When people lose a loved one, they usually go through a difficult readjustment during which financial matters such as life insurance and estate matters may be put on hold. Sometimes the beneficiary may not even know the decedent had life insurance or named them as a beneficiary. What happens when they discover there is life insurance months later? Can they still file a claim?
What Is the Timeframe for Filing a Life Insurance Claim?
Generally, there is no single rule for when to file a life insurance claim. Every policy has a provision outlining a timeframe for when it is allowed to file a claim. However, if there are circumstances preventing the beneficiary from filing a claim during the period set out in a policy, the beneficiary may still be able to file a claim later explaining their inability to file timely.
There are many reasons why beneficiaries do not file their claims timely:
Don’t know what insurance company issued the policy
Beneficiaries may know a policy exists, but have no idea where to locate it. In these cases, it is best to do some investigation as soon as practicable. If the insured is a family member, look through their bank statements or credit card bills to see where the premium for the policy was sent, go through the deceased person’s mail or email and see if there is any correspondence from a life insurance company. You may even try contacting several life insurance companies and provide them with the decedent’s information to see if there is a policy for this person in their records. Finally, if the insured was employed at the time of death, chances are he/she had employer-provided life insurance coverage. Calling the employer’s benefits department may provide some clues.
Don’t know they are beneficiaries of a life insurance policy
Unless the decedent shares this information with you, you may not know you have been named as a beneficiary. Moreover, you may not know that if you have been named a secondary (contingent) beneficiary and the primary beneficiary is deceased or revoked, you have the right to file a claim.
If a relative or a friend had a life insurance policy and named you as a recipient but never shared this information with you, you may not find out about this until years later. Unfortunately, many life insurance policies have gone unclaimed because insurers made no effort to locate beneficiaries or find out if the insured died. Many states are passing legislation requiring life insurance companies to use the Social Security Administration’s “Death Master File” (DMF) database to identify life insurance policyholders who have died and whose beneficiaries are owed payments.
Were told by an insurance company not to file a claim
Sadly, this happens far too often. A person may have a valid life insurance claim, but an insurance company’s representative, after getting some facts on the phone, may wrongfully say the claim will not be paid. For example, a beneficiary is a former spouse of the insurance. She called the insurance company to get claim forms after her ex-husband’s death and was told she is automatically revoked as the ex-spouse and cannot file a claim. The ex-wife may not be revoked because the state where the policy was issued and where they lived may not have such law, the claim may be governed by federal law or she may have a divorce decree obligating the insured to keep her as a beneficiary.
We recommend everyone who was told by an insurer to not file a claim to have a consultation with a life insurance attorney. Here’s how we won
What Happens If You Don’t Claim Life Insurance Benefits
The National Association of Insurance Commissioners (NAIC) reports that millions of life insurance benefits are left unclaimed every year. If a life insurance policy is not claimed, the insurer will turn the funds over to the state’s unclaimed property office. Beneficiaries will then need to contact that state’s unclaimed property office to get the benefits.
While there is no certain deadline to claim life insurance benefits on a valid policy, there are deadlines for when to dispute a denied life insurance claim or sue an insurance company. Statutes of limitations for denied claims vary from state to state. We advise beneficiaries who had their life insurance claim denied to consult an attorney as soon as possible to ensure the statute of limitations does not pass.
Many people wonder whether there is a special set of rules applicable to life insurance beneficiaries. You may also wonder whether spousal rights are the same as beneficiary rights. This article will address these and many other topics about beneficiary and spousal rights. Simply put, a life insurance policy is a contract between the insurance company and the owner of the policy. This contract outlines rules about naming, changing, or removing beneficiaries. A beneficiary is a person who is named in this contract as a recipient of the life insurance proceeds in the event of the insured person’s death. The beneficiary may be a spouse, a relative, a child, a friend, a trust, etc. Usually, the owner of the policy may name any person or an entity as the beneficiary.
Does the Surviving Spouse Automatically Become the Beneficiary of a Life Insurance Policy?
