Life Insurance Claim Issue

[sly_wolf 199]

Hi. We need some advice regarding a life insurance claim.

My stepson passed away unexpectedly 3 months ago. We received the final death certificate 2 weeks ago due to required autopsy and applied for a claim. This is the part that really pisses me off. Because my stepson passed away a few days before the second aniversary of the policy, they wont guaranttee any payment because they need to investigate the claim. The autopsy found nothing unusual. We are trying to recoup the cost of the funeral and they are scewing around over such small $'s. I just dont understand how they can screw with people like this after a death. My stepson's death was totally unexpected and a big shock to the whole family. Our society has gotten so F'n greedy that anything goes now ... dammit. I am debating on whether to consult a lawyer on this but I dont trust them either .... another long story.

Anyone with some advice please? I am just so pissed!

[Dan and Judy 614]

Hi. We need some advice regarding a life insurance claim.

My stepson passed away unexpectedly 3 months ago. We received the final death certificate 2 weeks ago due to required autopsy and applied for a claim. This is the part that really pisses me off. Because my stepson passed away a few days before the second aniversary of the policy, they wont guaranttee any payment because they need to investigate the claim. The autopsy found nothing unusual. We are trying to recoup the cost of the funeral and they are scewing around over such small $'s. I just dont understand how they can screw with people like this after a death. My stepson's death was totally unexpected and a big shock to the whole family. Our society has gotten so F'n greedy that anything goes now ... dammit. I am debating on whether to consult a lawyer on this but I dont trust them either .... another long story.

Anyone with some advice please? I am just so pissed!

Sorry to hear about your stepson, You sure dont need this ####### at a time like this.

Instead of consulting a lawyer who would charge an outrageous fee, Call the state agency in charge of insurance in your state. I believe each state has it's own agency to regulate insurance.

If you dont get satisfaction from the agency in a week or less, call your state congressman, The guys that make the laws within your state, not the guys that go to washington. they have a staff

that checks into things like this so you will be happy and vote for the congressman in the next election. Dont worry if you voted for their opponet last time, they will help you anyway.

More than likely if you read the insurance policy (nobody ever does) it probably gives them a right to investigate. It probably limits the amount of time they have to investigate. If they make a decision that they wont pay because they think there was fraud, then you can appeal to your state agency and they would probably make the final decision Unless the policy would be considered excessive like$100,000 or something they

should probably be able to do a relatively quick routine investigation and give you your money.

So far the big delay seems to have been caused by goverment bureaucracy. If nothing has happened a month from now, most communities have a local news station that has some kind of consumer reporting. They look into it and do a news report. None of the people above, the Ins company, the regulatory agency, or the congressman wants their name in a news story about

a legitimate claim not being paid.

Good luck

Dan

[sly_wolf 199]

Sorry to hear about your stepson, You sure dont need this ####### at a time like this.

Instead of consulting a lawyer who would charge an outrageous fee, Call the state agency in charge of insurance in your state. I believe each state has it's own agency to regulate insurance.

If you dont get satisfaction from the agency in a week or less, call your state congressman, The guys that make the laws within your state, not the guys that go to washington. they have a staff

that checks into things like this so you will be happy and vote for the congressman in the next election. Dont worry if you voted for their opponet last time, they will help you anyway.

More than likely if you read the insurance policy (nobody ever does) it probably gives them a right to investigate. It probably limits the amount of time they have to investigate. If they make a decision that they wont pay because they think there was fraud, then you can appeal to your state agency and they would probably make the final decision Unless the policy would be considered excessive like$100,000 or something they

should probably be able to do a relatively quick routine investigation and give you your money.

So far the big delay seems to have been caused by goverment bureaucracy. If nothing has happened a month from now, most communities have a local news station that has some kind of consumer reporting. They look into it and do a news report. None of the people above, the Ins company, the regulatory agency, or the congressman wants their name in a news story about

a legitimate claim not being paid.

Good luck

Dan

Thanks. The claim is very legitimate and the $ amount is much less than $100K. We did read that they can contest the claim within a 2 year period, but I expected that would be in cases of suicide or fraud which would make sense. I will check into your suggestions. We definitely dont need this #######. I guess they dont have any problems sleeping at night.

[Deputy Purple 1,294]

What you received is probably an automatically generated form letter simply acknowledging receipt of your claim and then having some stuff based of flags in the database (such as claim filed before 2 years).

Since you state that you've only had the death certificate for 2 weeks I take it the claim was just recently filed. Maybe follow-up with them weekly until you get a decision.

[Krikit 1,163]

My condolences, Sly_Wolf.

