New York Life Insurance Claim Lawyer

Cause of Death Usually Does Not Impact Life Insurance Payment

UNLESS A SUICIDE WAS INVOLVED AND OCCURRED WITHIN CONTESTABILITY PERIOD

Many people mistakenly assume that the cause of death might impact whether the life insurance company pays the claim for life insurance. Under most circumstances, however, the cause of death would only directly impact the life insurance company’s decision to pay the benefit owed (1) if the deceased committed suicide and (2) if the death occurred within the “look back” period, referred to as the contestability period. This rule would not apply to an accidental death policy.

The contestability period, which is two years in most states (including New Jersey, New York, and Massachusetts), allows the life insurance company to review the initial application to ensure that the policy holder accurately provided all the relevant information and did not leave out any details that would have affected the type of policy issued and/or the amount of the premium charged. Additionally, if a suicide occurs within that period, the life insurance company can deny the claim for benefits, on the theory that the policy holder may have been intending to commit suicide when the policy was purchased, and that the insurance company would not have issued the policy if that information had been known in advance.

Within the contestability period, other than a suicide, the insurance company would not be directly concerned with the cause of death. For example, if the insured had a heart attack, that fact in itself would not impact whether the life insurance company pays the benefit owed. However, for any death occurring within the contestability period, the life insurance company is entitled to review the policy application and request the deceased’s medical records, to confirm that all key information had been included in the application. So, for the example of a person whose death was due to a heart attack, the life insurance company would review the application to see if any prior history of heart disease had been disclosed. If a prior history of heart disease had been listed on the life insurance application, the insurance company cannot claim that it did not have all the information necessary to properly analyze the risk of issuing the policy and to figure out the proper premium to charge. It therefore cannot point to the cause of death as a reason to deny payment of the benefits owed under policy (assuming the premiums had been paid on time). Additionally, if the medical history shows that the policy holder had no history of heart disease at the time of the application (meaning that the condition developed later on), the life insurance would not be able to deny the claim based on the cause of death. On the other hand, if the life insurance company finds that some other medical condition was not disclosed on the application, it could deny the claim, even if that other condition was completely unrelated to the cause of death. Similarly, if false financial information or other false statements were made on the policy application, the life insurance could deny the claim.

Beyond the contestability period, the cause of death is generally not relevant to the life insurance company’s determination of whether to pay the benefit. Other grounds for denial are still possible, however, such as failure to pay the premiums.

In summary:

  1. Within the contestability period:
    1. Suicide can be basis for the life insurance company’s denial; and
    2. Other causes of death would not directly be basis for life insurance company’s denial, but could provide the life insurance company to review the application to ensure that any medical information related to the cause of death had been disclosed (if known at the time of the application).
  1. Beyond the contestability period: cause of death is not relevant

If you recently lost a loved one who had life insurance for which payment was denied or which you fear may be denied, the life insurance attorneys at Trief & Olk are available to answer your questions and represent you if life insurance has been denied. Feel free to consult our website for examples of the many successes we have had when life insurance companies denied payment or call us directly to discuss how we may help you.

 

Life Insurance Policies with Vanishing Premiums – and Vanishing Policies

Life Insurance Policies with Vanishing Premiums – and Vanishing Policies

Many life insurance companies have sold life insurance policies with the enticing premise that the premiums paid in the early years of the policy will accrue interest that will pay for the premiums owed in the later years. These policies were marketed with illustrations showing the interest being used to pay the premiums, referring to them as “vanishing premiums.” The theory behind policies with this structure is that the premiums are relatively high when the policy is first issued, while the policy-holder is in his or her earning prime. The premiums paid then accumulate cash value, which generates interest that is used to pay the premiums in later years, when the policy-holder is earning less or retired. Thus, the premiums are supposed to vanish, which is an appealing prospect for someone purchasing a whole life or universal life policy they plan to maintain until their death. (These policies differ from a term life policy, which lasts for a fixed number of years, for which the premiums are generally much lower than whole or universal life policies offering the same level of insurance coverage.)

