Legal Question in Insurance Law in Florida

death benefit denial by insurance company

Just prior to passing away my father took out a $20,000 life insurance policy. I helped him fill out and send in the application with the standard medical questions. He was also required to do a personal phone interview. All information on the application was accurate to the best of my knowledge and he answered all questions asked by the insurance company truthfully. After he passed away, because the policy was less than 2 years old the insurance company did an investigation to contend the claim. They have denied payment of the claim based on information received from the V.A. stating that my father was treated for and received nitroglycerine therapy for a heart condition. This information was not on the application for insurance. I contend that the information was not intentionally left off the application because he did not remember everything he had been treated for over the last 2 year period. Also, the insurance representative had an opportunity to ask these questions during the phone interview. I feel that the insurance was purchased in good faith without intention to defraud. My question is do I have any recoarse or am I at the mercy of the insurance company?


Asked on 5/31/02, 9:30 pm

2 Answers from Attorneys
Michael Tobin Michael M. Tobin, P.A.

Re: death benefit denial by insurance company

An accurate and reliable reply cannot be given without examining the application, the policy and the VA records. You are only at the mercy of the insurance company if you fail to consult with an attorney experienced in these matters. Even if all the things you say are true the insurance company has a clear obligation to return all premiums paid by your father. I have won cases solely on the basis of the failure to return the payments within a reasonable time. Other attorneys had declined the case because the misrepresentation was obvious. But every case has its own unique facts and even judges may disagree on the same facts. Litigation is an art, not a science. Insurance companies will routinely deny claims hoping their answers will be blindly accepted and dropped. Free attorney consults are available and in Florida the insurance company can be tagged with your attorneys fee on top of the policy benefit. You have nothing to lose but your time and effort. Call me at 305-445-5475 if you want a review and I can suggest a lawyer in your home area.

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Answered on 6/01/02, 9:58 am
David Slater David P. Slater, Esq.

Re: death benefit denial by insurance company

Althought to be sure I would have to read the policy, I am sure the carrier reserved a contestability clause. It wouldn't matter if your father intentionally or unintentionally failed to inform them of a heart condition. It is a material omission. Sorry.

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Answered on 5/31/02, 9:57 pm


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