sought medical advice relating to a heart condition. In truth, however, Jason learned in September 2015 that he had early-stage heart disease. Depending on when Jason dies, that misrepresentation could have drastically different impacts on the effectiveness of his policy.

In the first scenario, imagine that Jason dies in a car accident on January 6, 2017 – less than two years after obtaining his life insurance policy. In that instance, Jason’s insurer would be able to investigate all of the representations made in his application. They might examine medical records or even scour Jason’s social media posts to see if they could catch him in a lie. Here, of course, the insurer would likely find evidence of Jason’s heart condition. Given that the two-year incontestability clause had not lapsed, the life insurance company would almost certainly deny any claim against his policy based on the fact that Jason did not disclose his heart disease – even though his death had nothing to do with that condition.

In the next scenario, picture all of the same facts, except here Jason dies in a car accident on January 6, 2020. Here, his policy has been in effect well beyond two years. Generally speaking, that means that the insurer – even if it discovers Jason’s earlier medical records – has to pay his beneficiaries the death payout he intended for them.

Of course, both of the above scenarios are simplistic. Most claims are not so easily resolved. Insurance companies don’t stay in business (and generate tremendous profits) by indiscriminately paying out every claim that arises after a policy has been in effect for two years. This article discusses some of the most common situations in which a life insurance claim can be denied even after that critical policy period.

Fraudulent medical exam

Let’s stick with the Jason example. In the next scenario, Jason was a little more subversive in applying for life insurance. Specifically, he knew his heart disease was detectable through standard medical exams. Nonetheless, he was highly driven to obtain a life insurance policy so that his wife and kids would have a more secure financial future if he were to pass away.

So, what did Jason do? He hired a guy named Tom to take his life insurance physical examination for him. Tom was about the same height and build, with the same general coloring. The only real difference between the two men was that Tom was balding and in perfectly good health while Jason was neither of those things.

While Jason may have had pure intentions in substituting Tom in during the physical exam, those actions amounted to fraud. Consequently, it wouldn’t matter how many years into the policy Jason passed away, if the insurance company discovered the fraudulent medical exam, it could avoid any and all obligations under the policy.

The beneficiary kills the policyholder

Anyone who has ever spent any amount of time watching TV crime dramas is probably familiar with this scenario. A husband (let’s stay with Jason) takes out a $2 million life insurance policy naming his wife as the sole beneficiary. Jason pays all the premiums necessary to maintain the policy for over five years. During the sixth year, however, Jason winds up dead on the floor of a hotel bathroom with two bullet holes in his chest.

Jason’s wife files a claim with the life insurance policy. At that point, most insurance companies would undertake their own investigation into the circumstances of Jason’s murder. Notwithstanding how many years the policy had been in effect, if there is even a slight chance Jason’s wife was also his murderer, there is no way they will pay out on her claim.

No insurable interest

Finally, a life insurance company will not be bound by an incontestability clause when it finds out the owner of the policy has no insurable interest. This scenario looks a little different from the others. In this circumstance, imagine a young man named Mike who finds out through an online genealogy site that he has a very distant, very elderly, and very wealthy uncle named Jim who lives half way across the country. Without ever meeting Jim, Mike takes out a policy of insurance on his life.

Mike then watches the obituaries in Jim’s hometown newspaper and faithfully pays premiums on the policy. When he reads four years later that his uncle has died, he files a claim with the insurance company. The insurer’s investigation reveals that Mike and his uncle never met or corresponded, nor did Jim ever intend to leave any death benefit to Mike. In that instance, the insurance company would likely deny Mike’s claim on the grounds that he had no insurable interest in Jim’s life. That simply means he was never financially tied to Jim, Jim didn’t intend him as a beneficiary, and there is no reason for Mike to get the money.

As lawyers who specialize in the wrongful denial of life insurance claims, we know that insurance companies are often playing fast and loose when they deny claims. In those situations, we are here to help beneficiaries get the recovery they deserve. We do understand, however, that in cases of blatant fraud (such as those outlined in this article), the chances of recovery are slim to none.

If you need advice about a denied life insurance claim, please call us today. We’re here to help.