New York Life Insurance Claim Lawyer

Trief & Olk Files Fraud Case Against American Income Life Insurance Co.

Trief & Olk has filed a complaint on behalf of its client against American Income Life Insurance Company (“AIL”) in Essex County, New Jersey, alleging that AIL and its agents misled its customers (the beneficiary of the life insurance policy and her now-deceased husband), persuading them to purchase $5,000 in whole life insurance coverage and $200,000 in term life insurance coverage, but actually issuing a policy with different terms.  The policy AIL issued had no term life insurance but did have an accidental death rider for $200,000.  Because accidental death coverage only applies in very limited circumstances, such plans are not a substitute for term life insurance, under which the beneficiary is paid whether the insured dies of illness or accidental causes.  The family never received a copy of the AIL policy, despite repeated requests, and had no opportunity to confirm that the policy issued was the policy they thought they had purchased.

When the insured passed away in 2018, his wife submitted a claim for the insurance payment she thought AIL owed.  Because her husband’s death was not accidental, however, AIL denied the claim.  It was only at that point that she learned that hat the policy AIL issued had an accidental death rider rather than the $200,000 in term life insurance she and her husband thought they had purchased.  She and her husband had been paying premiums for insurance that ended up being useless, rather than the insurance they thought they had purchased, under which she would have received the $200,000 benefit.

Trief & Olk has found numerous complaints of other AIL customers who claim that they did not receive copies of their policies and were not properly informed of the terms of the policies purchased.  The complaint claims that AIL (and its agents) committed fraud and violated the New Jersey Consumer Protection Act, and were negligent in supervising their affiliated agents, who failed to properly explain the terms of the policy to the Ilizarovs.

If you think you have a claim related to the denial of life insurance coverage (against AIL or another life insurance company), the life insurance attorneys at Trief &Olk are available to answer your questions and represent you if life insurance claim has been denied improperly or is disputed by another purported beneficiary.

Buying and Selling Life Insurance Policies in New York

Insurer’s Late Notice of Premium Due Leads to $1 Million Payment for Trief & Olk Client

Individuals who have purchased life insurance in New York are protected by certain provisions of New York’s insurance law, so that policies cannot be canceled or payment denied for failure to pay the premiums on time without the insurance company providing adequate notice.  If the proper notice is not provided, the policyholder has the benefit of a one-year grace period during which the policyholder can pay the amount owed and the policy claim cannot be denied.

Section 3211(a)(1) of New York Insurance Law requires that for policies for which premiums are paid annually, semi-annually, or quarterly, any notice that the policy will be canceled due to non-payment must be sent “at least fifteen and not more than forty-five days prior to the day when such payment becomes due . .”  The notice must provide the following details:

  • The notice must be mailed to the last known address of the policyholder (or any other person designated to receive notice on behalf of the policyholder); and
  • The notice must state the amount due, date due, place to where and person to whom the payment is payable; and
  • The notice must specify that if the payment is not made within the given time frame or the specified grace period thereafter, the policy will terminate or lapse.

Section 3211(b)(1), (2).  If an insured who lives in New York receives notice from an insurance company that a life insurance policy has been cancelled due to non-payment, the policyholder should investigate whether the initial notice of premium due complied with the procedures outline above.  For example, if the notice was sent only 10 days before the payment was due and the insurer cancelled the policy for non-payment, the insured could challenge the cancellation because the notice did not comply with the statute.  As long as the insured sought to cure the default by paying any outstanding premiums owed within the one-year grace period, the insurer would have to reinstate the policy.  If the insured dies within that one-year grace period, the insurer would have to pay the claim.

Note that without the benefit of this grace period, the insurance company may offer the policyholder the opportunity to have the policy reinstated but can require the insured to undergo new medical underwriting.  In other words, the insurer would have another opportunity to review the insured’s medical history and could decide not to re-issue the policy or to charge a higher premium than before.  If the insured’s health has declined since originally obtaining the life insurance, the new coverage may be more expensive or provide a lower benefit than under the policy as originally issued.  Thus, the one-year grace period provided by Section 3211 protects the insureds from losing affordable life insurance coverage.

Trief & Olk recently obtained the full $1 million owed under a life insurance policy issued by Protective Life Insurance to a New York resident when the notice was mailed 11 days prior to the date the premium was due.  Because the insured had recently moved, the notice apparently did not reach him prior to the date the payment was due.  He eventually received a follow-up notice after the policy had been cancelled and tried to have the policy reinstated but the insurer undertook new medical underwriting, which had not been completed by the time the insured passed away.  The beneficiaries sought our firm’s assistance and after a close review of the documents, we recognized that the premium notice had been sent 11 days from the due date, which was outside the timeframe provided by the statute.  After we demonstrated non-compliance with New York law, Protective Life Insurance agreed that the premium notice did not comply with Section 3211 and agreed to pay the policy proceeds in full, along with the interest that had accrued since the death.


