Beneficiaries are individuals who are named on life insurance policies as recipients of the benefits when the insured person dies. Most of the time, beneficiaries know they have been designated as the benefit recipients but they do not know their rights regarding policy information, time frame for filing a claim or interest payable on the claim.
After years of working with clients whose life insurance claims have been denied or delayed, we have outlined several important points life insurance beneficiaries should know about what information they are entitled to and what rights they have.
1.Right to know the policy amount
Unless the insured person shares the policy information with their beneficiary, the beneficiary may not even know how much the policy is. Without knowing the value of the policy many beneficiaries are left to file a claim and wait to receive a check.
For example, a beneficiary who is not a family member and did not maintain close contact with the insured does not know he had been named a beneficiary and does not have any information about the insured individual’s policy. Then he gets a call or a letter from the insurance company informing him that he is the benefit recipient and asking him to file a claim. When he asks the claims representative about the value of the policy, he is told that that information cannot be disclosed to him. It is not true.
After an insured person’s death, beneficiaries have the right to know the value of the policy. Sending a letter to the insurance company and the employer (if it is a group employer-provided life insurance) requesting to know the value of the policy is the first step.
2.Right to know how to file a claim
The right to know how to file a claim is a basic beneficiary right. It guarantees the beneficiary is informed about how to file a claim: how to complete claim forms, what additional documents to enclose, where to send the claim forms and the additional documents and within what time frame they are expected. Similarly, the insurance company must inform the insured of the claim review process and how long it will take to make a determination.
3.Right to know why the claim is delayed
In most cases, it should not take an insurance company more than 30 days to pay a claim. There are certainly cases that require more time. For example, if an insured died within the first two years of the policy effective date, the insurance company might take longer to get all the records. Similarly, if the death involves police investigation, an insurance claim is likely to be delayed until the investigation is over. Regardless of the reason for delay, beneficiaries have the right to know the reasons why the claim is delayed and how long it may take for the claim review to finalize.
4.Right to know why the claim is denied
If a claim is denied, the beneficiary needs to know why. We have represented many clients who had no idea why their claims had been denied when they called us. It is true that in many cases an insurance claims representative will send a simple letter stating the benefit is not payable without going into details. In another common scenario, a denial letter may say that the claim is not payable because the beneficiary is an ex-spouse. Without providing any information about a state statute revoking an ex-spouse or any other reasons for denial, such denials are vague and confusing.
For example, in a case where the insured was an ex-spouse to the beneficiary, a denial is not automatic. Laws differ from state to state, the policy may not even be controlled by that state law, or there may be special circumstances that would make the claim payable. Beneficiaries have the right to know specific reasons for denial, including statutes and documents the insurance company relied on in denying the claim.
5. Right to examine the documents used in reviewing the claim
If a claim is denied, beneficiaries have the right to examine the documents the insurance company used in denying the claim. Without examining these documents, beneficiaries will be left to take the insurance company’s denial as the final verdict. It should not be a secret what documents the insurer reviewed and relied on in denying the claim. For example, the insurance company made a decision to deny an accidental death claim due to drug exclusion. It sent a letter to the beneficiary stating that the insured had drugs in his system and his death is not covered by the policy for this reason.
The beneficiary in this case has the right to know what documents the insurer reviewed. Whether it is a toxicology report, a medical examiner’s report, a coroner’s report/autopsy, a police report or pharmacy records, the beneficiary can request and receive a copy of these documents. In some cases, beneficiaries are also entitled to a copy of the internal guidelines that the insurer used in reviewing the claim or a copy of the resume of the expert witness who provided his professional opinion that the insurer relied on.
6. Right to know how to file an appeal
If a claim is denied, beneficiaries need to know how to file an appeal. In ERISA cases, for example, an insurance company must provide appeal information at the end of the denial letter. The instructions must be very detailed and clear. A beneficiary in an ERISA denial must follow a specific time frame for filing an appeal. It is important to know the deadline for filing an appeal and where to send it. If a denial letter does not state this information, the beneficiary can request it in writing from the insurer.
