Life Insurance Lawyer Pennsylvania

Whether you reside in: Bryn Mawr; Villanova; Lancaster; Main Line; Bensalem; Bethlehem; Scranton; Upper Darby; Reading; Erie; Allentown; Pittsburgh or Philadelphia; our life insurance attorneys who live and work here in Pennsylvania are here to help resolve your delayed or denied life insurance claim.

Getting a divorce? Don’t forget your life insurance policy

If you don’t make the requisite changes, your intended beneficiaries may lose out

Divorces can be particularly ugly. Both sides pay exorbitant amounts to lawyers to do things like determine alimony, fight for custody, and – importantly – to split assets. One of the assets people sometimes forget about during divorce proceedings, however, is the life insurance policy.

Most life insurance policies are obtained by couples during the good times. Each person wants to make sure that the other is provided for financially in the event of an untimely death. Almost without exception, the spouse is named as the sole beneficiary. Moreover, if the insured fails to name a beneficiary altogether, most state laws and insurance policies dictate that the spouse is first in line to receive the death payout.

Of course, when couples get divorced, most people no longer wish to have their ex-spouse receive anything upon their death. As one case out of Texas illustrates, the divorce, in and of itself, is not enough to remove an ex-spouse as a policy beneficiary.

The fairy tale gone wrong

When Jim and Linda Parsons got married, their friends were all envious. They appeared to be the perfect couple. Both were avid hang gliders, they loved to travel, and they truly seemed to enjoy each other’s company. Both were also incredibly successful. Jim was the CEO of a lucrative alcohol distribution company and Linda was the founder and President of a large fashion boutique.

As part of Jim’s executive benefit package, he received a life insurance policy worth $5 million. Despite the fact that Jim had two adult daughters from a previous marriage, Jim named his beloved wife Linda as the sole beneficiary under the policy. Linda had a similar life insurance policy that named Jim as her sole beneficiary.

Unfortunately, six years into their marriage, Linda had an affair. When Jim found out, he was livid. He immediately hired a lawyer and initiated a divorce. He instructed his lawyer to be as aggressive as possible in splitting the couple’s assets.

When all was said and done, the divorce settlement was rather favorable to Jim. Importantly, for purposes of this article, one of the divorce requirements was for Jim to change his life insurance policy’s beneficiary designation. The changes were intended to remove Linda as the policy beneficiary and to name Jim’s two daughters instead. This point was negotiated, agreed on by both parties, and ordered as part of the divorce decree by the judge.

Following the divorce, Jim tried to put Linda out of his mind. He traveled extensively, grew his business exponentially, and even started dating a new woman whom he admired very much. What Jim forgot to do, however, was to formally change the beneficiary of his life insurance policy. In fact, after the divorce, he never gave the policy another thought. The premiums were paid out of his executive stipend, which made the whole thing very easy to forget.

Nine months after the divorce was final, Jim passed away suddenly from a heart attack. No one was expecting his death and that left the family scrambling to figure out his posthumous affairs. At some point, Jim’s daughters reached out to his former divorce attorney, seeking any advice he could offer about Jim’s wishes for his estate.

Not surprisingly, the lawyer informed the two women of their father’s intent to name them as his life insurance beneficiaries. The lawyer suggested the girls submit a claim to the insurer in order to receive the payout. The daughters did just that.

Several weeks later, the daughters were shocked to receive a denial letter in the mail. The letter stated that their father’s stated beneficiary was Linda and that all policy benefits would be paid to her without delay. Everyone in Jim’s inner circle was shocked. They knew Jim had nothing but disdain for Linda at his death and that he would never want her to receive his life insurance proceeds.

Linda was likewise shocked. As far as she knew, Jim was supposed to change his beneficiary as part of the divorce settlement. While she had heard of his death, she never submitted a claim to the life insurance company because she assumed she was no longer the beneficiary. The next thing she knew, however, she received a check for $5 million in the mail.

Another ugly lawsuit

As a result of all the confusion, Jim’s daughters sued the life insurance company and Linda. They argued that the denial of their claim was wrongful. Specifically, they claimed the death benefit was intended only for them, as evidenced by the clear language of the divorce decree. They also presented ample evidence of their father’s dislike for Linda.

Linda, meanwhile, became used to the idea of a $5 million payout. She argued that Jim had almost a year to change his policy beneficiary if that had been his desire. She claimed that Jim simply never stopped loving her, which is why he kept her on as the beneficiary. From her standpoint, she was the only person who should recover anything under the policy.