There is nothing inherently wrong with a vanishing premium policy; however, since interest rates are much lower in recent years than was the case when the policies were issued, the result is that the accumulated interest ends up being insufficient to pay the premiums in the long term. So, for example, the policy-holder pays high premiums for years 1 through 15; the cash value of the accumulated interest covers the premiums for years 16-20; and then suddenly, in year 21, the insured is again asked to make a premium payment. Having grown accustomed to not paying the premiums, the policy-holder often does not understand the change in circumstances, is confused by the notice demanding payment, or does not have the money to pay. The unfortunate outcome in these situations is that the policy-holder does not make the required premium payment. When this occurs, the policy is cancelled, despite the fact that thousands of dollars in premiums (or hundreds of thousands of dollars) have been paid over the course of many years and despite the fact that the illustration used in marketing the policy turns out to be incorrect. The likelihood of this occurring is particularly high when the policy-holder is elderly and may not fully comprehend complex financial documents or is in a lower earnings bracket.

If you or a family member has a life insurance policy with this type of premium structure, it is important to monitor any notices you receive from the insurance company. Be on the look-out for any notice indicating that a payment must be made by a specific date in order to avoid cancellation of the policy. If it is not clear whether a payment is owed or whether the accrued interest is sufficient to cover the premium, contact the insurance company to make sure you understand the situation.

If you recently lost a loved one who had life insurance for which payment was denied, you may have a claim. The life insurance attorneys at Trief & Olk are available to answer your questions and represent you if life insurance has been denied. Feel free to consult our website for examples of the many successes we have had when life insurance companies denied payment or call us directly to discuss how we may help you.

Don’t Lose Life Insurance Coverage When you Need it Most – When you are Gravely ill

Don’t Lose Life Insurance Coverage When you Need it Most – When you are Gravely ill

Many employers provide employees with the option to purchase group life insurance coverage in addition to basic coverage provided by the employer and paid for by the employer. This coverage, often referred to as optional, voluntary, or supplemental life insurance, does not, necessarily remain in place once the employee has left the company. As attorneys representing life insurance beneficiaries denied coverage, Trief & Olk sees many cases where the client’s loved one has passed away after a long illness. The beneficiary –such as a surviving spouse –seeks payment under the supplemental life insurance that had been in place while the deceased was employed, only to find out that the insurance company claims that the coverage had previously ended, so the insurance claim is denied. Challenges to such life insurance denials are possible, but must be pursued according to the specific procedural requirements of the Employment Retirement Income Security Act of 1974, known as ERISA, 29 U.S.C. §§ 1001-1461, the federal statute that governs insurance plans provided to employees as part of a benefits package.

Denials of life insurance coverage under employer-provided life insurance typically arise when the employee stops working due to a serious illness (such as cancer) that requires extensive treatment and makes the employee too ill to work. The employee eventually is required to go on long-term disability leave. She may continue to receive disability payments under the employer’s disability policy and therefore may assume that the life insurance coverage continues as well. Depending on the terms of the insurance plan, however, the employee’s coverage under the life insurance policy may end at a certain point. Frequently coverage ends one year after the employee first went out on disability, at which point the employee may no longer be considered an employee. The employer and insurance company cannot, however, simply cut off coverage. They must provide notice that the policy coverage will end and explain the employee’s options. For example, many policies require that the employee have the opportunity to convert the group policy to an individual policy (for which the former employee will be required to pay monthly premiums). Certain policies also offer the possibility of continuing coverage under the group policy beyond the standard cut-off date if certain conditions are met. In such circumstances, the employee may be able to apply for a waiver of the monthly premiums.

If you or a family member have recently stopped working due to a serious illness, it is important to find out from the employer what benefits –including life insurance coverage –continue while on disability, how long those benefits will continue, and what options are available if and when those benefits terminate.