Usually, there is no requirement in the policy itself that only a spouse be named as the beneficiary. The policy owner has the right to choose any beneficiary they wish. Likewise, the policy owner has the right to change their designation. However, if the policy owner chooses to name their beneficiary as irrevocable (versus revocable), he or she will not be able to later remove or modify this designation. Revocable designations, on the other hand, are easily changed. To be valid, a beneficiary change/designation must be made according to the rules outlined in the life insurance policy itself and must be received, approved and recorded by the insurance company.
Another scenario where the policy owner may be restricted in choosing the beneficiary is when there is a court order, such as a divorce decree, that obligates the policy owner to name a specific person as the beneficiary. For example, if the divorce decree obligates the husband to carry a private life insurance policy in the amount of $250,000 for the benefit of his children, the husband will not be able to remove the children as beneficiaries and name someone else. This restriction, however, does not automatically apply to such policies as SGLI, VGLI, and FEGLI. The person who is planning to enforce such a divorce obligation needs to make sure that the insurance company is put on notice and that the designation is irrevocable.
A life insurance policy also sets out rules about what happens when there is no named beneficiary. In many policies, the surviving spouse automatically receives the life insurance proceeds when no beneficiary is named at the time of the insured’s death. In others, the money goes to the estate of the insured. It is common for the insurance company to outline the order of precedence that governs who has the right to collect the proceeds when there is no beneficiary.
Can Spousal Rights Override Life Insurance Beneficiary Designations?
There is no short answer to this question. It all depends on the type of the policy, the state where it was issued, the state where the couple lived and the way the premiums were paid. For example, in community property states, certain types of life insurance policies may be considered community property if couples used community funds to pay for such policies. There are exceptions to these rules and is it always wise to consult a life insurance attorney.
Are Life Insurance Policies Marital Property in Community Property States?
Community property states are Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington and Wisconsin. In Alaska and Tennessee, adhering to the community property laws is optional. If you live in a community property state, community property laws may trump beneficiary designation on a life insurance policy under certain circumstances. Since both spouses have an equal share of any income earned during the marriage, they also equally own any property purchased with that money. If a life insurance policy was purchased with community property income (if premiums were paid using community property money), the surviving spouse may claim half or a portion of the life insurance proceeds if someone other than the spouse is listed as the beneficiary. The beneficiary will receive the rest.
Can Spouses in Community Property States Waive Rights to Life Insurance Benefits?
If a spouse wishes to waive his or her right to a certain life insurance policy, the couple may sign an agreement specifying the policy will be considered separate (not community) property. Usually the insurance company needs to be put on notice of such waiver of spousal rights. In some cases, the insurance company may ask the spouse who wishes to waive his/her rights to sign a consent form. In order to be valid, agreements waiving spousal rights must comply with state law requirements.
What Happens When The Insured Forgets to Remove an Ex-Spouse As The Beneficiary?
When a couple goes through divorce, it is ideal to discuss life insurance policies as part of the property settlement agreement. In this case, the policy is included in the divorce decree, the insurance company is notified of the divorce agreement and both parties are clear as to what happens in case of the insured’s death. If, however, a life insurance policy is not part of the divorce decree and the insured spouse forgets to remove his/her ex-spouse as the beneficiary, conflict often arises as to who is entitled to get the life insurance benefit after the insured’s death.
Under many state laws, an ex-spouse is automatically revoked as a beneficiary to a life insurance policy unless the ex-spouse is able to show that there was a written agreement to keep him/her as the beneficiary in spite of the divorce. Not all life insurance policies fall under these revocations laws. For example, life insurance policies controlled by federal laws will pay to the listed beneficiary regardless of the conflicting state laws.
What happens if a couple divorced and decided to keep each other as beneficiaries on their policies without executing a written agreement and without putting the insurance company on notice of such verbal agreement? Such cases are extremely complicated and the insurance company will most likely have to file an interpleader and let the court decide whether a verbal agreement is sufficient to take the case out of the state law revocation requirement.
When To Hire a Life Insurance Lawyer?
There are many aspects to beneficiary and spousal rights. They vary not only from state to state but also from case to case. Every situation is unique and the general rules outlined above may not apply to your specific situation. If you’re not sure about your rights or have questions about the process, speak with our life insurance attorney about your options. We collect life insurance claims fast and work with our clients through difficult times involving a family dispute, beneficiary contests, denied life insurance claims, delayed life insurance claims and interpleader actions. Call us for a free consultation.
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.