The case was litigated all the way to the Supreme Court of the United States. Ultimately, that body sided with Linda. The simple truth was that Jim’s life insurance policy clearly and unequivocally named Linda as the sole beneficiary. While the divorce decree was intended to change the beneficiary, Jim (as the sole policy owner) never took a single step to make the change. That evidence, in and of itself, was enough to make the court side with Linda.

As attorneys who specialize in the denial of life insurance claims, we see this exact scenario all the time. In fact, we have successfully represented people on both sides of a case like this. If you have received the denial of a life insurance claim based on similar facts, please don’t hesitate to call us. We will confidentially evaluate your case and advise you as to your best chances for recovery. We’re here to help. Call us.

Pennsylvania Life Insurance Law
Policies through work are governed under ERISA. The primary regulating force here in Pennsylvania is Title 31 of the Pennsylvania Code, and oversight is provided by the Pennsylvania Insurance Department.
A life insurance policy is a contract between a policyholder and an insurance company which obligates the insurance company to pay a certain amount of benefits to a beneficiary upon the insured's death. After the insured's death, the beneficiary should file a claim and provide sufficient proof of death in order to get paid. An insurer usually has 30 days to review a claim and make a final determination. However, many insurance companies delay the review of claims over the 30-day period for various reasons.
The most popular reasons for delaying life insurance claims in Pennsylvania are:
  • Contestability period review;
  • No beneficiary designation on file;
  • Fraud investigation (the insurance company suspects there may have been a fraudulent procurement of the policy);
  • Competing claims (multiple parties claims their entitlement to the life insurance proceeds);
  • Divorce of the insured and the beneficiary after the issue of the policy.
Many life insurance claims can also get denied. Some reasons for denying a life insurance claim are legitimate. For example, if there was a material misrepresentation on the life insurance application, the insurance company may deny a claim. Pursuant to life insurance law, material misrepresentations, even if innocent, will justify rescission of a life insurance policy under the doctrine of equitable fraud. Equitable fraud is available to rescind a life insurance policy even after the death of the insured. To secure rescission of a policy, an insurer must demonstrate that the applicant) made a misrepresentation to the insurer and that such misrepresentation was material.
This means that when an applicant for life insurance is completing an application, he or she must answer all the questions correctly in order to ensure the beneficiaries get the payout after his/her death. When an applicant makes a mistake on the application, even an innocent one, the insurance company may try to deny the claim. This usually happens if the insured's death occurs within a 2-year period after the issue of the policy. This 2-year period is called a contestability period. During this time frame, the insurance company may contest the policy - get all the medical records of the insured to check if the questions on the application were answered correctly.
Under life insurance law, only a material misrepresentation may serve as a basis for denying a claim. However, many insurance companies use this law in their favor unfairly and deny valid claims relying on material misrepresentations. For example, the application for life insurance has the following question. "In the past 3 years have you consulted a physician for any reason?" The applicant answered "No." The insurance company issued a policy. The insured subsequently died within the 2-year contestability period. Upon receiving a claim for payment from the beneficiary, the insurer engaged in the routine practice of contesting the policy and found out that a week prior to completing the application, the insured went to a dentist for a check-up. If the insurer denies the claim based on a material misrepresentation, the beneficiary may appeal the denial, arguing that the non-disclosure of the dental check-up is not a material misrepresentation.
There may be different scenarios of this example depending on the type of the policy that the insured took out and the questions presented on the application. If your claim for life insurance benefits was denied due to material misrepresentation, you may have a right to appeal the denial and get paid. For a free case evaluation and claim review, please call one of our life insurance attorneys in Pennsylvania. We have dealt with many insurance companies and know how to get claims paid fast. If you have questions about a claim delay due a contestability period review, do not hesitate to give us a call.
What do I do if my life insurance claim was denied?
Whether your claim was delayed or denied, our life insurance lawyers will get you your benefits. To date, we have a 100% success rate in recovering the full policy amount for our clients.
How much does a lawyer cost for a life insurance delay or denial?
We don't charge you a single cent unless we recover 100% of your policy. If any other firm has told you a fee %, we will undercut that fee percentage, and resolve your claim for less money out of your pocket.
What is a contestability period on a life insurance policy?
If the insured dies within the contestability period, the company can get the medical records of the deceased to compare with the application so that they can avoid paying the money to which the beneficiaries are due. This is not a problem. Contact us right away, and we can handle it. We have never lost a single case.
What do I do if the insured missed a payment on a life insurance policy?
