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Life insurance claim investigation uncovers bad policy management by insurer resulting in $5 million death claim payout.
MIAMI - ncarol.com -- The Center for Life Insurance Disputes recently represented the widow of a Florida dentist in a $5 million life insurance claim dispute. The widow tried to file a claim for the death benefits of a life insurance policy upon her husband's death but was told by the insurer the policy had lapsed two months before his death.
The life insurance was intended to take care of her financial needs after his death. It appeared there would be nothing for her. She was devastated.
The widow retained the Center for Life Insurance Disputes (the Center) to investigate and establish if she had a valid claim.
From their claim investigation the Center found that the insurer had been providing the husband with incorrect policy information for at least 2 years before the policy lapsed. It also uncovered that the insurer had sent more than one set of premium notices that showed different amounts owed at about the same time. And finally, the Center determined that the insurer was managing the policy under the rules and regulations of the wrong state.
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One especially critical policy management violation by the insurer was that the insured was being mailed policy status statements quarterly and annually but the information didn't match when it should have. The policy information on the last day of the year should have been the same on both the Quarterly Statement and the Annual Statement – it wasn't.
The Center argued that these errors caused the policy to lapse, not the policyowner.
Life insurance companies are obligated to provide accurate and reliable information to their policyholders. The information an insurer provides -- especially for universal life insurance and whole life policies -- sets the foundation for how a policyowner can keep their policy in good standing. When the information is faulty so too will be the owner's efforts to pay enough premium.
The Center presented their findings to the life insurance company and it was met with skepticism and pushback. The insurer bellowed that their systems were reliable. Their aggressive stance didn't deter the Center, which knew the facts would prove them correct. After several rounds of document sharing and arguments the insurer conceded by paying the claim -- but not admitting any wrongdoing.
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This was not just a violation of a single policy and its effect on a beneficiary. The mismanagement of the policy by the insurer affected everyone whose policy was being managed by the same computer system and practices.
The widow received her $5 million life insurance claim payment.
The life insurance was intended to take care of her financial needs after his death. It appeared there would be nothing for her. She was devastated.
The widow retained the Center for Life Insurance Disputes (the Center) to investigate and establish if she had a valid claim.
From their claim investigation the Center found that the insurer had been providing the husband with incorrect policy information for at least 2 years before the policy lapsed. It also uncovered that the insurer had sent more than one set of premium notices that showed different amounts owed at about the same time. And finally, the Center determined that the insurer was managing the policy under the rules and regulations of the wrong state.
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One especially critical policy management violation by the insurer was that the insured was being mailed policy status statements quarterly and annually but the information didn't match when it should have. The policy information on the last day of the year should have been the same on both the Quarterly Statement and the Annual Statement – it wasn't.
The Center argued that these errors caused the policy to lapse, not the policyowner.
Life insurance companies are obligated to provide accurate and reliable information to their policyholders. The information an insurer provides -- especially for universal life insurance and whole life policies -- sets the foundation for how a policyowner can keep their policy in good standing. When the information is faulty so too will be the owner's efforts to pay enough premium.
The Center presented their findings to the life insurance company and it was met with skepticism and pushback. The insurer bellowed that their systems were reliable. Their aggressive stance didn't deter the Center, which knew the facts would prove them correct. After several rounds of document sharing and arguments the insurer conceded by paying the claim -- but not admitting any wrongdoing.
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This was not just a violation of a single policy and its effect on a beneficiary. The mismanagement of the policy by the insurer affected everyone whose policy was being managed by the same computer system and practices.
The widow received her $5 million life insurance claim payment.
Source: The Center for Life Insurance Disputes
Filed Under: Business
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