They take your premiums, and promise to pay benefits when your loved one dies, but then they don't. It's an all too common phone call we get from heart-broken and frustrated beneficiaries who expected to receive life insurance benefits when their loved one passed away.
Unfortunately, life insurance companies often try to figure out any way to not pay the benefits after somebody dies.
The many reasons for life insurance denials
There are several reasons we've seen where beneficiaries thought they were entitled to life insurance benefits, but then the insurance company refused to pay. Some of the common life insurance denial claims are:
Material misrepresentation - this is where the life insurance company generally claims that the policy owner or insured lied on the policy application. Even though they easily could have cleared things up while the insured was alive, they instead often choose to do nothing and investigate the insured's medical history if the person dies within 2 years of the policy's effective date.
Child who died was not covered - life insurance companies often sell policies to cover both parents and their children. What they don't always tell you is that children may only be covered to a specific age, and only in specific circumstances, like if they are a full time student. Sometimes, though, an agent or the insurance company may still tell you a child is covered. If you take out a policy and are told your children are covered, then you may still be entitled to benefits even if the policy language says otherwise. The insurance company cannot tell you one thing to have you rely on it to your detriment. That is not fair and often not legal.
General life insurance vs Accidental death and dismemberment - one common type of life insurance claim we see is where a life insurance company denies a claim under an accidental death and dismemberment claim. In order to qualify for coverage, the death must generally be the result of an accident. We had a case where the a woman was hit by a car and killed while crossing the street not at an intersection. The life insurance denied the accidental death claim by stating that she caused her own death by jaywalking. Rather than accept the denial, the beneficiary called our Florida life insurance attorneys for help. We proved the law to the life insurance company that the death was an accident and not intentional, and they paid the entire policy limit within 21 days!
Even if the life insurance company lied to you, you may still be entitled to the insurance proceeds
When a life insurance company fails to pay life insurance benefits, they may be in breach of the life insurance contract. Failure to pay the benefits is often looked at as a breach of contract. However, there are many intricacies of life insurance law that an experienced life insurance attorney can help navigate.
The law of promissory estoppel may entitle you to the insurance proceeds
Life insurance companies cannot lie to you. They cannot misrepresent facts and get you to keep paying life insurance on a policy which they never intended on paying out.
For example, we represented a beneficiary who was told that her son would be covered under the policy. However, after he died, the life insurance company denied the claim and argued that he was not covered under the policy because he was under the age of 25 but not a student. Our life insurance attorneys were able to request copies of the phone calls between the beneficiary and the life insurance company, and were able to prove that they made representations to her which she relied on to her detriment. The life insurance company reversed itself and paid the full benefit to the beneficiary.
For questions on any life insurance claim in Florida, feel free to call our FL life insurance lawyers at 800-337-7755 for a free consultation.