Tag Archives: Life Insurance Claims

Legal Issues in Life Insurance Claims

It’s hard to believe, but under a life insurance policy, the last thing you would expect to happen is an insurance provider refusing your death benefits. Believe it or not but this happens all the time and insurance providers can and may refuse a death benefit claim under some cases. In this article, when an insurance provider fails to pay the proceeds of a claim, we briefly discuss the problems involved. If, under a scheme, you are a beneficiary, here are some things you should be aware of: Get more informations of  Disability Insurance Attorney near me
Disputability. The insurer has the right to refuse payment during the “contestable” time under a lawsuit. Simply put, if the insured (the person who purchased the policy) dies less than 2 years after the policy has been released, the insurer may examine the insured’s responses to the insurance application. The firm would usually request that the insured’s medical records be checked. If the insurer considers that the claimant has misrepresented his or her medical condition or has omitted relevant details, the payment may be refused. The legislation enables such action to be taken by insurance firms. However, even though the rejection takes place, it does not mean that the recipient has no redress. The beneficiary can have some reasons available to address the rejection of the petition.
Around materiality. In general, the misrepresented or excluded reality must be material in fact for a corporation to refuse reimbursement under a policy. A relevant fact is ‘material’ if the insurer has either declined coverage or given coverage to the insured under different conditions, had it been completely and accurately disclosed on the application. It is not difficult to show, sadly for the beneficiary, that the fact at issue was material.
Awareness and Confidence. In order to decide if the claimant has made a material omission or misrepresentation of the document, the beneficiary’s lawyer has to analyze the application itself. Many applications use language that allows the insured to attest that the information given is true to his or her “knowledge and/or belief” Such language is important because it may put a heavier burden on the entity to show that a misrepresentation has been made. For example, even if his medical history suggested otherwise and his assertion was made sincerely and not with an intention to mislead, if the insured claimed that he did not see a doctor in the last 5 years, there is arguably no misrepresentation.