Whether the payment was made within the grace period or not, the Lassen Law Firm, life insurance attorneys, has successful recovered the full policy amount for all supposed lapsed policies.
What do I do if I am the beneficiary of a policy that wasn't reinstated?
You can retain the life insurance lawyers of the Lassen Law Firm to investigate. If we feel that we can win, we'll handle the case for you.
What do I do if I have a beneficiary dispute?
The Lassen Law Firm handles dozens of beneficiary disputes every year, and we have a perfect record of success.
Where do I find a lawyer to handle an interpleader?
Our firm handles a large number of interpleader actions, and our success rate has been 100% to date.
What do I do if I have an Accidental Death and Dismember Claim (AD&D Claim) that was delayed or denied?
Our firm handles more AD&D claims than anything else, and mainly because these policies are so inexpensive, and when death occurs, the insurance company doesn't want to pay the benefits.
What do I do if my life insurance company changed to another one?
This happens all the time. These companies claim they dropped your policy during the conversion. The Lassen Law Firm will get you the benefits to which you are due.
Where do I find a lawyer for an Accelerated Death Benefit claim?
The Lassen Law Firm handles Accelerated Death Benefit Claims every week. We will get you the benefits that you are due.
Where do I find an attorney for a Group Life Insurance delay or denial?
Our firm handles all Group Life Insurance delays and denials.
What do I do if my life insurance benefits were denied due to a misrepresentation on the application?
Our firm will submit an enormous legal brief to the legal department of the insurance carrier, and our success rate has been 100% to date.
What do I do if my benefits were denied due to suicide and/or self-inflicted injury?
We have handled hundreds of cases involving suicide and self-inflicted injury, and we have filing cabinets full of legal briefs. We have never lost an appeal.
Where do I find an ERISA lawyer in Pennsylvania?
The Lassen Law Firm has filed hundreds of ERISA appeals, and to date, we have never lost.
What do I do if my benefits were denied due to an alcohol exclusion on the policy?
Our firm knows the way to handle these cases. We have written hundreds of legal briefs, and have employed the top experts, and we have never lost a single appeal. We know how to beat the insurance companies.
You might be surprised to know how many excuses life insurance companies have for denying life insurance claims. When your claim is denied, you need representation. The Lassen Law Firm, life insurance lawyers, handles life insurance claims in every state.
Nobody knows how to resolve denied life insurance claims faster than the Lassen Law Firm. Our success rate is second to none. Again, we handle these claims nationally, and we can start working on your claim today.
After a loved one dies, most people typically believe that the life insurance will pay out immediately, but nothing could be further from the truth. Once the insurance company is in receipt of the death certificate, it should only take a couple of weeks to pay the life insurance benefits. Sadly, many claims are not paid out in a timely fashion. When a life insurance claim is delayed, you need representation. The Lassen Law Firm, life insurance lawyers, handles life insurance claims in every state.
Insurance companies have a checklist of reasons to deny claims as they don’t make money by paying out claims. Insurance representatives don’t get bonuses because they pay out claims, they get them for denying claims. If your life insurance claim has been delayed for more than two weeks, you likely have a big problem, and it is better to get a life insurance lawyer now before the claims has been actually denied, as it is much tougher to obtain the benefits after a formal denial.
Once people have been denied payment of their lost loved one's life insurance, they may feel helpless. It is hard enough for people to deal with their significant loss, let alone the financial difficulties that are often associated with a loved one's passing.
If you were denied life insurance payment, you should speak with a credible attorney. At the Lassen Law Firm, we believe that our clients should be allowed to focus on recovering from their loss without having to stress over their future well-being. We are skilled civil litigation attorneys who will aggressively fight for maximum recovery of life insurance policy funds that have been denied.
We can sign you up over the phone and start working on your case today.
The Life Insurance Felony Exclusion
Most life insurance policies contain felony exclusion language. That is, the life insurance company will not pay out a death benefit if the insured died as a result injuries or wounds received while committing a felony. But the life insurance company isn’t always right. In fact, many family members have defeated life insurance company’s attempts to deny claims on the basis of the policy felony exclusion, for a number of reasons.
Not all denials are because the insured died while committing armed robbery on camera. Life insurance companies have tried to deny legitimate claims and claim the felony exclusion for much less. And often lose. But they keep trying, because most beneficiaries whose claims are denied don’t consult a life insurance lawyer, and don’t even realize they have a case.
A qualified, experienced life insurance attorney may be able to help you get the promised death benefit you’re entitled to.
Why felony exclusions?
A felony exclusion serves to protect other policyholders in the risk pool from people taking out life insurance policies knowing they are involved in dangerous criminal activity, or from people taking out life insurance policies on known criminals in the belief that they will benefit if the criminal is killed.