7. Right to know they are beneficiaries on the policy after the death of the insured
In recent years, there have been many lawsuits against insurance companies that never informed beneficiaries of their right to collect life insurance benefits after the death of the insured policyholders. Beneficiaries may not know they have been designated as beneficiaries (if the insured does not inform or remind them), they may forget about it or they may not even know they have the right to collect. In these cases, after the insured person dies and no one claims the life insurance proceeds on his policy, it is the insurance company’s obligation to inform the beneficiaries of their right to collect the proceeds. If the insurance company fails to do so, it retains the benefit, and beneficiaries may find out about it years later, or never.
Beneficiaries have the right to know they have been designated as recipients on a life insurance policy and have the right to collect the proceeds even if the insurer failed to inform them in a timely manner.
8.Right to know how much interest will be paid
Usually, insurance companies must pay interest on claims that are delayed. Even if a claim is investigated for valid reasons, insurance companies must pay interest on the total amount of the claim. Unfortunately, not every beneficiary knows they need to ask about interest payable on their claim and insurance companies may get away with not paying it. The dates from which interest starts to accumulate and the amount of interest payable may differ from case to case. It is important to know that as a beneficiary you are entitled to know how much interest you will receive and when interest will start to accumulate.
As you see, beneficiaries to life insurance policies have many rights that protect them. If you have questions about any of these rights, you can address them to your insurance company or a life insurance attorney.
When a loved one dies and your life insurance company denies your life insurance claim, you need an experienced life insurance lawyer on your side. The right life insurance attorney can get your denied life insurance claim paid fast. There are several things you need to consider when you search for an attorney who deals with denied death claims.
First, when it comes to fighting denied life insurance claims, experience matters! A life insurance company may use a variety to reasons to deny your life insurance claim and your attorney should know how to fight all of them. Only an experienced life insurance lawyer who has worked with many life insurance claim denials and delays and who has fought many life insurance companies will be able to get you the results you want.
Second, a death claims lawyer fighting denials must have great knowledge of the life insurance law and know how life insurance companies deny life insurance claims. For example, a life insurance or an accidental death claim may be denied due to life insurance lapse, life insurance beneficiary disputes, exclusions in the policy, failure to submit evidence of insurability, failure to file a conversion application, material misrepresentation, automatic revocation upon divorce and many other reasons. To successfully appeal the denial and overturn the insurance company’s unfavorable decision, your life insurance attorney must be in expert in the field of life insurance law. Life insurance lawyers working exclusively in the field of life insurance law are better equipped to get your denied life insurance claim paid fast. During your initial consultation with an attorney ask him/her whether life insurance law is their expertise. At Kadetskaya Law Firm, our life insurance attorneys handle exclusively life insurance matters of different types. If your death claim has been denied, call us for help.
Third, ask about all the fees that may be involved. When you consider which law firm to hire to fight a large life insurance that denied your claim, you want the best life insurance attorney. However, legal work may be very expensive. Some life insurance lawyers charge an hourly fee that must be paid upfront even if they are not successful at getting you any money. Moreover, there may be litigation costs associated with fighting a life insurance claim denial in court. Contingent fee contracts, on the other hand, allow a life insurance beneficiary whose claim has been denied to hire an attorney without paying anything upfront but paying a percentage of the recovered sum if the life insurance lawyer wins the case. This may help beneficiaries of life insurance policies whose claim has been denied to hire a lawyer for life insurance claims even if they do not have a large sum of money to pay the legal fee upfront. At Kadetskaya Law Firm, our attorneys work mostly on a contingent fee basis and charge a fee only if they win your case.
Fourth, online research is very importance. Today, most research is done online. Researching a life insurance attorney should not be an exception. There are many different websites (such as avvo.com) that allow clients to write a review for their life insurance lawyer’s service online independently of the law firm. Attorneys cannot remove an unfavorable review posted by their clients and can only comment on a review. While searching for a life insurance lawyer to hire, focus on reading client reviews. It will allow you to accurately assess your life insurance lawyer’s skills and professionalism. Kadetskaya Law Firm has dozens of positive five-star reviews of grateful clients whom we helped to get their denied death claims overturned.
