Life Insurance

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Non-payment of life insurance benefits following the death of a loved one can be devastating to the remaining family members. Most of these disputes involve coverage disputes over allegations of misrepresentation at the time the life insurance policy was purchased and non-payment of premiums. These cases can be very complicated and made more difficult by the fact that usually the party with the greatest knowledge of the circumstances surrounding the policy has passed away.

Misrepresentation of Original Life Insurance Application for Policy

Life insurance policies generally include a provision that allows life insurance companies to rescind the policy based on an innocent material misrepresentation if death occurs within the first 2 years after the policy was issued. This occurs if the life insurance provider concludes that incorrect information was provided when the life insurance policy was taken out and they wouldn’t have issued the life insurance policy had they known otherwise. If you believe that there was no error or omission regarding the information provided, it may be possible to challenge this decision and you should contact one of our life insurance lawyers to discuss whether there is any chance of success in pursuing the claim further.

Exclusions Under the Life Insurance Policy

• Suicide within the first two (2) years
• Death caused by war
• Death from being involved in a speed race (motor vehicle, boating, etc.)
• Death occurs while committing or trying to commit a criminal offence
• Operating a motor vehicle or participating in a dangerous sport while under the influence of alcohol or drugs.

There may be other exclusions, but these are the main ones most life insurance policies have. The circumstances of death are not always clear and sometimes claims are denied without a thorough or complete investigation. If the insurance provider is claiming that your loved one passed away for a reason excluded in the insurance policy, contact our team of life insurance lawyers to see how we can help you.

Example: Fraudulent Misrepresentation Alleged

Here is an example of how a life insurance claim may be denied. A 45-year-old woman decides that she needs life insurance to protect her family from the financial devastation her early death would cause, as she is the sole provider for her family.

She approaches an insurance agent to purchase $500,000.00 in life insurance. She believes she has properly answered all questions related to her medical health history, to the best of her knowledge.

She has disclosed a past history of high blood pressure, which is controlled by medication, but she failed to disclose that she had consulted a specialist regarding her blood pressure in the 2 years prior to the date of her application.

The insurance company reviewed the application and issued the life insurance to her with a higher premium because of the information she provided, but they still issued the insurance to her.

About 5 years after the Life insurance was issued, she died after a battle with cervical cancer.

The beneficiaries under her policy were her son and daughter ages 22 and 19. They submitted the claim to the insurance company and after many months of following up with them, they received notification that the claim was being denied on the basis of misrepresentation.

The son and daughter were relying upon the life insurance proceeds to continue with their university education, and without the financial assistance, it would be very difficult for them to continue to pursue their education.

They couldn’t understand how the insurance company could deny the claim based on an alleged misrepresentation regarding a specialist their mother had consulted around 7 years ago regarding her blood pressure. This didn’t seem to have anything to do with the illness that took her life.

This type of situation is one that Share Lawyers can look into to determine whether there is any hope of recovering all or part of the life insurance proceeds from the insurance company.

A thorough review of the medical information that the insurance company reviewed as well as additional medical records they may have overlooked would have to be undertaken and experts would have to be consulted to determine whether the failure to disclose the one consultation with a specialist would have resulted in the policy never being issues, as the insurance company said in their denial.

With the passage of more than 2 years from the date the policy was issued, the insurance company would have to establish that the misrepresentation was fraudulent or reckless, as well as establish that the failure to disclose would have resulted in them not issuing the policy. (Time limits do not start from when you purchase life insurance, but when you receive a life insurance denial.)

We Can Help

Before accepting a refusal by an insurance company to pay out on your loved one’s life insurance policy, our lawyers for life insurance claims encourage you to consult further with us to determine whether we can assist you in recovering all or part of what rightly belongs to you or your family. We are not personal injury lawyers, we specialize in a life insurance dispute.