Life Insurance Lawyer West Virginia

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What are 20 top reasons for a denied life insurance claim?
There are various reasons why a life insurance claim may be denied. Here are 20 potential reasons:
  1. Lapsed policy: If the policy lapsed due to non-payment of premiums, the claim may be denied.

  2. Material misrepresentation: If the policyholder made a material misrepresentation on their application or during the underwriting process, the claim may be denied.

  3. Suicide exclusion: If the policyholder committed suicide within a certain period after the policy was issued, the claim may be denied.

  4. Intentional act exclusion: If the policyholder's death was the result of an intentional act, such as suicide or criminal activity, the claim may be denied.

  5. Contestability period: If the policyholder dies within the contestability period (usually the first two years of the policy), the claim may be denied if the insurance company discovers that the policyholder made a material misrepresentation or concealed information during the underwriting process.

  6. Exclusion for high-risk activities: If the policyholder died while engaged in high-risk activities that are specifically excluded from coverage, such as skydiving or scuba diving, the claim may be denied.

  7. Drug or alcohol exclusion: If the policyholder died as a result of drug or alcohol use, the claim may be denied if the policy contains an exclusion for such circumstances.

  8. Exclusion for pre-existing conditions: If the policyholder died as a result of a pre-existing medical condition that is specifically excluded from coverage, the claim may be denied.

  9. Failure to disclose health conditions: If the policyholder failed to disclose a health condition during the underwriting process that later contributed to their death, the claim may be denied.

  10. Failure to disclose travel plans: If the policyholder failed to disclose plans to travel to a high-risk destination during the underwriting process, the claim may be denied.

  11. Beneficiary dispute: If there is a dispute over who is entitled to the death benefit, the claim may be denied until the dispute is resolved.

  12. Failure to name a beneficiary: If the policyholder did not name a beneficiary, the death benefit may be paid to the estate, which could delay payment and potentially result in a denial.

  13. Fraud: If the policyholder or beneficiary engaged in fraud, such as submitting false documentation, the claim may be denied.

  14. Non-accidental death during contestability period: If the policyholder dies due to non-accidental causes during the contestability period, the claim may be denied.

  15. Policy restrictions: If the policyholder died in a manner that is specifically excluded from coverage, such as during the commission of a crime, the claim may be denied.

  16. Non-disclosure of occupation: If the policyholder failed to disclose their occupation or engaged in an occupation that is specifically excluded from coverage, the claim may be denied.

  17. Non-disclosure of lifestyle habits: If the policyholder failed to disclose their lifestyle habits, such as smoking or engaging in dangerous activities, the claim may be denied.

  18. Failure to provide medical records: If the policyholder failed to provide required medical records during the underwriting process, the claim may be denied.

  19. Insufficient premium payments: If the policyholder did not pay the required premiums to keep the policy in force, the claim may be denied.

  20. Policy exclusions for pandemics or other global events: Some policies may have specific exclusions for pandemics or other global events that may result in a denied claim.

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Life Insurance Beneficiary Rules and Disputes West Virginia

2023-2024 Life Insurance Claims in West Virginia Recently Settled

  • Liberty Mutual coronavirus death denial $304,900.00
  • Mass shooting West Virginia denied life claim $105,000.00
  • Kentucky Central wrong last name $39,000.00
  • Accidental Death & Dismemberment $56,300.00
  • Global Atlantic COVID-19 death denied $125,000.00
  • Farmers Life sickness exclusion won $33,000.00
  • Wilton fentanyl overdose rejected resolved $77,000.00
  • American Fidelity Life felony exclusion $59,000.00
  • Mutual of Omaha suicide self-inflicted $524,000.00
  • Costco lapsed the policy resolved it $40,000.00
  • AD&D claim rejected high BAC alcohol $76,000.00
  • Guarantee Security Life POA change $109,000.00
  • Phoenix Life terminated policy resolved $81,000.00
  • Globe Life lapsed the policy $33,000.00
  • CNO Financial smoking in medical records $15,000.00
  • Baltimore Life power of attorney change $29,000.00
  • Great West missed several payments paid $78,000.00
  • Mutual Omaha alcohol toxicology report $45,000.00
  • Mass Mutual application material misrepresentation $439,000.00
  • Globe autoerotic asphyxiation death claim $118,400.00
  • AIG AD&D denied claim accidental death $452,000.00
  • West Virginia denied life insurance claim $1,027,000.00
  • Columbus alcohol exclusion resolved $203,000.00
  • West Virginia ERISA and life insurance $285,000.00
  • The Hartford felony exclusion resolved $337,000.00
  • Denied life insurance claim West Virginia $648,000.00
  • Gerber denial of benefits sickness exclusion $206,000.00
  • SGLI spouse and ex-spouse dispute $400,000.00
  • West Virginia divorce and life insurance $941,000.00
  • FEGLI appeal of life benefits resolved $148,000.00
  • Penn Mutual interpleader lawsuit won $417,000.00
  • American General reinstatement issue $182,000.00
  • West Virginia bad faith life insurance $825,000.00
  • Stonebridge illegal drug exclusion $114,000.00

Interpleader Lawyer West Virginia

West Virginia Life Insurance Law

It’s hard to say whether Americans are suffering from mental illnesses at a greater rate than ever before or if the discussion about mental illness has just become less taboo in our society. Regardless, mental illnesses are real, significant, and prevalent problems that impact the lives of most American families at one point or another.