Finally, one of the main reasons clients are unhappy with their attorneys is poor communication. Life insurance attorneys are busy and may have many client meetings, court appearances, depositions, etc. However, when it comes to communication, they must set aside time to return emails and calls to make sure their clients are aware of everything that is happening in their case. Unfortunately, not all law firms are great at returning client calls in a timely fashion. Not only does this cause frustration in a new client, but it can also undermine trust in the life insurance lawyer and even the success of the case. If your life insurance claim has been denied and you are considering a particular law firm, ask them about their practices of communicating and decide what level of communication you are comfortable with. One of the central topics in all of our client reviews at Kadetskaya Law Firm is the accessibility of our life insurance lawyers. We usually return client calls and emails within a few hours.
What is life insurance law? What type of law firms resolve life insurance disputes? Where should I start my research? Many people do not have to deal with life insurance law or attorneys who practice it. However, if you are one of the people who have been turned down by a life insurance company after a loved one died, this article will help you understand your legal options. While life insurance law is practiced by both plaintiff and defense attorneys, this blog is focused only on the laws protecting a person whose life insurance claim has been denied.
Generally, life Insurance law is an area of law that deals with life insurance and accidental death policies, life and accident claim review and litigation that may ensue as a result of disputes involving denied or delayed life insurance and accidental death claims. While life insurance issues may be handled as part of general litigation, divorce or estate planning, there are law firms that specialize only in life insurance. Plaintiff’s life insurance attorneys represent an individual whose claim has been denied. They protect the individual’s interests in his/her fight against life insurance companies, employers, group plans and competing claimants. Life insurance law is diverse and varies from state to state. In addition, some policies are controlled by federal insurance laws and not state insurance laws. An experienced life insurance attorney will explain which law will apply and how your case will proceed.
Life insurance law may encompass many different scenarios, the most common ones are listed below:
revocation of a former spouse as a life insurance beneficiary under state law;
denial or delay of a life insurance or an accidental death claim;
conversion of a group policy into a private policy;
estate planning using life policies;
changing beneficiaries following a divorce or a court order;
setting up a trust involving a life insurance policy;
naming minors as beneficiaries on life insurance policies;
problems arising from not complying with policy terms;
group life insurance requirements for evidence of insurability;
group life insurance requirements for waiver of premium;
life insurance policy lapse;
group life insurance claim denials in policies controlled by ERISA;
disputes about which law applies to a particular life insurance policy;
denial of claims for supplemental life insurance obtained through employment;
payment of claims to the wrong beneficiary;
ERISA violations by fiduciaries in life insurance cases.
At our law firm, we have helped hundreds of clients with these and many others life insurance matters. We have experience in resolving beneficiary disputes, winning ERISA appeals, and overturning life and accident claim denials. As our potential client, you will receive a free consultation and a free confidential review of the documents in connection with your case. Our life insurance lawyers do not charge any fees unless we win your case. Call us today at 1-888-510-2212 for a free consultation.
An accidental death policy offers protection when the insured dies as a result of an accident. Accidental death benefits may be found as part of a regular life insurance policy or as a separate contract.
If your life insurance claim has been denied, you may feel confused and frustrated. After all, the essence of a life insurance policy is in the insurer’s promise to make a payout upon the insured’s death.
Unfortunately, that promise is not always kept. Almost every life insurance policy has a list of exclusions which outline scenarios of when the insurer will not pay the claim. What is alarming is that these reasons not to pay your life insurance benefits can often be interpreted in such a way that almost any death falls outside of the coverage area.
Illegal drug use is one of the reasons the insurance company will not pay your benefits. Keep on reading to find out how to fight this and win your case!
Key person life insurance (aka key man life insurance or corporate owned life insurance) is life insurance coverage on top executives, directors, partners, proprietors and key employees in a corporation.
The proceeds from a key man life insurance policy are paid directly to the corporation that took out the policy, since the business is the beneficiary under the key man life insurance policy.
Death of a key person in a corporation often causes a loss of income, business and opportunities. It may result in substantial business expenditures associated with hiring and training a new employee replacement.
Not surprisingly, having key man insurance coverage on highest paid officers and director is a standard procedure for many corporations that many investors now expect.