Life Insurance Lawyer Wyoming

Whether you reside in: Jackson; Rock Springs; Gillette; Laramie; Casper or Cheyenne; our life insurance attorneys who live and work here in Wyoming are here to help resolve your delayed or denied life insurance claim.

Wyoming Denied Life Insurance Claims Recently Settled

  • Globe problem with misrepresentation on application $106,000.00
  • SGLI dispute between two beneficiaries $400,000.00
  • Wyoming denied life insurance claim $2,150,000.00
  • Transamerica interpleader lawsuit $408,000.00
  • Columbus sickness exclusion $132,000.00
  • Gerber beneficiary dispute siblings $315,000.00
  • Denied life insurance claim Wyoming $864,000.00
  • AIG accidental death claim AD&D $417,300.00
  • FEGLI appeal successfully resolved $140,000.00
  • Wyoming divorce and life insurance $300,000.00
  • Northwestern Mutual felony exclusion $259,000.00
  • State Farm prescription drug overdose $126,000.00
  • ERISA life insurance claim Wyoming $138,000.00
  • National autoerotic asphyxiation death $119,000.00

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.

Wyoming 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 Wyoming can help, whether you are in: Cheyenne; Casper; Laramie; Gillette; Rock Springs; Jackson; or anywhere in the state of Wyoming, we will get you the benefits to which you are entitled.
Wyoming Life Insurance Law
Policies through work are governed under ERISA. The primary regulating force here in Wyoming is Title 26 of the Wyoming Statutes, and oversight is provided by the Wyoming Insurance Department.
Most Common Reasons for a Denied Life Insurance Claim in Wyoming
  • 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.
What if there is more than one cause of death?
Will accidental death and dismemberment coverage be denied?
When consumers are considering purchasing life insurance, one of the options they are typically provided is the option to add an Accidental Death & Dismemberment (“AD&D”) rider to their policy. Almost without exception, AD&D riders double the policy payout if a policyholder dies as the result of an accident. At first blush, the AD&D rider sounds like a great deal, especially since the insurance company does not typically double the premium payment.
Consumers should be leery of this “deal,” however. As lawyers who specialize in contesting the denial of life insurance claims, we know that life insurance companies have gone to great lengths to make sure AD&D riders do not result in death benefit payouts that hurt the company. So, how do they do that? Well, they have a number of tactics. This article explores a couple of ways that life insurance companies manipulate policy language to avoid paying AD&D claims.
The “sole and exclusive cause of death” clause
An unfortunate reality of life insurance policies is that they are long, wordy, and filled with arcane legalese. This is not by accident. Insurance companies are hoping you won’t read and analyze the policy language before you sign on the dotted line and start paying premiums. AD&D riders are no exception.
Even if most people did read their AD&D riders, however, they might still miss the tiny phrase that insurance companies rely on over and over to deny valid claims. That phrase goes something like this:
The insurance company will pay an AD&D claim in full provided that an accident is the sole and exclusive cause of death of the insured.
Let’s consider for a moment how life insurance companies exploit clauses like this to their advantage. By way of example, imagine a policyholder who got into a fatal car accident while he was suffering from pneumonia. The death certificate lists the official cause of death as an “accident.” The autopsy report, however, notes that the policyholder died as the result of an accident and that he was suffering from pneumonia at the time of the crash.
It is not beyond the norm for an insurance company to deny a claim for AD&D coverage using the following logic: (a) the insured was suffering from pneumonia; (b) pneumonia causes extreme fatigue; (c) the insured got into a car accident while suffering from extreme fatigue; (d) but for that fatigue, the accident may not have occurred; therefore, (e) an accident was not the “sole and exclusive” cause of death. The claim would be denied.
If this sounds far-fetched to you, think again. Insurance companies rely on this phrase all the time in denying claims. Unfortunately, these denials just cause additional grief and hardship for beneficiaries who are already suffering from the loss of a loved one.
Claiming the accident was not an accident
Another trick that life insurers will use to deny valid AD&D claims is to claim that an accidental death was not the result of an accident at all. Consider the following scenario:
A policyholder goes on a backpacking trip. While traversing a particularly narrow trail in the mountains, the policyholder slips, falls 50 feet down the mountain face, and perishes. The authorities investigate and rule the incident an “accidental death.” Accordingly, the policyholder’s beneficiary files a claim for death benefits. It is denied because the insurance company concludes of its own accord that the policyholder jumped from the trail – rendering the death non-accidental.
In another example, a policyholder purchased a new sportscar and took it for a spin on a curvy, back-country road. While traveling 20 miles per hour above the posted speed limit, the policyholder lost control of the car, wrapped it around a tree, and was instantly killed. As with the prior example, the police investigate the scene and determine the death was accidental. The beneficiary files a claim and, just like in the prior example, it is denied by the life insurance company.
This time, the life insurer claims that the policyholder was engaging in “intentionally dangerous conduct.” It argues that the claim denial is proper because “intentional” conduct cannot result in an “accidental” death. Again, these sort of claim denials happen all the time.
Don’t give up if you receive an AD&D claim denial
In each of the above scenarios, the beneficiaries would be understandably upset upon receiving the claim denial letter in the mail. The insurance companies know this, and they’re hoping that their discomfort prevents them from pursuing the claim any further.
This is exactly why each of those beneficiaries should contact a lawyer specializing in the denial of life insurance claims. We’ve seen each of these situations before and we know that the life insurance company is simply playing games.
In fact, we know that life insurance companies hire armies of lawyers for the sole purpose of intimidating beneficiaries to the point where they will give up. Fortunately, we never give up on valid claims. We’re not intimidated by all of those lawyers and we’re happy to beat them at their own game.
We’re also familiar with all of the prior court cases holding that such tactics by insurance companies are improper. We’ll confront the life insurance attorneys with those cases and try first to get your claim paid without the necessity of litigation.
If, however, the life insurer is unyielding in its position, we’re not afraid to take them to court to get you the money you’re owed. In fact, we have a very successful track record of contesting these very types of claims.
If you or someone you know has had an AD&D claim denied based on one of the above situations, please contact us without delay. We’ll talk over your case, review your file, and give you an objective opinion on whether we think we can help you recover the death payout your loved one intended for you. We’re here to help. Call us today