If you recently lost a loved one who had employer-provided life insurance for which payment was denied, you may have a claim if the employer and/or insurer did not provide the proper opportunity to convert or extend the life insurance coverage. The life insurance attorneys at Trief & Olk are available to answer your questions and represent you if life insurance has been denied. Feel free to consult our website for examples of the many successes we have had when life insurance companies denied payment or call us directly at 212-486-6060 (NY) or 201-343-5770 (NJ) to discuss how we may help you.

Life Insurance Ramifications of DNA Sequencing

Life Insurance Ramifications of DNA Sequencing

With the advent of affordable DNA sequencing, nearly one million Americans have had their DNA tested.  Yet from a life insurance standpoint, the consequences of such a decision remain unclear.  The Genetic Information Nondiscrimination Act (GINA) passed in 2008 specifically excluded life, disability, and long-term care insurance from its protections.  As a result, many patients concerned about inherited diseases are cautious that their DNA results could be used against them by insurance companies.

To date, at least one insurer, Northwestern Mutual Life Insurance Company, has begun to ask potential customers whether they underwent genetic testing, noting that a failure to disclose results could have an adverse impact on the application.  Whether this trend continues is unknown, however it remains a possibility insurers are considering.

Buying and Selling Life Insurance Policies in New York

Buying and Selling Life Insurance Policies in New York

A ruling by the New York Court of Appeals has paved the way for individuals to buy life insurance policies and transfer them as investments.  Kramer v. Phoenix Life centered on attorney Arthur Kramer’s acquisition of several life insurance policies totaling $56.2 million in coverage that were subsequently sold to unaffiliated investors.  The issue before New York’s highest court was whether the sale of those insurance policies to persons with no insurable interest was appropriate.

In a 5-2 decision, the Court upheld the sale, finding that New York’s insurable interest rules did not prevent an insured from obtaining a policy on their life and thereafter transferring the policy to an individual with no insurable interest.

New York’s insurance law defines an insurable interest as:

 . . . in the case of persons closely related by blood or by law, a substantial interest engendered by love and affection or, for others, a lawful and substantial economic interest in the continued life, health or bodily safety of the person insured.

Further,

 Any person of lawful age may on his own initiative procure or effect a contract of insurance upon his own person for the benefit of any person, firm, association or corporation. Nothing herein shall be deemed to prohibit the immediate transfer or assignment of a contract so procured or effectuated.

However,

No person shall procure or cause to be procured, directly or by assignment or otherwise any contract of insurance upon the person of another unless the benefits under such contract are payable to the person insured or his personal representatives, or to a person having, at the time when such contract is made, an insurable interest in the person insured.

Applying the statutory text, the Court noted that, “There is simply no support in the statute for plaintiff and the insurers’ argument that a policy obtained by the insured with the intent of immediate assignment to a stranger is invalid. The statutory text contains no intent requirement; it does not attempt to prescribe the insured’s motivations.  To the contrary, it explicitly allows for ‘immediate transfer or assignment’ (Insurance Law ‘ 3205[b][1]).  This phrase evidently anticipates that an insured might obtain a policy with the intent of assigning it, since one who ‘immediately’ assigns a policy likely intends to assign it at the time of procurement.”

In sum, New York law was found to permit a person to procure an insurance policy on his or her own life and immediately transfer it to one without an insurable interest in that life, even where the policy was obtained for just such a purpose.

New York Life Insurance Claim Lawyer

New York Life Insurance Claim Lawyer

Filing a life insurance claim after your loved one passes away seems like it should be a simple and quick process. You assume that when the company agreed to the policy, and your loved one’s death met the policy criteria for a claim, that there was no way the life insurance company would deny the claim.

Unfortunately, in states like New York, insurance companies have a longer time period to investigate and contest your life insurance claim on grounds of “material misrepresentation”.  In fact, in New York and states with similar policies, the contestability period extends for two years after you sign and begin a new policy. Allegations that the policyholder included incorrect or incomplete information can refer to the initial application or any supplementary document the decedent filed after initially purchasing the policy. The company might interpret a statement’s meaning incorrectly, and deny your claim based on the misinterpretation.

