Life Insurance Lawyer Utah
Whether you reside in: Millcreek; Layton; St. George; Ogden; Sandy; Orem; West Jordan; Provo; West Valley City; or Salt Lake City; our life insurance attorneys who live and work here in Utah are here to help resolve your delayed or denied life insurance claim.
When a life insurance policyholder dies before a planned suicide
Most people have a pretty clear idea of the interplay between life insurance and suicide. Generally speaking, if a person commits suicide within two years of obtaining a new life insurance policy, their death is not an insurable event and their planned beneficiaries will not get paid when they die.
What many people do now know, however, is that life insurance companies have a significant financial incentive to make a policyholder’s death look like suicide, even when it is not. They do this, of course, because the more they can avoid paying out on claims, the higher their annual profits. It’s simple economics.
As lawyers who specialize in the wrongful denial of life insurance claims, we’ve seen insurance companies make some outlandish “findings” of suicide in cases where they clearly just wanted to avoid paying beneficiaries. Take, for example, the case of a young man who died in a car accident while speeding at 10 miles per hour above the speed limit. His insurance company claimed that the very act of speeding was intentionally reckless and therefore aimed at causing an untimely death – even though there were no other indicators that the policyholder was depressed or suicidal.
That was a case where it was relatively easy to overcome the wrongful claim denial. In some cases, however, the facts are a little more complex and the life insurance company needs to be challenged with a lot more vigor. This article explores one such case.
Sometimes plans go sideways
The case involved a 45 year-old man named Brian. For most of his life, Brian had been a carefree, happy guy. In 2000, he married the love of his life – a woman named Brenda – and the two enjoyed a storybook romance. Brian was a pharmaceutical sales rep who made great money and traveled quite a bit.
In December 2010, Brian was hired by a new pharmaceutical company. He was offered a lucrative salary and a generous benefits package. Among the benefits paid for by his employer was a group life insurance plan. The plan was a good one and provided coverage for most types of death. There was, however, an exclusion if Brian were to die from suicide during the first two years of the policy term.
In 2011, tragedy struck Brian’s life in the harshest of ways. First, Brian’s best friend and mentor, his father, passed away rather suddenly from a rare form of cancer. Just as Brian was grieving that loss, his wife Brenda was killed in a freak automobile accident. Though Brian tried to deal with the losses as best he could, he sunk into a deep depression.
In fact, following the death of his wife, Brian actually sat down and penned several suicide notes. He simply didn’t want to live with the grief he was experiencing. In fact, at one point Brian actually went so far as to purchase a gun that he planned to use as the instrument of his death. He wrote about the purchase in a couple of the suicide notes, all of which were collected in one spiral-bound notebook.
As it turned out, Brian never had a chance to use that gun. One day in the summer of 2012, Brian’s sister came to check on him. She found him face down on the living room floor of the home he had shared with Brenda. He was not breathing and, in fact, appeared to have been dead for a few days. The sister called 911 and the police and paramedics arrived within moments.
The police officers who investigated the scene found Brian’s spiral-bound notebook and read his suicide notes. Thus, their first instinct was to suspect that Brian had somehow caused his own death. As per protocol, they ordered a full autopsy that included a full tox-screen and an examination of all of Brian’s internal organs.
The final autopsy report wasn’t released for nearly two months but the findings were surprising to everyone who knew Brian. Despite all those suicide notes, Brian hadn’t killed himself at all. Rather, he died of a brain aneurysm that, according to the coroner, was a complete medical fluke. Brian’s body didn’t show the presence of any drugs, alcohol, or other toxins. His friends and loved ones figured he simply died of a broken heart.
A claim denial from the life insurer
After Brenda had died, Brian named his sister as the beneficiary under his life insurance policy. She first filed a claim with the life insurer while the autopsy report was still pending. Thus, it wasn’t a huge surprise when the company denied the sister’s claim pending a formal cause of death from the coroner.
Once that report was published, however, the insurance company did not reverse its denial. To the contrary, it claimed that the coroner’s conclusions were speculative and that, given all the indicia of suicide found in Brian’s home, the death had to be self-inflicted. Consequently, the insurance company claimed it was compelled to deny the claim.
Brian’s sister was not convinced. A business lawyer herself, she reached out to another attorney she knew who specialized in the wrongful denial of life insurance claims. After discussing the facts and circumstances of Brian’s death, the attorney agreed to take on the insurance company. He filed a lawsuit on the sister’s behalf and submitted all the evidence regarding Brian’s case to the judge.
Ultimately, the judge sided with Brian’s sister. Just because Brian had been thinking about suicide did not mean he actually did it. In fact, the judge found the testimony and reports from the coroner to be persuasive with respect to the true cause of Brian’s death. As such, he ordered the insurance company to pay Brian’s sister the full death benefit, with interest.
If you have received a life insurance claim denial based on an alleged suicide, don’t just accept the insurance company’s decision. Call our firm, discuss your case with one of our attorneys, and let us help you decide whether to challenge that denial. Call us today. We’re here to help.
- 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.