Thousands of Americans each year plan for their futures with life insurance policies. The process can be rigorous, but at the end, the insured feels confident that he has done the right thing for his loved ones, and can face whatever the future brings without worrying about their well-being.
But more and more, insurance companies in America are refusing to pay benefits to the beneficiaries of these life insurance policies. They use any tactic possible in order to rescind the policy, in hopes that the beneficiaries that are bogged down in mourning and painful emotions will be unwilling or unable to fight back. After all, even during the best times of our lives, few of us feel equipped to take on these giant insurance companies and feel confident that we will win. During times of mourning and loss, we all feel even more uncertain.
This is why you need the denied life insurance benefits attorneys at Kirkendall Dwyer LLP on your side. We can take the burden off of you, and provide you with the representation strong enough to get the results you want. You do not have to be alone during this difficulty time. Call Kirkendall Dwyer LLP today for a free consultation regarding your case.
How and Why are Life Insurance Companies Doing This?
In acquiring life insurance, an individual not only has to get approved, but then has to keep up to date with premium payments. An insured individual can rest easy knowing their insurance policy is paid to date, and her loved ones will be taken care of in the worst situation. Right? Not always.
Even when premiums are paid to date, it is possible that the insurance company will not pay your claim. There is plenty of fine print in every insurance policy, and even when the situation does not fall in the exclusion category, insurance companies utilize tactics in order to deny a claim. Some of these tactics may include:
- Twisting facts, such as alleging undisclosed mental health issues, drug or alcohol dependencies, or claiming suspicious circumstances surrounding the death
- Fabricating excuses, such as invoking irrelevant laws and legal standards
- Ignoring medical evidence, including autopsy reports and findings from the medical examinerIn the majority of instances, insurance companies do pay out the policy to the beneficiaries. We hope that you are in this group of beneficiaries who never have to worry about facing down an insurance company. There are plenty however, that do not. In 2009 insurers disputed $1.3 billion in claims. While insurance companies are fast to try to sell insurance, and have often even used illegal tactics to procure large group policies, when it comes to paying on these policies, they will often use any method available to keep from paying the money.
Just how far are insurance companies willing to go to procure your business? In the past decade, insurance giants MetLife and Prudential have each had to settle and pay out on accusations that they made undisclosed, improper payments to brokers in order to win new corporate clients. In one case, MetLife admitted its illegal actions, and was forced to pay the U.S. Justice Department $13.5 million in order to avoid criminal prosecution.
These are the lengths insurance companies are willing to go to in order to get your premiums. They are willing and capable of the same deceptions when it comes to denying your claim, because it means more money in their pockets.
ERISA–Providing Protection to Insurance Companies, Not Individuals
Unfortunately, the laws that are meant to protect the public actually are skewed to provide better protection to the insurance companies. ERISA, the Employee Retirement Income Security Act, was a federal act intended to protect individuals from widely varied state laws that lacked uniformity and consistency. While the notion underlying ERISA may seem noble, it has not provided even a semblance of the types of protections initially intended.
In fact, it has created many more hurdles for individuals to cross when dealing with insurance companies that deny claims or refuse to pay a survivor what is owed. Individuals can not get assistance from local and state insurance agencies, because they have no jurisdiction over these insurance claims.
Another major disadvantage to ERISA is that no matter how egregious an insurance company’s behavior, compensatory and punitive damages may not be awarded, nor may there be jury trials in these cases. In many cases, the behavior of the insurance company may have been bad enough for a jury to grant millions of dollars in punitive or compensatory damages, but instead the insurance company does not even get a slap on the wrist. In the best case scenario, the judge will find that the insurance company wrongly denied the claim, and the insurance company has not lost anything, or has not been punished in any way.
In fact, ERISA almost encourages insurers to drag litigation out. Not only do they not have to operate under the threat of jury trials or exemplary damages, but they are also allowed to keep and invest the money while any claims are under dispute, even when they are in court. There is essentially no motivation for insurance companies to hurry through the legal process, or to even have the contest resolved.
Despite the fact that individuals have limited recourses against insurance companies in these cases, they are able to pursue claims under ERISA. But insurance companies will take great efforts to convince those that have been denied that there is no point in suing, and that the denial is just another unfortunate fact that has to be accepted. More often than not, the survivors believe the insurance company. They either don’t believe that the insurance company would blatantly lie, or they do not believe themselves to be strong enough to fight against the insurance company.
This is far from the truth. You have every right to fight back, and you should. With the proper representation on your side, you can get the money that you deserve. Your loved one intended for you to be protected in case the worst happened, and we can help ensure that that is the case. The attorneys at Kirkendall Dwyer LLP can help you hold the insurance company responsible for its actions. You are entitled to the benefits of your loved one’s life insurance policy. Let us help make sure you get what you deserve.
Twisting the Facts
As we’ve discussed, because of the way life insurance is regulated by ERISA, insurance companies have very little to discourage them from holding out on policy payments through litigation. One way that they may drag out litigation is by twisting the facts.
One of many such stories is the story of Ernest Loan. Mr. Loan had a life insurance policy at the time of his death. After a few glasses of wine, Mr. Loan fell down a flight of stairs in his house and died. Prudential refused to pay the benefits of the policy to his widow, claiming that under drunk driving laws, Mr. Loan had been legally intoxicated.
The judge in the case sided with Prudential, stating that this was sufficient under ERISA. Fortunately Mr. Loan’s widow pursued an appeal, and the ruling was reversed by the Sixth Circuit Court of Appeals, which pointed out that Mr. Loan was not driving or operating any sort of machinery when he fell to his death in his own home. Prudential was citing a completely irrelevant legal standard in order to somehow criminalize Mr. Loan’s behavior.
Had the survivor not aggressively pursued the case, she would have been denied the $300,000 policy.
Another way that the world of life insurance is skewed in favor of the insurance companies is ERISA’s low burden of proof. In many cases, insurers will twist the facts and make allegations with only the barest offer of proof. Often no medical evidence or testimony will be presented. In fact an internet search may be the only form of proof an insurance company provides during the case, and the judge may still have to find it sufficient because the threshold for proof is so low. An insurer need only show the most modest reasonableness in order to have its decision upheld.
If you find yourself in the unfortunate situation of facing an insurance company in such a situation, contact the attorneys at Kirkendall Dwyer LLP to discuss your case. Often, in order to succeed, you will need serious representation to fight on your behalf. We can provide the immediate answers that you need in order to move forward. Call our attorneys today.
Retained-Asset Accounts: Another Way for the Insurance Companies to Keep Your Money
As you can see, from start to finish, insurance companies utilize every trick in the book in order to keep your money in their bank accounts. Even when they know they will have to pay, they still manage to create ways to keep your money for as long as possible.
One such methodology is the ‘retained-asset account’. Instead of paying the beneficiaries a lump sum of the money to which they are entitled, insurance companies often send a ‘checkbook’ to the survivor, which allows them limited access to the money. In many cases, survivors will repeatedly request a lump sum check from the insurance company, but the requests are simply ignored.
One particularly egregious case of insurance companies utilizing these retained-asset accounts is with regards to Prudential. Prudential provided life insurance policies to many soldiers, and instead of paying lump sums to the families of those who had passed away in combat, they would send these checkbooks. Once the US Department of Veterans Affairs found out about this, they forced the company to begin paying lump sums when they were requested.
Unfortunately, this has not changed the way insurers conduct themselves with all cases. It is still commonplace to find survivors requesting lump sums, but being ignored despite multiple requests.