Legal Question in Insurance Law in Pennsylvania

overlooked insurance policy

My late mother had taken an insurance policy for her brother. At the time of his death (2002), the policy was paid in full. She had notified the company of his passing and submitted a death certificate. 3 months later she fell and had a SDH. She suffered some memory and cognitive problems,and later passed away. Going through her paperwork recently, the policy was never redeemed. The policy had a 2 year time limit to submit. Is the insurance company able to deny payment to her estate?


Asked on 2/09/06, 9:32 am

2 Answers from Attorneys
Richard Teitell Richard K. Teitell, Esquire, P.C.

Re: overlooked insurance policy

A thorough review of the policy needs to be performed. If the death cert was submitted within 2 years, there may be enough time to file a law suit if the 4 year statute of limitations applies. You need to have a lawyer review this ASAP. Please contact my office if you need more help. Good luck!!

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Answered on 2/09/06, 11:47 am
Roger Traversa Arjont Group (Law Office of Roger Traversa)

Re: overlooked insurance policy

It depends. Very often the "four corners" of a contract will trump. But in this case it will result in an unjust enrichment for the insurer. Because of the time limitation they will claim entitlement to money which they rightly should have paid. While the contract will bear weight I think it could be overcome by the strong intervening incident and the theory of unjust enrichment. There are also various other methods and claims that may be available to shake the money free.

That said, the insurer will not roll over and just offer up the payment on the policy. This situation calls for an someone who can negotiate around and with the insurer and possibly the people who regulate the insurer. It's even possible that the matter would not be settled without a lawsuit.

No matter what you should pursue it. The value of the insurance policy will dictate how much to pursue. Of course it would make no sense to spend 110 percent of the proceeds to capture the claim but it may only cost 10 percent and may even be worth it to you to spend a higher percentage.

I can't give you any more definite information without seeing the contract. Please be aware that the time you have to act may be extremely limited and you should consult with an attorney right away. I would be happy to speak with you about this or any other legal matter. You can tact me at [email protected]

Regards,

Roger Traversa

Arjont.com

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Answered on 2/09/06, 10:35 am


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