Life Insurance Lawyer Ohio

Whether you reside in: Youngstown; Canton; Parma; Dayton; Akron; Toledo; Cincinnati; Cleveland or Columbus; our life insurance attorneys who live and work here in Ohio are here to help resolve your delayed or denied life insurance claim.

Life insurance policyholders: protect your beneficiaries

There are many circumstances under which a person obtains life insurance. For many people, a policy is issued as part of an overall employment benefits package. Still other people may acquire a policy in secret after being moved by the death of someone close to them. Perhaps most people get life insurance as a way to ensure their loved ones are financially secure after they pass away.

Regardless of the reason a person obtains a life insurance policy, one universal truth holds true: they must make a clear and unambiguous beneficiary designation if they want their intentions to be honored when they die. Importantly, this is an ongoing process. A life insurance policy, like any estate planning document, must be revisited each time a significant life event occurs. This could include marriage, divorce, the birth or death of children, and any other event that might impact the policyholder’s wishes.

As lawyers who specialize in the wrongful denial of life insurance claims, we often handle disputes regarding a policyholder’s intentions when it comes to his or her beneficiary designation. While we’re happy to fight these battles for the beneficiaries who are deserving of the intended benefit, it makes life easier for everyone if designations are made clear while the policyholder is alive.

This article explores a one scenario where a policyholder’s lack of clarity caused his intended beneficiary to lose all of the life insurance proceeds he undoubtedly wanted her to receive. While most of the articles on this site focus on cases where beneficiaries have had a claim denied, sued the life insurer, and then won in court, this is not such a case. Nonetheless, it serves as an important cautionary tale regarding the importance of keeping your life insurance policy front of mind and up to date as life changes occur.

A conflict between the policy and the will

One situation that we see with alarming frequency is this: an individual obtains a life insurance policy and faithfully pays premiums on that policy for years or even decades. During that time, several significant life changes occur yet the policyholder does nothing to change his policy so as to reflect those changes. An illustrative case is described below.

Bill was a real estate broker who married his high school sweetheart, Marla, when the two were 25 years old. They were married for 10 years and had two children. During that entire time, Bill had a life insurance policy that was supplied by his employer. It named Marla as his sole beneficiary.

By the time the couple divorced, Bill was only 35 years old. He wasn’t even thinking about estate planning at that point in his life. He continued to keep the same life insurance policy in place following the divorce, but rarely (if ever) thought about the policy since his employer paid all of the premiums.

When Bill was 43, he met a woman named Susan. While they never married, the two lived together and were a very loving couple. At that point, Bill was already experiencing some slight heart-related ailments and, as such, he decided to have his attorney draft a will. His will was relatively simple. It left 100% of his assets to Susan. Still employed by the same brokerage firm and still covered by the same life insurance policy he’d had since his twenties, Bill did nothing to update his life insurance policy. He actually forgot it even existed.

Unfortunately, Bill passed away in a car accident at the age of 45. As Susan sorted through all of his effects within his home office, she found a copy of his will, and a end-of-year statement from Bill’s employer that noted the amount the company had paid on his life insurance policy over the year prior. Susan didn’t have access to the policy itself but upon reading Bill’s will, it became clear to her that Bill intended for her to have all of his assets including, presumably, his life insurance proceeds. Consequently, she filed a claim for benefits with the insurer.

A claim denied with no real recourse

Sadly, Susan’s claim was denied by the life insurance company on the grounds that Marla was still the named beneficiary under Bill’s policy. This came as a shock to Susan because, in her opinion, Bill’s estate planning documents were exceedingly clear that she was to receive all of his assets. Since the will was a more recently-drafted document than Bill’s life insurance policy designation, it seemed logical that the more current document would reflect Bill’s true intentions.

Susan even went so far as to have Bill’s estate planning attorney call the life insurance company to argue the point. Because that attorney didn’t specialize in life insurance claim denials, however, he wasn’t familiar with the law of their state on this point. Simply put, the life insurance policy is a legally binding document and its terms take precedence over the terms of the will. In other words, there was no getting around Bill’s express designation of Marla as his beneficiary. Consequently, she was awarded the $100,000 death benefit called for in Bill’s policy.

As attorneys who specialize in the denial of life insurance claims, there is nothing that frustrates us more than a situation where the law binds our hands when we’re trying to help beneficiaries obtain life insurance proceeds the policyholder intended for them. In many states, however, the law on this point is clear and well settled. The life insurance policy trumps the will.

Because of that, sometimes we have to educate our readers on the steps they must take while they are alive to make sure their wishes regarding life insurance proceeds are carried out after they pass away. This is one of those situations.

If you have a life insurance policy and you want to control who receives the death benefit, then you need to remain diligent about changing your beneficiary designation to match your intentions. If you have questions about this or any other life insurance payout issue, please call us today. We’re here to help.