We suggest that you seek legal help before bringing an appeal of any denied claim. State laws can vary widely and it’s best to consult a New York life insurance claim lawyer who specializes in working with large insurance companies. You may avoid a lengthy lawsuit by consulting with a lawyer, who can leverage years of experience in negotiating with the life insurance company. A professional attorney’s involvement from our office will help you better understand how to negotiate with the company and will ensure that it doesn’t take your appeal lightly.

New York Life Insurance Claim Lawyer

When your claim is denied, please contact a New York life insurance claim lawyer in our office. We advise you to take advantage of a free consultation to determine if a chance exists that you can successfully appeal the decision and negotiate with your insurance company. Beneficiaries are already going through a difficult period, after losing a loved one. We treat each potential client with great importance and will listen intently to your situation. When we accept a case, each client receives service from at least two senior attorneys.

If all negotiation options are exhausted, our litigators are experienced in taking on big insurance companies in the court system. We know that many surviving loved ones don’t know where to turn when a claim is denied. Big insurance companies may count on that vulnerability when they investigate your claim and reject it as routine policy. Pursuing your claim won’t cost you money upfront. We will carefully review your situation, at no charge to you, and determine if grounds are present for further pursuit of an appeal or lawsuit.

New York Life Insurance Claim Lawyer Services

Since 1987, the law firm of Trief & Olk has provided numerous legal services to a wide variety of clients. If you or a loved one has a legal need, please contact us to find out more specific information about our firm or for a free consultation to discuss how our firm can help to resolve your case. Our law offices can be reached via telephone at (212) 486-6060 or by completing our confidential online form. When you fill out the form, include a detailed and thorough description of your case. We look forward to serving your needs.

 

Don’t Lose Life Insurance Coverage When you Need it Most – When you are Gravely ill

Life Insurance Denial Lawyer

When your life insurance claim is denied, don’t accept an unfair decision and give up. In most states, insurance companies have up to two years to investigate an approved insurance policy and deny the policy or a claim. That’s a standard practice for some large companies, who can begin such investigations even after your loved one has passed away.

The official reason for many of these denied claims is “material misrepresentation”, and it’s usually based on one of several common subjects, for example tobacco usage, age or income. Material misrepresentation occurs when you purposely conceal a fact that’s relevant to whether the company approves your life insurance policy.

But don’t be dissuaded by a denied claim from a life insurance company that insists your loved one did something wrong. Most misrepresentations on life insurance forms aren’t material. In other words, even if the information had been provided when the policy holder purchased the insurance, the company still would have approved the application. That means the misrepresentation isn’t a good reason to deny your claim. If your claim has been denied, please speak with a life insurance denial lawyer to discuss your case and the options available to get the money you’re entitled to receive under your loved one’s policy.

Life Insurance Denial Lawyer

You shouldn’t feel powerless just because a big company has denied your claim. Instead, contact a life insurance denial lawyer, who can help you assert your interests and protect your rights. If we decide your case has merit, our experienced attorneys will work together in a team setting to best serve your needs. Using a thorough research process, we determine the full background of why your claim was denied and work hard to help you receive the money that was promised to the decedent.

Remember, after your claim is denied, you still have several options to recover the money that’s due you. First, we can work with you to appeal the denial and attempt to negotiate with the insurance company. If that attempt isn’t successful, we have a number of skilled and capable litigators who can argue your lawsuit in court. Because consumers are buying fewer policies today, insurance companies are more likely to scrutinize your claim and deny it, sometimes mistakenly or in bad faith. In the end, your loved one bought an insurance policy to ensure you could cover your day-to-day and long-term expenses. You deserve to continue your normal life without hardships.

Life Insurance Denial Lawyer Services

Since 1987, the law firm of Trief & Olk has provided numerous legal services to a wide variety of insurance clients. If you or a loved one has a legal need, please contact us to find out more specific information about our firm or for a free consultation to discuss how our firm can help to resolve your case. Our law offices can be reached via telephone at (212) 486-6060 or by completing our confidential online form. When you fill out the form, include a detailed and thorough description of your life insurance claim case. We look forward to serving your needs.