A Word of Advice from a Colorado Lawyer…. If you have property damage from the recent floods, it pays to get insurance attorneys involved early.

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.

Lee DiGeorge Law 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.

Lee DiGeorge Law has an office in Boulder, Colorado, so this catastrophe is personal for us. We also practice in New Jersey and have extensive experience in similar claims. Our firm is highly experienced and uniquely equipped to handle these types of cases. We want to help our friends in Boulder and surrounding communities get back on their feet as quickly as possible. Lee DiGeorge Law 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 @ 800-403-5710.

Lee DiGeorge Law Expands to the Great State of New York

We are proud to announce that Lee DiGeorge Law is now serving clients throughout New York State. Life insurance attorney and co-founder Heather D. Lee visited Albany this week to attend the admissions ceremony for the Supreme Court of New York.

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The more we expand, the greater number of people we can protect against wrongfully delayed and denied insurance claims. If your life or property insurance claim has been denied in Pennsylvania, New York, New Jersey, or Colorado, or if your insurance company is based in one of these states, our experienced Life Insurance Lawyers may be able to assist you. We provide free consultations, so you have nothing to lose and everything to gain! Visit our website at http://www.leedigeorgelaw.com or call (800)403-5710 for more information today.

The Insurable Interest Doctrine and Its Effect on Your Life Insurance Claim

It may seem surprising that life insurance claims are commonly denied, and for a number of different reasons.  Life insurance companies reportedly refuse payment on approximately 5,000 policies each year, although many believe this figure is even higher.

One of the most interesting reasons that life insurance claims are denied involves the lack of an insurable interest.  According to the insurable interest doctrine, an individual cannot take an insurance policy out on the life of another person without having a legally-recognized insurable interest in that person’s life.  In other words, one cannot insure the life of another unless he or she derives some benefit or advantage from the continuance of the insured’s life.  To be sure, the law does not want to encourage the practice of “wagering” on the life of another.  Also, allowing an individual to procure a policy on someone’s life without requiring the existence of an insurable interest may open the door to crimes being committed against the insured person.

The rules setting forth what constitutes a sufficient relationship differ amongst the states.  Generally, states consider the insurable interest requirement to be satisfied by blood ties or other affection-based relationships.  In many states, a monetary tie such as a business partnership is sufficient to create an insurable interest.  The line drawn by the various state statutes remains fuzzy, to say the least.  The majority of courts have found that determining whether a relationship gives rise to a sufficient insurable interest is an issue of fact, meaning it is determinable on a case-by-case basis.

Whether an insurable interest exists is relatively easy to determine in some relationships.  For example, a husband and wife will almost always be found to have an insurable interest in each other’s lives.  But what about an unmarried couple?  Or grandparents and grandchildren?  Even the relationship between parent and child is treated differently depending on the state where the policy is issued.  Indeed, Illinois courts have found that the blood tie alone can be insufficient and have, in some cases, required a showing of monetary interest in order to bolster the insurable interest.  In New York and Pennsylvania, on the other hand, the parent-child relationship alone establishes an insurable interest sufficient to take out a life policy.

To further complicate the insurable interest doctrine, courts have held that expiration of the contestable period for life insurance policies does not defeat a claim denial for lack of an insurable interest.  Typically, insurance companies have a 2-year period to challenge the validity of a policy.  The vast majority of jurisdictions have held, however, that a lack of insurable interest can be raised to challenge a policy’s validity at any time, even after the contestable period has passed.  In New York, an outlier state, life insurance companies cannot refuse payment on such a basis unless the challenge was raised within the contestable period, which begins to run on the policy’s date of issue.

The lack of uniformity with respect to what constitutes an insurable interest can cause a great deal of confusion for beneficiaries.  Without the assistance of an experienced life insurance attorney, a proper beneficiary may lose the right to collect against a policy based on an insurance company’s arbitrary determination that a sufficient insurable interest does not exist.  If your life insurance claim has been delayed or denied, you should speak to a life insurance lawyer at Lee DiGeorge Law or in your area.