An unfortunate corollary to increased rates of mental illness is an increased suicide rate. Suicide rates among military veterans in particular have risen at alarming rates over the past couple decades. The same can be said for other groups such as teenagers and, perhaps unexpectedly, older adults. Indeed, people between the ages of 45 and 64 currently have the highest suicide rate among all age groups.

Certain mental conditions – such as depression, bipolar disorder, borderline personality disorder, and paranoid schizophrenia – carry with them a greater risk of suicidal ideation. To add insult to injury, many of the prescription drugs used to counteract these conditions can actually increase one’s desire to end his own life.

To be certain, life insurance companies have been watching these trends in both the prevalence of mental illness and the concomitant increase in suicides. Contrary to popular belief, a life insurer cannot automatically deny a life insurance claim just because the insured committed suicide. Generally speaking, if that suicide occurs more than two years after policy issuance, the suicide itself is not a sufficient reason to deny coverage.

Nonetheless, any time a policyholder does commit suicide, the life insurance companies will float all sorts of theories to deny death benefit claims made by beneficiaries. This article explores one such case and illustrates that when it comes to issues of mental health and suicide, an outright denial of coverage is not always the correct outcome.

Life was great until it wasn’t

The case involved a woman named Linda. By all outward accounts, Linda led an idyllic life. After getting her Master’s Degree in structural engineering, she was hired by a national engineering firm and quickly rose through the ranks to the title of Vice President. Linda was married to her high school sweetheart, a man named James, and the couple had two children in elementary school.

Linda and James were active members of their community. They belonged to the PTA, the local Rotary chapter, and their kids were involved in little league baseball, soccer, and swimming. They had scores of friends and hosted several outdoor parties throughout the spring and summer. No one who knew the couple would ever describe either one of them as depressed.

That all changed in the fall of 2006, however. On one unusually cold evening in their small, New England town, James had picked up the kids from soccer practice. He needed to stop by the grocery store before heading home. To do so, he had to get on the freeway as it presented the quickest path to the local shopping center.

As James entered the freeway, he hit a patch of black ice and lost control of his sedan. The car spun out of control and ended up right in the path of an oncoming 18-wheeler truck. As the big rig hit the car, James and both children were instantly killed.

As anyone might imagine, Linda was devastated. Over the next several months, despite regular therapy and loving support from her community, Linda spiraled into an unyielding depression. No matter what she did, she couldn’t seem to recover from the heartache that plagued her every breath.

The helping hand from a good friend

Shortly after the accident, Linda’s best friend from college (a woman named Chelsea) came to stay with her. Chelsea was willing to do anything she could to help Linda get back on her feet. Among other things, Chelsea took care of all the administrative stuff that one has to do when loved ones pass away. For example, Chelsea helped filed a claim for benefits under James’ life insurance policy.

That process reminded Linda that she now had to change her own policy beneficiary since James and the kids were no longer alive. In light of her gratitude to Chelsea, she changed her beneficiary designation to name her friend.

Unfortunately, shortly after making that gracious effort, Linda’s grief became too much. She wrote a lengthy suicide note expressing her fear that her depression would never subside, swallowed an entire bottle of sleeping pills, and died sometime in the night.

Weeks later, Chelsea took the painful step of filing a claim for benefits under Linda’s life insurance policy. A seasoned business lawyer, Chelsea had read the policy and realized that the initial two-year suicide exclusion was no longer effective. Thus, she didn’t anticipate any problems with the payout.

A month later, however, Chelsea received a claim denial letter in the mail. The insurer claimed that Linda – who clearly died as the result of depression – had been untruthful in her initial application for life insurance. Specifically, the company claimed that Linda’s failed to disclose any level of depression, which constituted a material misrepresentation that nullified the policy. This didn’t sit right with Chelsea. Linda had actually been the furthest thing from depressed when she applied for the policy.

She contacted a former classmate who now specialized in the wrongful denial of life insurance claims. That lawyer instantly recognized that the insurer was using Linda’s later-acquired and situational depression as a ruse to deny an otherwise valid claim. The lawyer suggested they fight the claim denial, which they did. They were successful in having the denial overturned during an administrative appeal.

Linda’s case just goes to show that insurance companies are willing to exploit certain conditions to try to justify claim denials. If Chelsea hadn’t been a lawyer herself, she might have taken the original denial letter as the final word on the topic. It’s an unfortunate mistake that happens all the time.

Life Insurance Contestability Period West Virginia

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If you’re facing a life insurance claim denial that just doesn’t seem right to you, please call our office for a free consultation. We’re here to help.