Our client contacted our law firm after the life insurance claim on her deceased mother was denied by a major insurance company. The insured in this case had life insurance coverage and disability coverage through the same insurer. Since she was totally and permanently disabled, she qualified for a waiver of premium benefit – no life insurance premiums were needed in order to maintain the coverage.

Several years prior to her death, our client’s mother received a letter from the insurance company advising her that her life insurance coverage was in effect and that the waiver of premium was active. She continued receiving disability payments from the insurance company up until her death. As a requirement for her disability eligibility, she was continuously providing the insurer with her medical records proving that she was totally and permanently disabled.

The insured died in February 2015. Her daughter, who was the beneficiary on her life insurance policy, filed a claim. The insurance company denied her claim stating that the documents they had on file were not sufficient to prove that the insured qualified for the waiver of premium benefit. More specifically, the denial letter stated that the insured could not possibly qualify for a waiver of premium, because there were no medical records showing that she was totally and permanently disabled (a requirement for the waiver of premium benefit).

Our life insurance attorneys investigated the case, negotiated a settlement and soon our client received the total amount of the life insurance benefit with interest. The claim was paid outside of court without the expense of litigation.