How To Win A Denied Life Insurance Claim It is estimated that at least two thirds of all life insurance is never paid to the policy beneficiary. So chances are pretty good that if you are reading this Blog Post that you are among the approximately 70% of life insurance beneficiaries who have received a denial letter from their life insurance company. The Application For Insurance is the first place the insurance company will look to escape its responsibility to pay the policy’s death benefits. Usually they zero in on the answers to one of the medical questions. They will obtain your loved one’s medical records and comb through them looking for any possible discrepancies. Some common “easy outs” include items like an entry for COPD or evidence of obesity or any prior drug or alcohol treatment. The first thing to know is that even after getting a denial for an inaccurate answer on the application, these are often winnable cases. These cases are very fact specific and require the skill of an experienced life insurance attorney. If you’ve been denied there’s no downside to letting an experienced life insurance attorney review your case. Feel free to contact the Life Insurance Recovery Team at DiGeorge Law www.digeorgelifeinsurancelaw.com
DiGeorge Life Insurance Law (www.DiGeorgeLifeInsuranceLaw.com) has successfully handled cases where our client had initially used another law firm to fight a denied life insurance claim only for their firm to also be denied. If their attorney is not able to get a policy paid, most people give up and stop pursuing the claim. Although it can be disheartening to receive repeated denials on a life insurance policy that should be paid, persistence often does pay off. There are many cases where getting a second opinion is the first step in getting a denial overturned.
In reviewing cases where another law firm had been hired by the client, we often see that the first attorney framed their legal argument incorrectly or failed to draw the correct inferences from subtle bits of information. In demanding that the policy be paid they did not put forth a winning “theory of recovery”. Establishing the correct theory of recovery is everything when it comes to getting a life policy paid. Obviously there are many life insurance claims that are rightfully denied. This blog, however, is referring specifically to those clients that have legitimate claims, but are still unable to get the policy paid. These clients have good cases; and, as the beneficiary, they are entitled to the policy being paid. Nevertheless, for any of a thousand possible reasons, the life insurance company is refusing to pay.
Establishing a winning theory of recovery means leaving the life insurance company no wiggle room to avoid its contractual liability to pay the claim. On the other hand, demanding payment based upon the wrong theory of recovery almost always guarantees a denial. In fact, insurance company claim agents are thrilled when the client or their attorney asserts the wrong theory of recovery because they will respond to the argument that’s put forth and avoid addressing the circumstances that would establish their legal liability to pay. If you, or your attorney, do not clearly establish the insurance company’s legal liability to pay the claim, the life insurance company is not going to do it for you.
Many life insurance cases turn on key dates. Did a policy lapse for nonpayment? Was a lapse notice sent? Was a payment or partial payment made and accepted before the grace period expired? When did the grace period expire? We recently saw a case where there was a pending lapse for nonpayment and then a payment was made and accepted by the insurance company. Based on the facts of the case, there were two potential dates that could have been argued as being the expiration date of the grace period. The attorney involved wrote a letter demanding payment from the insurance company, but instead of framing his legal argument on one of the two possible dates, he picked a third date as the expiration of the grace period. Unfortunately, there was no way this third date could have been legally correct and the insurance company promptly sent the lawyer another denial on a case that should have been paid.
When someone becomes aware that they are the beneficiary of a life insurance policy, they usually try to file the claim directly with the life insurance company. It seems simple enough, but it is amazing how many things can and do go wrong as the insurance company examines every possible way out of the contract. An alarming number of completely legitimate life insurance policies are never paid out. Good data is hard to find, but it is believed that the majority of term life policies are never paid. It’s not difficult to understand that the life insurance companies will look for every possible opportunity to avoid paying out the policy.
If you run into trouble getting a claim paid, discuss your situation with an attorney who understands the nuances of life insurance practice. Even a good attorney can easily get tripped up if they don’t have significant experience looking at these cases. If you used an attorney who was unsuccessful, we recommend that you let another lawyer review your file. It can’t hurt to get a second opinion. It is possible that you really did have a good case, but the theory of recovery was wrong.
As reported in the national media, the epic rains that inundated Boulder and surrounding communities earlier this month have left behind epic amounts of damage to homes, businesses, municipalities, cars and every other kind of property. Insurance companies, still reeling from Hurricane Sandy, are about to get slammed with a massive influx of new claims totaling in the billions of dollars.
The DiGeorge Life Insurance Law Firm focuses solely on insurance-related cases. Our firm represents you, the insured, to make “sure” your insurance claim is paid, and that you receive the full amount that you are entitled to. We represent individuals, businesses and municipalities to get the proceeds that they are going to need to rebuild.
Everyone knows that insurance companies make money by collecting premiums, not by paying out massive amounts of claims. Insurance companies by their very nature are going to try to minimize or avoid altogether the amount of their liability. This means that what you think might be a routine insurance claim is met with resistance on all levels. You may not get anything close to what you are entitled to receive or in many cases you will get nothing at all as your insurer finds one of many technicalities upon which to deny your claim. Don’t let this happen to you.
Hurricane Sandy showed us that there is a way to expedite and greatly improve your chances of getting what you deserve. You should consult with an experienced insurance attorney as soon as possible. Do not wait until you have a denial or other problem. If the insurance company knows that you have representation right up front, they will also know that you mean business. Most attorneys do not have any significant insurance experience so you need to contact someone who does this type of work all the time. It is also critical that you contact an attorney licensed to practice in your state. If you live in Colorado, you want a property insurance lawyer in Colorado.
The DiGeorge Life Insurance Law Firm can answer your questions and help guide you through the process of filing a successful insurance claim. We are here to help, so please email or call us any time @ 800-210-5397.