Lawyer for Life Insurance Claims
Many years ago a family came to us with a large life insurance claim. It was a contestable claim and because it was a big claim the insurer was going to investigate everything. They interviewed family members. They hired a really big law firm to aide their investigation. They got records from every doctor, clinic and urgent care office the insured had visited for many years. They had their doctors examine all of the records. They employed a financial specialist. They challenged the insured’s taxes and business endeavors. They left no stone untouched looking for any reason to deny the claim.
We were hired by the family to work for their interests. Specifically, to make sure the insurer was acting fairly in their investigation, that everything which supported the approval of the claim was presented to the insurer, and to challenge anything that may have caused the claim to be denied.
We had differences of opinion with the insurer and its lawyers, there were agreements, and there were out-and-out fights over the investigation. In the end the claim was paid. But equally important for me was what I learned from the experience. I learned that you don’t necessarily need a lawyer for life insurance claims to be paid.
The insurer and their law firm were extremely aggressive in their efforts, but they weren’t devious. They may have come to a conclusion about something they felt was important, but when we brought counter-evidence or when we demonstrated that one record was preceded by another that was more relevant, they considered our findings. They certainly didn’t concede anything that we couldn’t prove – either through documentation, statements or industry laws. Thankfully, understanding both life insurance underwriting and life insurance claims gave me an advantage of knowing how both were imperative to a claim investigation.
Our client could have hired a lawyer to battle things out in the legal environment, but what they really wanted was to get their claim approved as fast as possible and get their money. By hiring The Center for Life Insurance Disputes the family benefited because they had someone working for them who understood life insurance claims. The insurer knew this. I truly believe that had the family not had active representation monitoring and documenting the acts and efforts of the insurer and their lawyers, the claim would have been denied.
It’s the same question when there is a denied life insurance claim. Do you need a lawyer for life insurance claims that have been denied? A life insurance claim that has been denied can be handled the same way a contestable claim is handled. Everything has to be investigated Someone who understands the intricacies of both claims and underwriting will be a huge asset to the beneficiary.
One of many claim appeals we successfully overturned comes to mind as a great example of not needing a life insurance lawyer to get benefits paid. Most accidental death policies have exemptions for things like being drunk or having illegal substances in the blood at the time of death. Our client filed an accidental death claim for her brother who was murdered. The toxicology report showed that he had methamphetamine in his blood and that his blood alcohol was above the legal limit when he was killed. The insurer issued a denial letter stating that, according to their policy, they aren’t obligated to pay claims when an insured is intoxicated or under the influence of controlled substances at the time of the death.
Most people might concede that there was nothing else to evaluate and that the insurer was justified in denying the claim. We asked for the policy so we could see, in writing, the provisions and exclusions the insurer was referencing. What we discovered was that the clause in the denial letter did not match the wording of the policy insuring this person. His policy excluded things like committing a crime, but his policy did not even address intoxication or controlled substances.
Once we presented this evidence the insurer immediately paid the claim.
After getting tens of millions of dollars of denied claims repealed and paid, our answer is no, you don’t need a life insurance lawyer for getting denied claims paid. What’s needed is someone with experience who knows the claims business and can stand-up for the beneficiary and make sure their claim is handled fairly by the insurer.
Lawyer life insurance
Stephen C. Burgess is the founder and President of the Center for Life Insurance Disputes. Mr. Burgess has a 28-year career in the life insurance industry including being designated as one of only a few Life Insurance Analysts in the industry. He spent 13 years as a Sale Manager and Regional Director for Penn Mutual Life Insurance Company. In his positions he was responsible for the underwriting and issuance of 1000’s of life insurance policies. His experience in both underwriting and claims has helped him become one of the foremost experts of life insurance claims in the US. He’s regularly engaged by attorneys throughout the US to offer expert opinions. Mr. Burgess has consulted or offered expert testimony in over 200 life insurance lawsuits including such notable cases as the Phoenix Home Life Variable Insurance Company vs The Price Dawe 2006 Insurance Trust, Dukes Bridge LLC vs Security Life of Denver, and Dixhuit Fondation vs Prudential Life Insurance. As the President of the Center for Life Insurance Disputes Mr. Burgess brings all of his life insurance experience and is personally involved in every client’s claim
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