But that’s not much comfort to the families of people whose personal loss of a loved one is compounded by the financial devastation of the loss of his or her income, and by the denial of a life insurance claim they thought they could count on.
When an insured dies, the life insurance company will look at the death certificate for cause of death. If the cause of death is suspicious and potentially indicates criminal activity, they may delay paying the death benefit while they conduct an investigation, obtaining further medical records, police records, toxicology reports, witness statements and other pieces of information.
If they believe that the insured died as a result of committing a felony, they will probably deny the claim outright. And if they can prove their case, they are usually within their rights under the contract.
But you don’t have to take the life insurance company’s word for anything. Without an actual conviction in a court of law to point to, the life insurance company may have a hard time proving their case in court.
First, the burden of proof falls on the insurance company. Make them prove everything, if they can. Courts generally take a dim view of life insurance companies trying to avoid paying a claim to a bereaved widow or orphan, and if the case is at all disputable in good faith, they don’t do well in front of sympathetic juries.
If you receive a denial letter, or even a letter from the life insurance company informing you that payment of the promised death benefit has been delayed, call an experienced life insurance attorney. There are a number of steps we can take to dissuade the insurance company from fighting you, and preserve your rights in the future as your case moves forward.
An attorney can also help you identify the tricks of the trade that insurance companies may try to fool you into sabotaging your own case. For example, they may send you a refund of premiums paid to date. But what it really is is an attempt to get you to help them void the contract. If you cash that check, you are giving them evidence that you yourself acceded to voiding the policy.
They may also attempt to fool you by claiming that the past actions and felony convictions on the part of the insured make it clear the death was a result of felony activity. Many times, this is a bluff on their part: Most felony exclusions don’t include past history. The insurance company had a chance to underwrite those on the application. If there were no material misrepresentations on the life insurance application, and all the life insurance company’s evidence that the insured died committing a felony are circumstantial, they will have a hard time proving their case.
Furthermore, long-established case law and legal doctrine requires that courts interpret any ambiguity in the contract liberally in favor of the life insurance beneficiary. If your argument is reasonable, and presented by a skilled attorney, you have an excellent chance at prevailing.
For example:
1.) A life insurance company denies a claim because the insured was driving while intoxicated. He had a history of driving while intoxicated. But the policy states that the life insurance company will not pay a claim if the insured died while in commission of a felony.
But the insured didn’t die in commission of a felony. A bit of research showed that the jurisdiction he died in treats the first two DUI convictions as misdemeanors. Only the third and subsequent convictions are felonies.
The insured was not committing a felony under the law. The felony exclusion did not apply.
In a similar case, a life insurance company tried to deny a claim involving a death resulting from an accidental cocaine overdose. The insurance company argued that the insured died as a result of felony cocaine possession, and asserted the felony exclusion. But a judge found that the death resulted not from the possession of cocaine, but from its use, which was a misdemeanor, not a felony. The judge allowed the plaintiff’s case to go forward, and they eventually won, and won the insurance company’s appeal. (Weil v. Federal Kemper Life Assurance Co., 1994).
2.) Another individual was intoxicated while killed in an accident in which he was riding in the car as a passenger. The insurance company tried to deny the claim, citing language in the policy that excluded death from bodily injury while under the influence of alcohol or drugs. But courts rejected that argument as flatly unreasonable.
What to do if your claim is denied because of a felony
First, don’t speak to the insurance company directly. If you speak directly to the company, they could get you on tape saying something inadvertently that supports their case. That’s what attorneys are for.
Don’t cash any checks from the insurance company for less than the full death benefit amount without speaking to an attorney first.
Call an experienced attorney with a professional focus in life insurance law. Your attorney can help you avoid making mistakes that prejudice your case, help you gather evidence from a variety of sources, and help you make your argument.
Because the courts interpret life insurance policy language liberally in favor of the insured and beneficiaries, you may be able to get the life insurance company to reverse its decision. In many cases, when confronted with a determined and capable attorney representing the life insurance beneficiary, they will quickly change their minds and pay the benefit.
Call us today!
If you have received a letter of denial, or your loved one’s life insurance company has told you they are investigating a pending claim, call us today at 800-900-2521. Our initial consultation is free, with no obligation.
Don’t try to fight the insurance companies by yourself. They all have excellent attorneys who specialize in life insurance law working for them. You deserve the same fighting chance.
The call could be worth thousands of dollars to you.
What you need to know about contract law if a life insurance claim has been denied