Common Reasons For Delaying and Denying Life Insurance Claims

Approximately 5,000 life insurance claims are denied in the United States every year, and even more policies go unclaimed.  People are usually surprised to discover that life insurance companies can delay or deny claims for many different reasons.  In fact, most people believe that when an insured passes away, the beneficiary receives a payout immediately.  Unfortunately, this is too often not the case.  Like most businesses, life insurance companies are motivated by profit, having a strong financial incentive to collect premiums but later deny as many life insurance claims as possible.

DELAYED LIFE INSURANCE CLAIMS

If a life insurance company has failed to promptly issue payment of your life insurance proceeds, you may have a claim for breach of contract and bad faith insurance practices.  Life insurance companies must investigate your claim within a reasonable period of time, usually within sixty (60) days of the claim being filed or in accordance with the life insurance policy terms.  An insurance company may attempt to discourage you from hiring a life insurance lawyer by wrongfully delaying your life insurance claim, offering a reduced settlement amount, or making other efforts to avoid paying the full claim amount.

Some common tactics that life insurance companies will use to wrongfully delay your claim include but are not limited to the following:

Insured’s Death Occurring Within Contestable Period
Hospital Records/Medical Documentation Not Yet Received
Hospital or Medical Provider Refuses to Release Records
Failure to Provide Income Tax Returns
Failure to Provide Non-existent Medical Documentation
Independent Investigation Based on Suspicious Cause of Death
Independent Medical Review to Dispute Evidence
Beneficiary Dispute Based On Divorce
Beneficiary Dispute Based On Suspicious Cause of Death

You should never accept a settlement offer without the advice of an experienced life insurance attorney because an offer to settle your claim for a reduced amount may indicate that the insurance company’s reason for delaying or denying your claim is illegitimate.

DENIED LIFE INSURANCE CLAIMS

To discourage beneficiaries from pursuing a wrongfully denied life insurance claim, life insurance companies will mail complex denial letters that may be designed to confuse you.  Life insurance companies know that you are likely unfamiliar with the life insurance contract itself, or with your rights as the beneficiary.

Some common tactics that insurance companies will use to wrongfully deny your claim include but are not limited to the following:

Policy Lapse Due to Nonpayment
Misrepresentations Regarding Age, Employment and/or Income
Failure to Disclose Immaterial Pre-Existing Medical Condition
Failure to Disclose Medical Appointments/Regular Check-Ups
Failure to Disclose Unknown/Unofficial Medical Diagnosis
Failure to Disclose Condition Requiring Future Treatment
Failure to Disclose Prior Alcohol, Drug, or Tobacco Use
Failure to Disclose Criminal History on Application for Insurance
Accidental Death Related to Independent Medical Condition
Accidental Death Actually Self-Inflicted
Accidental Death Caused by Alcohol/Drug Use or Crime
Accidental Death Not Occurring Within Specific Time/Date
Accidental Overdose Caused by Misuse of Medication
Policy Not Active Due to Death Occurring Prior to Effective Date
Policy Not Active Based on Period of Limited Activity Exclusion
Independent Investigation Based on Suspicious Cause of Death
Insufficient Evidence to Show Heart Attack
Independent Medical Examiner Disputes Evidence
Change In Health After Policy Lapse Due to Nonpayment
Change In Health Condition Prior to Effective Date of Insurance
Handwriting Expert Claims False Application Signature
Failure to Elect and/or Qualify for Employment Coverage
Failure to Convert Employment Coverage to Individual Policy
Insurance Company Not Responsible for Agency Errors
Insured Not Resident of United States on Date of Death
Failure to Properly Change Beneficiary
Policy Lapse Due to Depleted Cash Value

Many insurance companies have large legal departments prepared to defend denied life insurance claims, which can discourage a beneficiary from hiring a life insurance attorney, appealing a denied life insurance claim, or filing a law suit.