Ohio 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 Ohio can help, whether you are in: Columbus; Cleveland; Cincinnati; Toledo; Akron; Dayton; Parma; Canton; or anywhere in the state of Ohio, we will get you the benefits to which you are entitled.
Ohio Life Insurance Law
Policies through work are governed under ERISA. The primary regulating force here in Ohio is Title 39 of the Ohio Revised Code, and oversight is provided by the Ohio Department of Insurance.
Most Common Reasons for a Denied Life Insurance Claim in Ohio
  • 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.
Dirty little secrets of the life insurance industry
They are businesses – not caring individuals
Unlike other types of insurance companies, life insurers have managed to maintain a relatively positive reputation among consumers over the years. This is probably because in many instances, the death payout on a life insurance policy can equate to financial security for the policy beneficiaries. Who doesn’t like financial security?
What many people do not know, however, is that there is a dark underbelly to the life insurance industry. While not all insurance companies engage in these practices, many do. Given that these companies are dealing with people during some of the most difficult times in their life, their game playing is actually quite appalling.
As attorneys who specialize in the denial of life insurance claims, we see these underhanded games all the time. In fact, it gives us great pleasure to help beneficiaries beat the insurance companies at their own game – and obtain all the benefits their loved ones intended for them.
In this article, we’ve compiled a list of some of the dirty little secrets of the life insurance industry that many people do not know.
Life insurance companies are in it for the money
As noted above, many consumers have a positive view of life insurance companies simply because they pay out large sums of money to surviving beneficiaries. Often, this money comes when it is most desperately needed.
What many people don’t realize, however, is that life insurers don’t keep their shareholders happy by indiscriminately paying out every death benefit claim that is submitted to them. Rather, they make the most money when they collect premiums over the course of several years and then can avoid paying a death benefit when the policyholder dies.
How do they do this? Well, have you ever read a life insurance policy from cover to cover? There are enough exclusions, exceptions, and exemptions to make your head spin. Of course, all of the provisions are written in arcane legalese. This is not by mistake. The more confusing they can make the policy language, the more likely the insured is to do something unintentionally that will preclude the life insurer from ever having to pay out a death benefit.
They don’t care if they’re putting you through more stress
Let’s face it, making a life insurance claim is never an easy process. It always means that someone who cared about you (and, in all likelihood, someone you cared greatly for) has passed away. It means there are funerals to attend, obituaries to write, and months and months of grieving to do.
Life insurers don’t care about those inconvenient realities. They will make you jump through as many hoops as possible during the claim submission process. They do this, of course, hoping that you will be overcome with grief and simply go away. It happens more often than you might like to think.
One of their favorite tricks is to continually ask for paperwork during the claims process. If you submitted a death certificate, they’ll complain that you didn’t give them an autopsy report. Once you get the autopsy report, they’ll claim they need police reports and medical records. Of course, each time you jump through one of these hoops, you’re only reminded of your pain. They don’t care. They’re hoping they can tire you out.
They will twist your words and use them against you
One part of the claim submittal process is worthy of its own section. Many insurers will require the beneficiary to submit a lengthy claim form. In it, they’ll ask for several written narratives concerning the circumstances of the policyholder’s death. They know that these may be incredibly difficult for you to write while you’re grieving. They don’t care. They want you to go through the process while you’re under duress.
Why? Because if you have to write out lengthy answers to numerous questions, there’s a chance you’ll slip up. Perhaps you’ll mention that the policyholder was depressed in the days before he died. They’ll twist that information and determine that the insured must have committed suicide – therefore relieving them of the obligation to pay the claim.
Or perhaps they’ll catch some sort of inconsistency between the policyholder’s life insurance application and the answers you give in the claim form. For example, maybe the policyholder said he was a non-drinker but your narrative mentions that he died after a cocktail party. They might then claim the initial application was based on fraud and try to rescind the policy – which again would relieve them of the responsibility to pay the death benefit.
They can make up their own cause of death
Did you know that life insurers don’t have to abide by the official cause of death reported by the county coroner? Let’s say, for example, that your loved one died from a blow to the head that he suffered when he slipped and fell from a seaside cliff. Even if there were witnesses at the scene who saw your loved one accidentally slip, and even if the police and coroner ruled it an accidental death, the life insurance company can decide it was a suicide. And they will deny your claim on that basis.
Of course, in all of these circumstances, it is our job to make sure the insurance companies don’t get away with these shenanigans. Because we practice in this area of the law day in and day out, we know all about the life insurance industry’s dirty little secrets. And we know how to beat them at their own game.
Our entire business is contesting wrongful life insurance claims – and we have a great track record of success. If you or someone you know have received that dreaded claim denial letter in the mail, please don’t panic. Gather all the information you have about the claim and give us a call. Many times, we’re able to successfully contest your claim without any upfront fees. We’re here to help.