Claim Denial Based on Material Misrepresentation Reversed on Appeal

Our client was the surviving widow of the insured who suddenly died of a heart attack. At the time of his death, the insured had a group life insurance policy available through his employer, which amounted to $150,000. The policy had been in effect for less than two years and, therefore, the insurance company started a contestability investigation.

During the investigation the insurance company obtained the insured’s medical records which showed that the insured suffered from sleep apnea. Based on this, the claim was denied.

The insurance company denied the claim based on material misrepresentation stating that had it known that the insured had sleep apnea, the coverage would not have been issued. Our group life insurance lawyers challenged this denial of benefits and the claim was paid promptly.

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