The life insurance lawyers at Lee DiGeorge Law are familiar with the various tactics used by life insurance companies to delay and deny life insurance claims, and we are experienced in pressuring insurance companies to quickly complete the claims process and pay all proceeds due under their life insurance policies.  If your life insurance claim is being wrongfully delayed or denied, we will contact the insurance company to demand immediate payment of your claim, including all interest accumulated during the duration of the delay.  Our life insurance lawyers are prepared to file a law suit on your behalf if the insurance company still refuses to resolve your claim, even after receiving our demand to pay you immediately. If your life insurance claim has been delayed or denied, you should ask a life insurance lawyer  about your case today.

Feds Immune from Federal Employees’ Group Life Insurance Act (FEGLIA) Lawsuit for Loss of Beneficiary Designations

In Graber v. Metropolitan Life Insurance Company, a lawsuit against the United States and Metropolitan Life Insurance Company to obtain the life insurance benefits of a deceased federal employee, a U.S. District Court in Ohio ruled yesterday that the federal government has sovereign immunity for the improper maintenance of life insurance beneficiary designation forms.  The dispute arose when Metropolitan Life Insurance Company denied a life insurance claim filed by the insured’s surviving spouse and subsequently issued payment of the benefits to the insured’s brother.  Met Life based its decision on the insured’s incomplete personnel file, which contained a form designating the brother as sole beneficiary in 1996 but lacked any record of the insured’s request in 2008 to change the beneficiary to her husband.

Under the Federal Employees’ Group Life Insurance Act, the United States has waived sovereign immunity for any “breach of legal duty owed.”  Although the federal government was responsible for maintaining the insured’s personnel file, the District Court’s holding that no duty exists to properly maintain FEGLI records precludes recovery, as the federal government has not unequivocally consented to be sued for the loss, misfiling, or misplacing of beneficiary designation forms.

Sound like a bunch of nonsensical legal mumbo jumbo?  Well, that’s debatable… even federal courts are somewhat split on the issue.  Prior to the Graber decision, the Fifth Circuit concluded in Metropolitan Life v. Atkins that the federal government does have the duty to properly maintain beneficiary designation forms in the care of its FEGLI personnel clerks.  Yet, other federal courts limit the United States’ duty under the Act to only negotiating and issuing the correct FEGLI life insurance policy.

The lesson to be taken away from this discussion is two-fold.  First, if you are a federal employee with group life insurance benefits, follow-up on any beneficiary designations to ensure that your personnel file accurately reflects your intentions.  And most importantly, always consult with a life insurance lawyer about your denied life insurance claim or beneficiary dispute.  Until the Supreme Court picks a side, every “designated” beneficiary deserves to make their case.

The full court opinions referenced in this post can be found here —–> Graber v. Metropolitan Life ; Metropolitan Life v. Atkins .

For additional information on how a life insurance lawyer at Lee DiGeorge Law can help you, visit www.leedigeorgelaw.com and www.life-insurance-law-firm.com.

Protecting Your Rights & Your Family

Lee DiGeorge Law is a civil law firm providing legal advice, counseling, and representation on a wide range of insurance contract disputes and consumer matters. We serve life insurance law clients in the States of Pennsylvania, New York, New Jersey, and Colorado. Our attorneys assist insured persons and their beneficiaries on life insurance disputes, homeowners and renters insurance disputes, and other civil and contract matters. The mission of Lee DiGeorge Law is to protect your rights and your family by ensuring that powerful insurance companies properly fulfill their legal and contractual obligations to you.

The Life Insurance Lawyers Blog keeps you informed on the laws, legal developments, and issues that affect you and your family. While the Life Insurance Law Bloggers are primarily focused on life insurance matters, it is our priority to provide helpful information regarding many areas of civil claims and consumer law.

The information on the Life Insurance Lawyers Blog is NOT and should NOT be construed as legal advice. The information contained on this website does not create an attorney-client relationship between any person who reads such information and Lee DiGeorge Law and/or the Life Insurance Law Bloggers. To obtain legal advice specific to your case, please contact Lee DiGeorge Law or another law firm that you trust and provide the details of your claim to a life insurance attorney.

For more information on Lee DiGeorge Law, visit http://www.leedigeorgelaw.com or contact our life insurance attorneys at (800)403-5710 for a free consultation today!