The death of a loved one can be devastating, and the denial of a life insurance claim makes a bad situation much worse. People buy life insurance to help their loved ones through the financial crunch that often arises with the death of a family member, especially the death of a family's primary breadwinner. The denial of a life insurance claim puts the family in a financial bind — a fact that insurance companies know and exploit to their advantage.
Insurance companies may deny a life insurance claim for various reasons, including:
Rutter & Russin has taken on the big insurance companies in cases involving the denial of life insurance claims and succeeded, time and again.
The insured was murdered in a drive-by shooting. His mother submitted a claim for his life insurance benefits, but the insurer balked because the last premium was supposedly paid late. The mother came to us after several lawyers had told her there was nothing that could be done. We obtained the files of the agent and the insurer and prepared a detailed timeline that demonstrated that the insurer’s changing billing practices had resulted in confusion about when the premium was due. The agent admitted that even he was confused. The insured’s premium payment had been late, but we proved that he mailed the premium before he was murdered. The insurer received the premium after the murder, and accepted and processed it – at least until its claim department received notice of the claim. Then it had its underwriting department refund the premium. The tactic did not work, and the insurer paid the entire benefit amount.
A married couple planning to travel to India decided to purchase travel insurance from a company online, primarily so that they would have health insurance while abroad. Tragically, the wife was killed by a hit-and-run driver while riding a scooter. The travel insurance policy contained several benefits, including coverage for accidental death. The insurance company suspected the husband may have been involved in staging the accident, based primarily on rumors that it heard about marital problems between the couple. After waiting over a year for the insurance company to pay the claim, the husband hired Rutter & Russin. Following a lawsuit in federal court, the insurance company paid the policy limits plus.
The president of an Ohio-based company was killed in a plane crash en route to a subsidiary company located in New Hampshire. The subsidiary company had purchased a $1.5 million life insurance policy for the president, naming his wife as beneficiary. The insurance carrier, however, denied the widow's claim, asserting that the policy had been canceled nearly a year before the crash due the subsidiary's failure to pay the premium. Rutter & Russin argued that the cancellation was ineffective because Ohio law applied and required a notice of cancellation to be sent to the insured president, not merely the subsidiary responsible for paying the premium. The parties settled for 90% of the policy limits.
The life insurance policy applicant truthfully answered "no" to the question on the application asking if he had ever suffered from "an alcohol related condition." After the insured died, the insurance company dug through his medical records and found that his family doctor had advised him to drink less beer. The insurance company decided that the insured had lied on the application because drinking too much beer is a form of alcohol abuse — an "alcohol related condition" in the company's mind. The federal judge did not buy the argument, especially after the family doctor testified that she never equated the insured's rather benign beer drinking to an "alcohol related condition" and that the term actually has no medical meaning.
The decedent had worked for his employer for over 30 years before retiring. His exit interview was supposed to include the signing of paperwork that would transfer his employer sponsored life insurance policy to an individual policy, but the employer forgot to present the correct forms to the employee, who died only a few months later. The insurance company was unmoved by the procedural snafu, so Rutter & Russin successfully asserted a claim against the employer for the full value of the policy that should have been in force.
The insured had paid premiums for her ex-husband's life insurance policy for over 20 years, even after they were divorced, but that did not mean much to the insurance company, which denied her claim when her husband died because, according to them, the group policy did not covers ex-spouses, but only actual spouses. Rutter & Russin refused to take the insurer's word for it, and pressed the company for not only the underwriting history of the policy, but the written promises that Prudential had made to the insured's employer when it assumed control of the group policy from another carrier that specifically agreed to cover ex-spouses. The insurer backed off, admitted that its denial was wrong, and paid the face amount of the policy.
After her father died, his daughter presented a life insurance claim, which the insurance company denied based on material misrepresentations in an application that was completed two years earlier. The father was not around to defend his answers, but Rutter & Russin obtained the agent's file and the company's underwriting file and showed that the false answers were probably the result of the agent's carelessness, and did not come from the decedent.
A young woman's husband tragically committed suicide following years of depression. The widow submitted a life insurance claim that the insurance company denied, arguing that its policy contained a suicide exclusion. Rutter & Russin established that the suicide exclusion was not in the policy when it was issued, and that the later versions of the policy that contained the suicide exclusion did not apply to this claim. The company paid the claim in full without the filing of a lawsuit.
Rutter & Russin has nearly 30 years of experience helping family members get full and fair settlements from insurance companies who have denied a claim. Contact us today for a free consultation.