[sly_wolf 199]

What you received is probably an automatically generated form letter simply acknowledging receipt of your claim and then having some stuff based of flags in the database (such as claim filed before 2 years).

Since you state that you've only had the death certificate for 2 weeks I take it the claim was just recently filed. Maybe follow-up with them weekly until you get a decision.

No. I did speak to the individual that signed the letter and he was non-committal and provided no clarity. I would really have liked too slap him across the head. I have no patience for anyone screwing with us.

My condolences, Sly_Wolf.

Thank you, Krikit

[Deputy Purple 1,294]

No. I did speak to the individual that signed the letter and he was non-committal and provided no clarity. I would really have liked too slap him across the head. I have no patience for anyone screwing with us.

Don't take it as being screwed with. There are rules and conditions as with any policy and they have to follow through with them. Remember that to the insurance company you are not a person they care about (I don't mean this is a bad way) but you are a business transaction. They are regulated and if they don't follow the documented processes and get caught it will cost them a lot down the road.

[sly_wolf 199]

Don't take it as being screwed with. There are rules and conditions as with any policy and they have to follow through with them. Remember that to the insurance company you are not a person they care about (I don't mean this is a bad way) but you are a business transaction. They are regulated and if they don't follow the documented processes and get caught it will cost them a lot down the road.

As long as they meet their proper obligations, I won't ..... and I already know they dont care about us. We are waiting for them patiently!

[Hugglebuggles 60]

So sorry to hear about your step-son sly

I'm an insurance agent, but I work in auto and home, not health and life, so I really don't have any direct experience when it comes to what you're dealing with. But, I can say that investigations are standard when it comes to the claims process, regardless of what a claim is for. In a property claim for example, it is pretty easy for an adjuster to come and verify there is hail damage to your roof or siding. When it comes to life insurance, investigating the circumstances around someones death is not as convenient and quick.

If you feel as though you are being wronged in some way, you can always contact the commissioner of insurance in your state. The commissioner overseas all insurance companies that are licensed to operate in your state, and it is part of his or her job to insure companies are operating ethically and following state laws. However, they may not provide much service until a decision is made on your case, but I can't be certain. If it is denied for whatever reason, putting a complaint in with the commissioner will force an investigation. Otherwise, if the claim is paid and you are still unhappy with the process, you can still log a complaint which will at least be on record, and may force an investigation into the companies practices.

As far as a lawyer, that is up to you. Lawyers can actually be quite effective. Insurance companies often do whatever they can to avoid a lawsuit, and will sometimes just pay out a claim to avoid a confrontation in court.

[Tunc 0]

I am life insurance agent. I am sorry to hear about your loss.

When a death occurs in the first 2 years of a life insurance policy, all death claims are investigated and payments are on hold. This is standard industry practice. Life insurance company can deny benefits if the application was missing medical information or something material was not disclosed. Most of the will pay a death claim after 2 years has passed since the life policy was issued. I would wait for the life insurance company to make a decision before hiring a lawyer. They need to receive all the medical records before making a decision.

Edited December 8, 2010 by Tunc

[sly_wolf 199]

So sorry to hear about your step-son sly

If you feel as though you are being wronged in some way, you can always contact the commissioner of insurance in your state. The commissioner overseas all insurance companies that are licensed to operate in your state, and it is part of his or her job to insure companies are operating ethically and following state laws. However, they may not provide much service until a decision is made on your case, but I can't be certain. If it is denied for whatever reason, putting a complaint in with the commissioner will force an investigation. Otherwise, if the claim is paid and you are still unhappy with the process, you can still log a complaint which will at least be on record, and may force an investigation into the companies practices.

As far as a lawyer, that is up to you. Lawyers can actually be quite effective. Insurance companies often do whatever they can to avoid a lawsuit, and will sometimes just pay out a claim to avoid a confrontation in court.

Thanks for the advice.

I am life insurance agent. I am sorry to hear about your loss.

When a death occurs in the first 2 years of a life insurance policy, all death claims are investigated and payments are on hold. This is standard industry practice. Life insurance company can deny benefits if the application was missing medical information or something material was not disclosed. Most of the will pay a death claim after 2 years has passed since the life policy was issued. I would wait for the life insurance company to make a decision before hiring a lawyer. They need to receive all the medical records before making a decision.

What would be considered a reasonable wait period? Our son had a mild seizure disorder (epilepsy) which was being treated with meds and fully disclosed to the insurance co. He was in perfect health otherwise and very athletic. Normally people do not suddenly die from an epilepsy condition but we unfortunately found out that it can happen .... something very rare. His death was not due to having a seisure at the time ..... he just passed away quietly in bed. That day we will never forget.

The insurance nonsense is just something we really dont need.