The Life Insurance Lawyer Expands to the Great State of New York

We are proud to announce that the Law Offices of Heather D. Lee are now serving New York.  Life & property insurance attorney and founder Heather D. Lee visited Albany this week to attend the Supreme Court of New York’s admissions ceremony.

New York Life Insurance Lawyer

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, the Law offices of Heather D. Lee may be able to assist you. We provide free consultations, so you have nothing to lose and everything to gain!  Visit our website at www.life-insurancelawyer.com or Call (800)403-5710 for more information now.

Insurance Consumers Win As Companies Are Made To Pay For Unfair Practices

Insurance consumer advocates have won another big battle recently, as the insurance regulatory agencies from Illinois, Indiana, Texas, Pennsylvania and Florida finalized a settlement with Bankers Life and Casualty Company.  Pursuant to the terms of the settlement agreement, the insurance company must pay a fine of $3.2 million for its failure to comply with regulatory recommendations imposed following an investigation of its practices in 2007.  The investigation found fault with many aspects of Bankers Life’s policies and procedures, including the company’s claims handling practices, and it ultimately led to the issuance of various recommendations to bring Bankers Life into compliance with states’ insurance regulations.  The 2012 review of the company’s progress revealed that it had failed to bring claims investigation, denial, and settlement procedures into compliance with the 2007 recommendations, specifically in the annuities, long-term care, and life insurance lines of business.

The settlement agreement reached with Bankers Life is just one of many recent settlements between state insurance regulatory agencies and insurance companies.  This trend is an important step forward for insurance consumers, as it shows that states are no longer willing to let insurance companies get away with unfair and misleading claims handling practices.  If your claim has been delayed or denied, you should consult with an experienced insurance attorney to ensure that you are not a victim of non-compliant or abusive insurance practices.

To review the 2007 and 2012 agreements, visit http://insurance.mo.gov/Contribute%20Documents/conseco-bankers_Stip.pdf and http://insurance.illinois.gov/newsrls/2012/11/BankersExecutedRSA.pdf.

Don’t Let the Not Necessarily Limiting ‘Suit Limitation’ Clause Deny Your Rightful Claim

Insurance policyholders face many hurdles when a loss occurs.  One such hurdle involves the time in which a law suit must be filed after the insurance company denies your claim.  Suit limitation clauses greatly reduce the time-period to pursue even an illegitimate claim denial.  While the Statute of Limitations for a breach of contract claim typically runs for 6-10 years (depending on the applicable state law), suit limitation clauses may reduce this window to as little as 12 months.  This is particularly problematic because limitation provisions are buried deep within lengthy, complex insurance policies and fail to provide actual and sufficient notice to policyholders.

Though a suit limitation clause functions much like a Statute of Limitations, in that both provide a specific time-period in which a suit may be brought, the difference between the two is important to note.  Significantly, a suit limitation clause is a condition imposed by contract, rather than by statute or law.  Therefore, the application or enforcement of a suit limitation clause may be challenged.

Like most issues relating to insurance policies, the law governing a contract’s suit limitation clause differs from state to state.  The majority of jurisdictions uphold such provisions, though some have not.  In those states where limitation clauses are considered valid, certain restrictions may be imposed on their use, with some states providing more protection for insured parties than other states.  Illinois, for example, extends the contractual limitation by the amount of time the insurance company takes to process the claim.  In other words, the period of time in which an insured may bring a law suit “tolls” for the number of days that pass from the filing of the claim to the date of the denial.

Further, states may provide additional protection against statute limitation clauses in the form of applying a notification requirement.  In Illinois, an insurance company waives its right to impose a time limitation clause if the denial notice does not include the remaining time-period for bringing a law suit.  The rules in Pennsylvania are less protective, on the other hand, with courts finding that a denial letter does not necessarily need to specify the amount of time to bring suit in order for a limitation clause to apply.

The effect of suit limitation clauses can be devastating to policyholders whose claims have been illegitimately denied, giving an insurance company the incentive to delay processing of the claim, and ultimately, the ability to escape liability.  If your insurance claim has been delayed or denied, you should speak to an insurance attorney immediately.  Even if you think too much time has passed to dispute your wrongfully denied claim, we can help collect the life or property insurance proceeds you deserve.

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 today.

Heather D. Lee Discusses Little League & Sunburn Lawsuits on Good Day Philadelphia – 6/26/12

Heather D. Lee appeared on Good Day Philadelphia last week to discuss the little league and sunburn lawsuits with Mike Jerrick – Watch us here!

Philadelphia News, Weather and Sports from WTXF FOX 29

Thank you for having us on the show, Mike!  For more information on the Law Offices of Heather D. Lee or to contact us for a free case analysis, visit www.Life-InsuranceLawyer.com and Life-Insurance-Law-Firm.com today.

State Probes Into Wrongful Life Insurance Practices May Lead To Your Lost Policy

The nation’s largest life insurance companies are feeling the heat as some states investigate wrongful insurance practices, particularly with respect to locating beneficiaries after an insured has died. In fact, it is estimated that tens of thousands of life insurance beneficiaries have been deprived of approximately $1 billion (or more) in unclaimed proceeds. Many of the life insurance companies currently under fire continue to claim that it is the sole responsibility of the beneficiary to notify the company of an insured’s death.

Life insurance beneficiaries often do not know a policy exists, however, and may not be in the best position to find out. Sometimes beneficiaries know about a loved one’s policy but do not know which life insurance company to contact and are unable to locate the policy documents.  Even worse, life insurance companies may mislead a beneficiary who does not have a copy of the policy and deter the filing of a claim.  When thousands of policies go unclaimed every year, insurance companies just sit on the money.

But a life insurance company does not know when an insured has died, right? Wrong. State probes revealed that these companies have routinely checked the Social Security Administration’s ‘Death Master File’ for decades to discontinue annuity payments.  Until recently, life insurance companies never used the same source to notify beneficiaries of unclaimed policies.

In the past several months, multi-state settlement agreements have been reached with leading life insurance companies, including Prudential, John Hancock, and Metropolitan Life. The States of Pennsylvania, New Jersey, Colorado, New York, California, and Florida are among the leaders of these probes. As a condition of the agreements, participating life insurance companies will be required to improve their practices and make better attempts to locate the beneficiaries of unclaimed policies. The problem with locating past unpaid beneficiaries, though, remains.

The issue that state regulators are not addressing is the inability to locate older records of unpaid policies. Life insurance companies are only required to keep records of “terminated” policies for a certain period of years. Consider that when an insured dies and a life insurance company no longer receives premium payments, the policy will be treated as “terminated.”  Years later, because these policies are not properly held as unclaimed property, the records are destroyed, leaving the beneficiary responsible for proving the life insurance company’s liability. Of course, if the beneficiary had such proof, the claim would not have been delayed.

If you believe that an insurance company owes you money, speak to a life insurance attorney about your options right away.  The Law Offices of Heather D. Lee can assist you in filing your life insurance claim, demanding that the company pay you immediately and with all applicable interest accrued as a result of the delay.  We work aggressively to collect wrongfully delayed and denied life insurance claims.

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.

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 Law Offices of Heather D. Lee 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, Contact Us now.