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.

Utah 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 Utah can help, whether you are in: Salt Lake City; West Valley City; Provo; West Jordan; Orem; Sandy; Ogden; St. George; Layton; Millcreek; or anywhere in the state of Utah, we will get you the benefits to which you are entitled.
Utah Life Insurance Law
Policies through work are governed under ERISA. The primary regulating force here in Utah is Title 31 of the Utah Code, and oversight is provided by the Utah Insurance Department.
Most Common Reasons for a Denied Life Insurance Claim in Utah
  • 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.
Life insurance can be a nightmare for surviving beneficiaries
Fortunately, you don’t have to handle the nightmare on your own
There is really only one main reason that people purchase life insurance – to insure that their loved ones are taken care of financially after their death. That level of care and planning seems like a lovely sentiment. Unfortunately, however, life insurance companies don’t make it easy for beneficiaries to collect the death benefit that was intended for them.
All too often, they turn to obscure policy exclusions to deny coverage. This is because life insurers have a financial incentive to deny claims. If they can collect premiums for years only to deny the death payout the policyholder thought they were purchasing, the insurance company is that much richer for it.
Looking at it from a pure business perspective, you can almost understand that an insurance company, like any other business, must do what it can to increase profits. Denying claims is a big tool in the profit-building arsenal. Life insurance companies, however, are not just like any other business.
As attorneys who specialize in the denial of life insurance claims, we know this perhaps better than anyone. Almost without exception, life insurance companies are dealing with people during some of the most difficult times of their lives. Any beneficiary who is filing a claim has just lost a loved and cherished person in their lives. They are grieving. They are often in financial distress. And, to add insult to injury, they may have to battle a life insurance company that is trying to put profits before their real, human distress.
In this article, we examine three of the most frequently-used justifications life insurers use to denial claims for death benefits. If you are facing any of these scenarios, please call our firm today. We have the knowledge and expertise to successfully contest even the most complicated life insurance claim denials.
The suicide exclusion
Not all life insurance policies prevent a death benefit payout in the event the policyholder commits suicide. Most, however, do contain a suicide exclusion if the death occurs within the first two years of the policy term.
What surprises many beneficiaries is that a life insurance company may decide the policyholder committed suicide (and thus deny a claim) even where police and autopsy reports conclude otherwise. Let’s say, for example, that a policyholder dies of an accidental drug overdose and that cause of death is documented in the autopsy report. The insurance company still may deny a claim on the grounds that the policyholder committed suicide.
Typically, the insurer’s argument goes something like this: (a) it takes intention to ingest enough drugs to end your life; (b) the insured took enough drugs to end her life; thus, (c) the death was the result of suicide. While this logic is flawed in most instances, it still doesn’t prevent the life insurance company from offering it up as a reason to deny coverage.
The worst part is that fighting this battle with the insurance company is a literal nightmare for surviving beneficiaries. That is why is often the best course to hire an attorney specializing in the denial of life insurance claims to fight these battles for you.
Inherently dangerous activities
Some life insurance policies exclude coverage if the insured dies while engaging in an “inherently dangerous activity.” Such activities might include skydiving, car racing, or motorcycle racing. In fact, oftentimes the insurer requires potential policyholders to reveal participation in such activities as part of the life insurance application process.
If a hobby such as this is not revealed, yet the policyholder later dies while undergoing such an activity, the insurance company may deny any claim against the policy. They will claim that the policyholder lied during the application process, which should alleviate them from having to pay claims.
The analysis, however, is rarely that easy. Many times, the policyholder is truthful when, in their application, they deny engaging in inherently dangerous activities. Yet after that application is submitted, many things can happen. An insured can take up a new sport. A person can die while trying a dangerous sport for the first time. The variables are endless.
Notwithstanding those variables, the life insurance company will deny the initial claim nine times out of ten. All this does is force the policyholder’s surviving loved ones to fight a battle with the insurance company during one of the hardest times of their lives.
Failure to pay premiums
Let’s face it, from time to time, every one of us forgets to pay a bill (or simply can’t pay one or more of our bills). When life insurance premiums are the obligations that get skipped, the consequences can be dire. Specifically, if a policyholder dies while premium payments are in arrears, the life insurer may use that as a reason to deny coverage, even if the policyholder had faithfully paid premiums for years prior.
Beneficiaries should be aware, however, that insurance companies do not have a carte blanche ability to deny claims based on non-payment. Insurance companies must follow strict laws regarding notice of cancellation before they can deny a claim. In many cases, the insurer will have failed in this regard. That may mean the policy remains in full force and effect and that any claims must be paid.
Each of these scenarios is complicated and there are dozens of factors that can ultimately impact a coverage decision. If you or your loved ones have received a life insurance claim denial, the best course is to immediately contact an attorney specializing in this area of the law.
Our firm focuses solely on the wrongful denial of life insurance claims. We’ve gone up against the biggest and most aggressive insurers and have a track record of success against them. We know the games they play and the intimidation tactics they deploy. None of that deters us from our ultimate goal – getting our clients the death benefit payout that was intended for them.