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Can I Sue My Insurance Customer?

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hummingbird
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Joined: 04 Dec 2007

Posts: 559

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4.34 Dollars($)

PostPosted: Fri Feb 08, 2008 5:01 pm   Post subject:   

We had a home owners policy once and we got a pitbull part lab puppy. My hubby told the insurace and they promtly canceled our policy. Seems there is a list of dogs that if you own you cannot get home owners insurance. One being a pitbull. But ours was a mixed breed. Turned out she got stolen(vicious dog,right?) so we got our insurance right. Why can't an insurance company just give a person a policy and give exclusions for what is high risk?
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InsInvestigator
Guide
InsInvestigator



Joined: 13 Oct 2007

Posts: 323

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Location: Central California


90.77 Dollars($)

PostPosted: Thu Feb 21, 2008 7:23 pm   Post subject:   

Hey Maze, I was scanning through the theads and ran across your story. Wow! That is incredible.

So, based on the parameters of your case; If, on his life insurance policy, a 52 year old male claims to be a 38 year old female (in order to secure the lower premium) and dies 2 years and 1 day later (contestability period of 2 years) then the insurance company would then be required to pay the claim? HA - I don't think so. That's called Material Misrepresentation and I wish I had been investigating that case.

_________________
Please feel free to go to my website at www.markcolbert.com or, if you have a specific question, you can email me directly. I hope I can answer any questions you might have. If not, I can certainly find an answer right away.
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InsInvestigator
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InsInvestigator



Joined: 13 Oct 2007

Posts: 323

InsInvestigator's Home Page
Location: Central California


90.77 Dollars($)

PostPosted: Thu Feb 21, 2008 7:29 pm   Post subject:   

Oh, by the way;
Slander is an Oral communication of false statements that injure a person's reputation.

Libel is a false publication in writing, printing, or typewriting or in signs or pictures that maliciously damages a person's reputation.

Defamation is to damage the reputation, character, or good name of by slander or libel.

I wish I could have helped you, bud

_________________
Please feel free to go to my website at www.markcolbert.com or, if you have a specific question, you can email me directly. I hope I can answer any questions you might have. If not, I can certainly find an answer right away.
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InsTeacher
Senior member
InsTeacher



Joined: 13 Aug 2007

Posts: 272

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98.75 Dollars($)

PostPosted: Mon Feb 25, 2008 5:59 pm   Post subject:   

Hey InsInvestigator...you picked an example that does not normally allow for denial of a claim based on fraud or misrepresentation in the application. Most states will NOT allow an insurer to cancel a policy or deny a claim due to age or gender misstatements. I know it's kind of strange, but here's an example of law (from Oregon):

Quote:
743.180 Misstatement of age. A life insurance policy shall contain a provision that if it is found at any time before final settlement under the policy that the age of the insured or of any other person whose age is considered in determining the premium or benefit accruing under the policy has been misstated, the amount payable or benefit accruing under the policy shall be such as the premium would have purchased at the correct age or ages, or the premium may be adjusted and credit given to the insured or to the insurer, according to the insurer's published rate at date of issue. [1967 c.359 §382]


There are people who truly do not know their age; born in a country with bad birth records, etc. As a result, most states have laws that say the insurer can only adjust something somehow (premium, death benefit, etc.) and cannot void or cancel the contract. Using your example:

Quote:
Let's say that we have a 52-yr. old man stating that he is a 38-yr. old woman just to get a better rate, and let's say that the face amount of the policy is $300,000. Doesn't matter what kind of policy it is, the law holds.


As a "38-yr. old female", let's say the premium rate is (just picking a number) $50 a month. If the insurer had know that the insured was a 52-yr. old man, let's say that the rate SHOULD have been $150 a month. The client only paid 1/3 of what he should have paid had the insurer known the correct age ($50 divided by $150). If the insured dies, the beneficiary will only receive 1/3 of the face amount, or $100,000 in this case. If the insurance company found out about this prior to the death of the insured, normally they will reduce the face amount to the amount the premium would have purchased had the company know the correct age. In this case, the amount of insurance would normally be dropped to $100,000.

Weird, huh?

Ins Teacher Cool
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InsInvestigator
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InsInvestigator



Joined: 13 Oct 2007

Posts: 323

InsInvestigator's Home Page
Location: Central California


90.77 Dollars($)

PostPosted: Mon Feb 25, 2008 6:18 pm   Post subject:   

Hey Teach, I'm looking like an idiot here and for that, I'm sorry. From now on, whenever I post something where I mean to be sarcastic, I'm going to put the word SARCASM somewhere in the text. Thus was the case in my first post above. I undoubtedly should have answered that question differently instead of trying to be funny.
Thanks,
Mark

_________________
Please feel free to go to my website at www.markcolbert.com or, if you have a specific question, you can email me directly. I hope I can answer any questions you might have. If not, I can certainly find an answer right away.
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InsTeacher
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InsTeacher



Joined: 13 Aug 2007

Posts: 272

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98.75 Dollars($)

PostPosted: Mon Feb 25, 2008 7:02 pm   Post subject:   

Quote:
Hey Teach, I'm looking like an idiot here and for that, I'm sorry. From now on, whenever I post something where I mean to be sarcastic, I'm going to put the word SARCASM somewhere in the text.


InsInvestigator- you are certainly NO idiot, and I enjoy your sarcastic wit. I think you're one of the few that actually has a handle on sarcasm and are able to use it properly. If I had actually re-read the whole thread, I would have noticed it. Now who's the idiot?? Laughing

This place wouldn't be the same without your knowledge...the idiots will do themselves in over time!

InsTeacher Cool
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InsInvestigator
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InsInvestigator



Joined: 13 Oct 2007

Posts: 323

InsInvestigator's Home Page
Location: Central California


90.77 Dollars($)

PostPosted: Mon Feb 25, 2008 7:11 pm   Post subject:   

Thanks, the vote of confidence and kind words were definitely a bright spot in my day.
_________________
Please feel free to go to my website at www.markcolbert.com or, if you have a specific question, you can email me directly. I hope I can answer any questions you might have. If not, I can certainly find an answer right away.
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InsTeacher
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InsTeacher



Joined: 13 Aug 2007

Posts: 272

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98.75 Dollars($)

PostPosted: Mon Feb 25, 2008 7:33 pm   Post subject:   

hummingbird wrote:

Quote:
I hear that you cannot get coverage if you have a fireplace either .Is that true?


Insurance companies routinely cover fireplaces. If not, half the homes in the U.S. couldn't get coverage on their homes. Insurers may, at times, have issues with certain woodstove and pellet-burning stoves, but if they're UL approved and properly installed to code, that's normally not a problem either.

InsTeacher Cool
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