Divorce Impacts Insurance Coverage Decisions

When a marriage ends in divorce, the parties’ attorneys should address issues relating to life insurance to ensure the parties’ intentions are fulfilled years later when an ex-spouse dies.  For example, the parties can include a provision in the divorce agreement requiring the party paying alimony and/or child support to maintain life insurance for the benefit of the former spouse.  This practice is a common tool to make sure that adequate funds are provided to the former spouse (and/or children) if the insured party passes away during the period when alimony and/or child support would have been owed.

Unfortunately, if the divorce agreement does not address life insurance at all or if the language in the agreement is unclear, disputes can arise after the insured former spouse passes away, resulting in the claim being denied or contested by multiple parties.  At Trief & Olk, our life insurance attorneys see many cases where different parties assert competing claims to the same insurance policy proceeds, such as disputes between children from the first marriage and the second spouse.

To avoid such a dispute regarding a life insurance claim, it is important for the attorneys who are handling the divorce to ask about any existing life insurance policies and the extent to which the parties intend for coverage to be maintained in the future for the ex-spouse and/or children; then the parties should take steps to put in place the coverage required and designate beneficiaries to comply with the terms agreed upon.  For example:

  • If the party providing child support is obligated to purchase life insurance, that party should make sure that the beneficiary is properly designated to show that the insurance proceeds are paid to an adult (usually the ex-spouse) on behalf of the children;
  • Steps should be taken to ensure that the party obtaining the coverage cannot change the beneficiaries without the consent of the party for whom the coverage is maintained;
  • The insured should notify the insurance company that payment of any insurance proceeds must comply with the terms of the divorce agreement or court order, and provide a copy of the relevant documentation; and
  • If the parties agree that the insured party can reduce the amount of life insurance coverage over time (such as when a child reaches the age of 21 or after a certain amount of alimony has been paid), the language in the divorce agreement should clearly reflect the parties’ understanding as to how such changes can be made and the amount of coverage that must remain.

One mistake that is sometimes made is assuming that a life insurance policy purchased while the couple was married will satisfy the obligation to obtain coverage, without making any changes.  If, however, no changes are made, the outcome could be the opposite of what the couple intended, depending on the law of the state where they reside.

In 26 states (including both New Jersey and New York), statutes provide that any life insurance beneficiary designations made prior to the divorce are considered to be revoked when the divorce is finalized, meaning it is as if the designation were never made.  These statutes are based on an assumption that the insured person usually would not want to keep the former spouse as the beneficiary of her life insurance policy but may have neglected to change the beneficiary after the divorce.  Although enforcing these statutes can lead to a result that is the exact opposite of what the parties wanted, the U.S. Supreme Court recently ruled that such statutes can be enforced, even if the statute in question was passed after the parties had divorced (and, thus, at the time of the divorce, they could not have asked their attorneys to plan accordingly).  Sveen v. Melin, 138 S. Ct. 1815, 1822-23 (2018).

The best solution for avoiding disputed life insurance claims that arise after a previous divorce is to plan in advance – making sure that the attorneys handling the divorce specifically consider what life insurance coverage should be in place and check to make sure that the beneficiary designations are documented properly to avoid later being undone by operation of state law.  If, however, you do have a dispute relating to life insurance proceeds, the life insurance attorneys at Trief &Olk are available to answer your questions and represent you if life insurance claim has been denied or is disputed by another purported beneficiary.  Feel free to consult our website for examples of the many successes we have had when competing parties contested payment of life insurance benefits or call us directly to discuss how we may help you.

Life Insurance Policies with Vanishing Premiums – and Vanishing Policies

Protecting Your Employer-Provided Life Insurance

Many employers offer their employees group life insurance coverage for which the employer pays the premiums.  The benefit offered (the amount of life insurance the employee’s family would receive if she passes away) may be for a fixed dollar amount or a multiple of the employee’s salary.  Employers may also offer the employee the option of adding supplemental life insurance coverage for which the employee pays the premiums.  Regardless of which type of coverage is obtained, the employer is the party that obtains the policy and deals with the life insurance provider.  Because the employee is not purchasing the life insurance directly, it is important for the employee and the employee’s family to understand the coverage provided through the employer, so that if the employee passes away, the beneficiaries will receive the insurance payments to which they are entitled.

