Denied Accidental Death Life Insurance Benefits
Denied Accidental Death Life Insurance Benefits
For the second time in less than two weeks, Mark Wolfe of Boteler, Finley & Wolfe has helped a local family recover accidental death life insurance benefits that were originally denied by the insurance company. In this most recent case, Mark was able to secure the benefits through the Federally required appeal process. In the other case, a lawsuit was required in State court but benefits were paid after written discovery and depositions had been completed.
Both matters centered around "coverage exclusions" in the accidental death insurance policies. According to Wolfe, most accidental death policies, or double indemnity provisions in life insurance policies, have a number of exclusions that insurance companies can fall back on to try and deny benefits. "These exclusions can apply even if the death certificate lists the cause of death as accidental," he said.
According to Wolfe, most people do not realize just how many exclusions are contained in accidental death life insurance policies nor do they understand the legal issues related to the application of these exclusions to the facts of the death. "These type of claims can be very legally technical and medically complex," he said. He further stated that many claimants do not seek legal advice after a claim is denied because the insurance company usually sends out a "detailed" letter explaining why the benefits are being denied and often these letters reference medical conditions or contain lots of legal jargon. "These denial of benefits letters are intended to be intimidating and designed to discourage the claimant from pursuing the matter further." However, Wolfe pointed out that a qualified and experienced insurance claims attorney can review the denial of benefits letter and investigate the denial further to determine if the denial is actually legitimate. He reported, "I helped one family that had received a two page denial of benefits letter explaining in complex medical detail what information from the deceased’s hospital records supported their position that the death was not accidental. The letter just didn’t seem right to me so I got involved and it turned out the company had simply reviewed the hospital admission summary and the death discharge report. They failed to review or consider a CT scan during the hospital stay prior to death that showed a large cerebral hemorrhage. I had the CT scan results reviewed by a radiologist and a neurosurgeon who both concluded that the hemorrhage was traumatic in origin and most likely from the fall the deceased had in her bathroom prior to being admitted to the hospital. On behalf of the family, I presented the insurance company with affidavits from both doctors confirming that the death was in fact accidental and the company paid the benefits as well as additional damages for the wrongful denial of insurance benefits."
Wolfe, who has been helping individuals present and prosecute insurance claims since 1988 and is one of America's best lawyers, urged anyone who has a claim for accidental death life insurance benefits denied to consult with an experienced insurance claim attorney. This is especially true if the insurance policy in question was provided through an employer. He also said, "most attorneys who practice in this area of law provide free consultations and will only charge a fee if they recover the benefits in dispute." If you have questions about a denied life insurance claim, e-mail Mark today at firstname.lastname@example.org
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