Joan Odorowski

Attorney at Law

18530 Mack Ave., Suite 286
Grosse Pointe Farms, MI 48236

(313) 926-6688

Email:
This e-mail address is being protected from spambots. You need JavaScript enabled to view it.

Websites:
www.michiganinsurancelawyerfreeconsultation.com
www.counselorjoan.com

Contact Information
Call Today!

(313) 926-6688

Articles

Life Insurance Denials Can Be Contested!

Why Life Insurance Claims Are Denied:

I have found that life insurance companies often look for excuses not to pay benefits for which the insured has paid premiums for years, or often decades. These excuses usually fall into one of three categories:

Excuse #1: Health History Misrepresented in Original Application

Life insurance applications ask many questions about the insured person's health history. The insurance company typically requires the insured to have a physical examination before the policy is issued. If the insured dies within the next two years, the insurer will look very closely at the application, obtain the insured's medical records, and decide whether the insured made any errors in the application about his or her health history. If so, the insurer will probably deny the claim.

If your claim has been denied for this reason, please contact me. Your benefits may have been wrongfully denied! Oftentimes, the insured person (now deceased) was not aware of the health condition that was misstated or not disclosed, or that the insured person forgot about the condition because it had been diagnosed long ago and/or there was no medical treatment of it. In some cases, the insurance company was not misled by the misstatement or omission, because its own physical exam revealed the health condition. In other cases, the misrepresentation had no relationship to the cause of death. I have handled cases in which I was able to obtain payment of the insurance claim through settlement negotiations or in a court case.

Excuse #2: Death was not "Accidental"

Many life insurance policies pay benefits only if the insured died as the result of an accident, or pay additional benefits ("double indemnity") for death caused by accident rather than illness. Insurance companies often deny accidental death claims with the excuse that the death was not really "accidental." The insurance company sometimes claims that a death was not accidental because the decedent's actions were so reckless that death was a foreseeable risk and thus not accidental. This excuse is frequently used by insurance companies in denying claims that involve drinking and driving.

In many cases, these denials are wrongful and the excuses are not legitimate. If your claim has been denied for this reason, please contact me. I have successfully handled cases where the insurance company improperly defined "accidental," or was unfairly selective about the law and evidence it considered in deciding whether the death was "accidental."

It is important for any person who makes a life insurance claim to know that they are not automatically "stuck" with an unfair claim denial, no matter what the insurance company or the policy itself says.

Excuse #3: Death Not Covered Because of Exclusion in Policy

Life insurance policies and Accidental Death policies often contain exclusions that preclude coverage under certain conditions. Typical exclusions include death caused by suicide, commission of a felony, intoxication, or in the case of an accidental death policy, exclusion for a death caused by illness or treatment thereof.

The exclusions in the policy are often misapplied by the insurance company to deny coverage. There are numerous issues that can be raised to defeat these exclusions including statutory limitations; causation requirements; and the fact that there is often more than one cause of death and determining whether the excluded cause is the predominant cause or just a contributing cause of the loss.

I have been able to assist policyholders in getting their benefits paid by making cogent arguments based on applicable legal precedent. Case law interpreting policy language is complex, and I enjoy researching the minutae of the law, and I especially enjoy winning a legal argument based on existing law which has been misapplied by an insurance company.

Do not hesitate to contact me if I can guide you through this process.

Contact Info

Joan Odorowski

Attorney at Law

18530 Mack Ave., Suite 286

Grosse Pointe Farms, MI 48236

(313) 926-6688

e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it.