Legal Question in Insurance Law in Georgia

Life Insurance

I have a family member that recently passed away in his sleep. To his wife and families knowledge there was no prior medical issue. Ins. company says that since the policy is 3 months from being 2 years from purchase that they will not pay off. Is this legal? They still want 10 years medical history on the deceased family member and still saying they will not pay off due to the policy not being 2 years old.

Asked on 12/07/07, 1:39 pm

3 Answers from Attorneys

David Glass Law Offices of David H. Glass, LLC

Re: Life Insurance

In order to answer the question properly, I would need to review the life insurance policy in full. I would assume the insurance company is hoping to nullify the policy because the recently deceased person omitted health problems when he/she applied for the coverage. This is called errors and omissions. However, that does not necessarily allow them to deny coverage.

If you would like for me to have a look, please call my office, 404.529.9081.

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Answered on 12/07/07, 2:21 pm
James Sadd Slappey & Sadd, LLC

Re: Life Insurance

May or may not be legal. Depends on how it is written in the policy. If there isno coverage, they should not be asking for additional information.

If you would like to discuss, feel free to call.



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Answered on 12/07/07, 3:45 pm
Ronald Arthur Lowry Ronald Arthur Lowry

Re: Life Insurance

Most life insurance policies have a clause that says that after a certain amount of time (usually one year but I have seen policies with other time periods such as two years) the insurer cannot contest the claim based on a misstatement in the application. This clause is commonly called an "incontestability clause." I am certain that is what the insurer is talking about. In order to avoid paying the claim the insurer has to identify at least one "material misrepresentation" on the face of the application. Even if there is not one they will say there is and use some innocent mistake if they can to void the coverage. This is VERY tricky litigation and needs someone who is an expert at this type of case. The average attorney will not understand the nuances. It takes someone with considerable experience in insurance law. The insurer has such attorneys on retainer (I know, I used to be one of them) and already has a legal theory to travel under identified in a memo from its lawyers. I have said for years that the insurer has an argument to get out of paying buried in every policy. The insurer then pays the small claims. It only trots out the argument when the policy is a big claim or if something happened to piss off someone at the company. Get a GOOD insurance lawyer to look at this. If the denial is bogus you possibly can get a bad faith penalty of 50% plus an award of attorney fees on top of the face amount of the policy. Don't give up. That is what they want you to do. Good luck.

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Answered on 12/07/07, 9:59 pm

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