Life Insurance Lawyer Wyoming
Wyoming Denied Life Insurance Claims Recently Settled
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How life insurers exploit accidental death & dismemberment riders
Many people use life insurance as one of their estate planning tools. The idea behind it is that if a person should meet an untimely death, their loved ones – deemed “beneficiaries” under the life insurance policy – will receive a payout that will give them a sense of financial security. In many cases, policy payouts exceed $1,000,000 and can be a life saver for those left behind.
When people are shopping for life insurance policies, they are often tempted to add what is known as an Accidental Death & Dismemberment Rider (“AD&D rider”) to their policy. At first blush, it seems like a great deal. With an AD&D rider, the policyholder pays a slightly higher premium. In the event he dies an accidental death, however, the AD&D rider will typically pay his beneficiary three times the regular policy amount. Thus, if the policy was for $500,000, the AD&D rider would add an additional $1,500,000 to the payout if the policyholder died in an accident.
Life insurance companies love to sell AD&D riders. This is true for a couple of reasons. First, life insurers know that statistically speaking, very few people die in accidents. Thus, they will collect increased premiums with a relatively low risk of having to pay the additional death benefit. Additionally, life insurance companies know that even if a policyholder does die in an accident, they can simply claim the death was not accidental in an effort to avoid the additional payout. In fact, this happens all the time and it is one of the most underhanded things life insurers do.
This article explores one case where a life insurance company tried to avoid an AD&D payout by characterizing an accidental death as something else altogether. As lawyers who specialize in the wrongful denial of life insurance claims, we hope this case illustrates just how important it is to get the legal assistance you need and deserve in these circumstances.
A death that shouldn’t have been
This particular case involved a man named Steven and his wife, Samantha. The pair were in their late 40s and had been married for just over two years. The couple owned and ran a rather successful vintage hotel in a small coastal town. Despite their success, they both knew that without their dual contribution to the business, it would be nearly impossible to survive.
Thus, both Steven and Samantha took out life insurance policies with a base payout of $200,000. The insurance salesman who sold them the coverage also talked them into adding AD&D riders worth an additional $600,000 on each policy. Given that neither one of them had significant savings, they both intended for their life insurance coverage to keep the business afloat if one of them were to pass away prematurely. Each named the other as the sole beneficiary under their respective policies.
Just over a year after obtaining the policies, the unthinkable happened. Samantha was working on a ladder to clean the gutters on the second-story roof of the hotel. There was a second-story deck that provided relatively easy access to the roof, but based on the layout of the deck, she was not able to set the ladder up properly. Instead, she had to prop it up against the roof line without any safety measures in place.
Normally, Samantha would have done the gutter work while Steven was there to help. On this particular day, however, the couple was expecting a full-house of new guests and she needed to tend to the gutters while Steven drove into town for supplies. As Samantha attempted to climb back down onto the ladder from the roof, the ladder fell to the side and Samantha fell off the roof. Police reports indicated that her body hit the railing of the second-story deck before careening down all the way to the parking lot below. Samantha broke her neck during the fall, which caused her to die within moments.
A devastating conclusion by the life insurer
A few weeks after Samantha’s death, Steven got himself together enough to file a claim with their life insurance company. In addition to the standard claim form, he also had to submit the police reports and the coroner’s report. Both listed the cause of death as “broken neck due to accidental fall from roof.” As such, Steven was confident the insurance company would not only pay the base policy amount, but also the amount owed under the AD&D rider.
Approximately one month later, however, Steven received a claim denial letter in the mail. In it, the insurance company claimed they could not make any payout under the policy because it “was clear” Samantha had purposefully decided to commit suicide by jumping from the roof.
Steven was flabbergasted. There was absolutely no indication that Samantha had committed suicide. Moreover, he knew his wife better than anyone and knew she was in love with life. When a friend suggested Steven call an attorney specializing in contesting the wrongful denial of life insurance claims, he did do immediately.
The attorney reviewed the file and suggested that Steven first pursue an administrative appeal with the insurer. During that process, the attorney took over all communications with the insurance company. He also put together a packet of evidence that included: (1) witness statements regarding Samantha’s positive state of mind prior to her death; and (2) the police report and additional forensic statements regarding the accidental nature of the death.
Fortunately, the insurance company’s administrative appeals board recognized that it would be futile to continue to deny the claim. They paid Steven the full policy amount, including the amount owed under the AD&D rider.
As attorneys specializing in the wrongful denial of life insurance claims, we see these sorts of bogus denials by life insurance companies all the time. We don’t stand for it. If you have received a life insurance claim denial letter, please call us to discuss the situation. Your initial consultation is free of charge and if we take your case, you won’t pay us a dime unless and until you get recovery from the insurer.