Legal Question in Insurance Law in Georgia

beneficiary rights

My 25 year old son Passed away in January. He had only one insurrance policy. It was an accidental death policy he had through his checking account. He had me listed as his beneficary. My son was married but has lived apart from his wife for about a 1 1/2 years. She has been living with another man and has a child with that man. The insurrance company unum life insurrance company of America has sent me a form telling me I must sign a medical release form for my son before they can complete the claim. My question is do I have the legal right to do that and what happens if I don't. I have never heard of the place the request is for and I know my son had never heard of them either. My sons death certificate says accidental. His toxicology says methodone. The place the release was questioned for is type of rehab. center. Thank you so very much for your time.

Asked on 6/01/08, 10:17 pm

2 Answers from Attorneys

Ronald Arthur Lowry Ronald Arthur Lowry
0 users found helpful
0 attorneys agreed

Re: beneficiary rights

First, please accept my condolences for the death of your son. It is a very difficult thing for a parent to have to deal with a child's death. You need to know right off the bat that UNUM is one of the worst insurance companies about trying to avoid paying claims. In fact, UNUM was sanctioned by vitually all the insurance commissioners of all the states in the US acting together, including Georgia, a few years ago and fined many millions of dollars for fraudulently denying disability insurance claims. I have a copy of the Order in my office if you would like to see it. Accidental death policies are notoriously easy devices for an insurer to trump-up an excuse to avoid paying because the beneficiary has to prove the deceased died as a result of an accident.There are all sorts of ways to argue "not an accident" and the finding of a medical examiner or coroner is not binding on the insurance company. There are also a lot of cases under Georgia law and also Federal law which, unfortunately, give ammo to the insurer to avoid paying. For example, if the policy has an exclusion for "self-destruction" there are cases that say taking drugs or abusing alcohol qualifies as self-destruction. Another way they use to get off the hook is the "illegal act" exclusion whereby they contend that the insured died as a result of committing a crime. That exclusion is sometimes used when the insured is killed in a car wreck but was driving drunk or recklessly at the time of the wreck. The fact that the insurer has asked you to sign a document to get medical records from a drug treatment facility strongly suggests that the insurer is looking for a way out of paying the claim. You need a lawyer who is an expert in insurance claims NOW. Do not wait any longer. You may already have damaged your claim by waiting this long. Also, do NOT get just any lawyer. Most lawyers who do criminal defense or divorces and the like will not know how to proceed properly. Get a bona fide insurance attorney. You should be able to find one within reasonable driving distance by using the internet. You will have to cooperate with the insurer by signing any document reasonably calculated to assist that company with its investigation and if you do not they can use that as a basis for denying the claim. Get the lawyer before you sign anything. Good luck.

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6/02/08, 1:43 pm
Ronald Arthur Lowry Ronald Arthur Lowry
0 users found helpful
0 attorneys agreed

Re: beneficiary rights

First, please accept my condolences for the death of your son. It is a very difficult thing for a parent to have to deal with a child's death. You need to know right off the bat that UNUM is one of the worst insurance companies about trying to avoid paying claims. In fact, UNUM was sanctioned by vitually all the insurance commissioners of all the states in the US acting together, including Georgia, a few years ago and fined many millions of dollars for fraudulently denying disability insurance claims. I have a copy of the Order in my office if you would like to see it. Accidental death policies are notoriously easy devices for an insurer to trump-up an excuse to avoid paying because the beneficiary has to prove the deceased died as a result of an accident.There are all sorts of ways to argue "not an accident" and the finding of a medical examiner or coroner is not binding on the insurance company. There are also a lot of cases under Georgia law and also Federal law which, unfortunately, give ammo to the insurer to avoid paying. For example, if the policy has an exclusion for "self-destruction" there are cases that say taking drugs or abusing alcohol qualifies as self-destruction. Another way they use to get off the hook is the "illegal act" exclusion whereby they contend that the insured died as a result of committing a crime. That exclusion is sometimes used when the insured is killed in a car wreck but was driving drunk or recklessly at the time of the wreck. The fact that the insurer has asked you to sign a document to get medical records from a drug treatment facility strongly suggests that the insurer is looking for a way out of paying the claim. You need a lawyer who is an expert in insurance claims NOW. Do not wait any longer. You may already have damaged your claim by waiting this long. Also, do NOT get just any lawyer. Most lawyers who do criminal defense or divorces and the like will not know how to proceed properly. Get a bona fide insurance attorney. You should be able to find one within reasonable driving distance by using the internet. You will have to cooperate with the insurer by signing any document reasonably calculated to assist that company with its investigation and if you do not they can use that as a basis for denying the claim. Get the lawyer before you sign anything. Good luck.

Read more
6/02/08, 1:44 pm

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