At Trief & Olk, we see many cases where the employee or former employee passes away and the insurance company has improperly denied payment or the claim.  Typically, these cases come up when the employer uses a third-party intermediary to process the paperwork related to the life insurance: signing up new employees, processing change in beneficiary forms, and handling payment requests if an employee passes away.  Unfortunately, with a third party added to the mix, it becomes more likely that mistakes will occur and the claim denied:  often, paperwork is lost, key information about the employee provided to the life insurance company is incorrect or incomplete, and it is unclear who is accountable to the employee and the employee’s family.  Over the past few years, Trief & Olk has resolved similar denied claims for families without having to file suit, by carefully reviewing the paperwork sent to the employee or employee’s family and finding that the employer and/or life insurance company had not handled the life insurance coverage or payment properly.

To avoid these problems, it is advisable for the employee and family to understand the relevant details regarding the life insurance coverage well before any problem arises. When the employee first obtains coverage, the following steps are recommended:

  • Obtain a copy of any paperwork documenting the existence of the employer-provided life insurance, the amount of coverage, and the designated beneficiaries;
  • Obtain information regarding what steps beneficiaries must take in order to claim the benefit;
  • Obtain a copy of the documents describing the terms of the policy and/or the policy itself or become familiar with the basic information available through the employer’s website or employee benefits portal; and
  • Notify the next of kin (spouse, parent, child) that this coverage exists and where the documentation is stored, so they know to follow-up with the employer if the need arises.

If the employee becomes ill and is forced to leave his job, in many cases there is an option to continue the employer-provided life insurance coverage (and other employee benefits) after the employment ends.  The employee and family are often focused on dealing with the illness, not matters such as life insurance; however, it is important to find out from the employer (preferably before the employment terminates) whether any coverage continues after the employee leaves the company, and if so, what steps must be taken to ensure the coverage continues. “Don’t Lose Life Insurance Coverage When You Need It Most – When You Are Gravely Ill”

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 properly process the claim.  The life insurance attorneys at Trief & Olk are available to answer your questions and represent you if life insurance claim 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.

Buying and Selling Life Insurance Policies in New York

Trief & Olk Victorious at Trial Challenging Denial of Life Insurance Proceeds, Recovers $3 Million

In a case tried before Justice Francis A. Kahn III of the Supreme Court of New York, Bronx County, Trief & Olk successfully prevailed in claims brought against William Penn Life Insurance Co., recovering $3 million (plus interest) in insurance proceeds owed on the life of Jhonny Jaar.  You can read the decision here.

Mr. Jaar was a key executive in Global Energy Efficiency Holdings, Inc. (“Global Energy”).  Due to Mr. Jaar’s important role in the company, Global Energy purchased “key man” insurance on Mr. Jaar’s life in two policies (one issued in 2012 and the other in 2013), for coverage totaling $3 million. Early in 2014, Mr. Jaar passed away.  Global Energy submitted to William Penn a claim for the insurance benefits payable under the policies. Because Mr. Jaar’s death occurred within two years of the policies being issued – during what is known as the contestability period – William Penn was entitled to conduct an investigation to ensure that the information provided in the applications for the policies was accurate and complete. Autopsy results showed that Mr. Jaar had marijuana, ketamine, and ecstasy in his blood at the time of his death, causing William Penn to investigate Mr. Jaar’s history of using these substances.  After obtaining additional background information, William Penn denied payment of the insurance proceeds on the grounds that Mr. Jaar had smoked and/or used drugs at the time of the applications and failed to disclose these facts, materially misrepresenting the risk of insuring his life.

Global Energy filed suit for breach of contract against William Penn, claiming that Mr. Jaar did not smoke (tobacco or marijuana) or use drugs at the time of the applications but that any use of these substances began shortly before his death.  Despite testimony from every witness who knew him well (including his widow) that Mr. Jaar was not a smoker and did not use drugs in the key 2012-2013 time frame, William Penn persisted in its denial of payment based on its theory that Mr. Jaar had misrepresented his history of smoking and/or drug use.

The parties tried the case without a jury in June 2018; Justice Kahn issued his memorandum opinion on October 22, 2018, finding that William Penn did not meet its burden to establish that Mr. Jaar had made any material misrepresentation on the life insurance applications. In particular, Justice Kahn found that the testimony of William Penn’s forensic expert, Dr. Michael Baden (who served as an expert in the O.J. Simpson trial) was not convincing, particularly in light of his reliance on inadmissible, unreliable hearsay statements.

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.

New York Life Insurance Claim Lawyer

Cause of Death Usually Does Not Impact Life Insurance Payment


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

NY High Court Rules on Ability to Transfer Life Insurance Policy To Non-Family

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.


 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.


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.