Our client called us to discuss his denied life insurance claim following an untimely death of his brother. His brother worked for a company that provided group life insurance coverage with a conversion privilege. However, when the insured retired, neither the employer nor the insurance company sent him a conversion notice. He was too ill at the time to investigate his options and died soon after. The insurance company denied to pay the claim.
When our attorney took over the case, we discovered that at the time of the insured’s retirement the insurance company was in the process of implementing a new computer system that was supposed to trigger sending out conversion notices to all departing employees of this particular employer.
However, the system was malfunctioning and no one who retired from that company at that time period received their conversion notices. Shockingly, the insurance company knew of this issue before our client filed his claim but decided to deny his claim anyway! We filed an appeal with the insurance company revealing the breach and the knowing cover-up of the technology problem. The insurance company reversed its denial on appeal and promptly paid the claim with interest. Our client was very pleased with the fast outcome in his favor.