Understanding contract law can help you determine if your claim denial was wrongful
As lawyers who specialize in the wrongful denial of life insurance claims, we know that life insurance companies are masters at manipulating the law. Indeed, life insurers hire more attorneys than almost any other industry in the United States.
They have lawyers for everything. Some are charged with drafting confusing policy language. Others are responsible for creating clever justifications for denying valid claims. Then there is a whole army of trial lawyers who attempt to get those bogus claim denials upheld in court. These lawyers are very well trained and know every trick in the book when it comes to insurance law.
Insurance is a complex area of the law. It involves numerous state and federal statutes. At their core, however, insurance policies are nothing more than written contracts. Thus, a quick review of basic contract law can be helpful in dissecting many claim denials.
Contracts are promises supported by consideration
On the first day of law school, young lawyers learn the simple truth about contracts. They are merely promises to do something (or refrain from doing something) that are supported by consideration. Consideration is the meat of the promise.
In the life insurance context, for example, a policyholder promises to pay premiums (his consideration) in exchange for the insurance company’s promise to pay a death benefit when he dies (its consideration). It is a simple exchange of value from the insured to the insurer, and vice versa.
Some contracts are simple, one-time deals – e.g., “I promise to pay you $5,000 today if you give me your car.” Life insurance policies, on the other hand, tend to include ongoing obligations. In most instances, the policyholder agrees to pay monthly or annual premiums in exchange for continuing life insurance coverage. Legally speaking, if the policyholder fails to make payments, he has failed to uphold his promise. In some cases, the insurance company then no longer has to uphold its promise. In other words, if the policyholder dies with his premium payments a couple months in arrears, the insurer will try to deny coverage.
As lawyers who specialize in the wrongful denial of life insurance claims, we can tell you unequivocally that this is one instance where state and federal statutes intersect with contract law to protect the consumer (i.e., the insured). For example, some statutes require the insurance company to give its insured several written notices of late payments before it can cancel a policy. It must also give formal, written notice of cancellation before it can deny a claim.
A common point of dispute arises in this context when the insured is gravely ill (and therefore unable to make premium payments) in the months leading up to his death. Generally speaking, if the insurance company fails to send written notice of the payment delinquencies, it cannot later deny a claim for death benefits based on non-payment.
Contracts must be based on truth
In order to be valid and binding, a contract must be based on truth. This means that when the parties are negotiating the terms of the agreement, they have to be honest with each other about the basic premises of their agreement.
If one party or the other tells significant lies during negotiations, the contract is based on fraud and can be rescinded by the party who was lied to. The key here is the significance of the lie. If one party tells a lie and the other party enters the contract in reliance on that mistruth, the lie is deemed by the law to be “material.” Material misrepresentations are legally sufficient grounds for rescinding a contract.
This is big sticking point in the life insurance context. Before they will agree to provide a policy, most life insurers require a lengthy application process. This can include written questions as well as a physical exam. Whenever a policyholder dies, the insurance company reviews the official cause of death (as determined by the coroner) and compares that cause against the representations the policyholder made in his life insurance application. If the investigation reveals a significant mistruth – a material misrepresentation – the insurer will deny the claim.
For example, if the policyholder’s application stated that he was a non-smoker, and he later died of a smoking-related illness, the insurance company would claim he made a material misrepresentation and would deny coverage. Cases are rarely this cut and dried, however.
We’ve seen life insurance companies use the material misrepresentation excuse in cases where the policyholder didn’t lie in the application at all. One example that comes to mind is a young man who, within his application, stated that he had no significant illnesses that he was aware of. This statement was supported by a recent physical examination showing he was in good health. He obtained a life insurance policy for $300,000. Eighteen months later, the man died of testicular cancer. Despite the fact that the disease had spread throughout his body, he was largely symptom-free until his death.
When his wife made a claim against his life insurance policy, the insurer denied the claim. They decided (entirely of their own accord, by the way) that the man had lied on his application when he stated he had no significant illnesses. They claimed he must have known, or at least suspected, that he was sick when he applied for the policy.
Of course, this was nonsense. The wife wisely retained a lawyer specializing in the wrongful denial of life insurance claims. They contested the denial and were able to prove the truthfulness of the application. Fortunately, the wife eventually received the full policy benefits.
If you have experienced the wrongful denial of a life insurance claim, don’t try to navigate the legal waters by yourself. Our firm is solely focused on overturning wrongful denials and can help you get the benefits you deserve. Call us today. We’re here to help.