by Guest » Sat Jan 17, 2009 01:31 am
Isn't it true if someone does lie on application and it goes 2 years with out the company catching it they can;t hold it against them. They will also be completely covered. Isn't it true if someone is covered for 2 years and they commit suicide they are also covered.
Posted: Wed Mar 24, 2010 12:07 pm Post Subject:
other than a person diagnosed as insane just moments before their suicide, how does one prove/disprove a dead person's sanity?
I see your point on this one (or, question, I shall say..). Let me give you a 'scenario' ..maybe you can help. One of my 'Clients' is younger than me. She had an 'accident', which resulted in a self-conflicted wound. She DID tell me she was going to "harm" herself and wanted to die to "get the attention she didn't have before." Well.....obviously, she didn't die and she lost her kids, etc. over this. She said she was "insane" when this happened. How can you be insane when you were planning to do something like this? It wasn't a 'last minute' thing?Posted: Thu Mar 25, 2010 05:36 am Post Subject:
And how can a person claim that by eating Twinkies the sugar rush caused him to experience temporary insanity (actual case in San Francisco in the 1970s or 80s)?
Bipolar individuals can have periods of lucidity and insanity. It's up to observers to know the difference. Here in the LA/Orange Co (CA) area, in just the past few weeks, there have be three or four persons who have committed "suicide by train" -- are they insane, depressed, sane -- who knows?
Do sane people commit suicide? Certainly.
But the whole point of this thread is do life insurers pay for death by suicide? The answer is, generally, yes, if more than two years from policy inception. Less than two years (in most states, one year in a few), consider the answer NO. A refund of premiums to the named beneficiary (or insured's estate, if dictated by state law) in lieu of the death benefit proceeds.
Why? Just an attempt to prevent "adverse selection" on the part of a person who intends to commit suicide.
Someone else can bring up the discussion of accidental death benefits (as opposed to life insurance) and suicide.
Posted: Thu Mar 25, 2010 10:11 am Post Subject:
It makes sense that suicide would not be excluded and it makes sense that suicide would be excluded for a couple of years.
The two year exclusion makes sense, as Max said, to prevent "adverse selection". "Tomorrow, I'm going to kill myself, so let me buy insurance today."
After the two year period, it makes sense for it not be excluded. Nobody is going to say, "I'm going to kill myself in a few years. Let me my coverage today." Suicide is already included in the mortality tables and insurance isn't for the dead person. It is for the living. There is no reason to penalize the living. It's a good thing that insurance payouts are pretty much black and white. Are you dead? "Yes". "Ok, here's the check."
Posted: Thu Mar 25, 2010 11:20 am Post Subject:
It's my understanding in my state (from an agent, as I've sadly had to deal with suicides twice in my family). That in MO, the timed exclusion is still in some carriers policys, but most policys are paying suicide anyway, as it has to be PROVED the policy was purchased with the sole intent of commiting suicide..apparently someone won a case....now, could that be proved if a poor soul purchased the policy and off'd themselves within days? maybe...but three, four six months? doubt it...
Posted: Thu Sep 09, 2010 12:20 pm Post Subject: exclusionary period question
Child's father died age 55, 12 years after huge accident and burns. He got several policies and died six months later and less. Now they say they do not have to pay. It was unexpected death, heart problem not there several months before. But he did have follow up medical from the 98 burn.
Is there any hope or way that these companies will pay His life insurance benefits? :?
Posted: Thu Sep 09, 2010 04:24 pm Post Subject:
Now they say they do not have to pay. It was unexpected death, heart problem not there several months before.
Very sorry for your and the child's loss.
Unless there is reason to believe that the heart problem was a preexisting condition and concealed during the application process, there should not be any legitimate basis for turning down a death claim unless there is some other language in the contract that allows it.
The timing of the policy purchases and the death is the reason for the matter. You should request that the insurance company(ies) state in writing the reason for their claims denials. If on any basis other than a named exclusion in the policy, such as a claim of concealment or misrepresentation, they have to prove that there was concealment or misrepresentation on the basis of documented proof that the insured knew he had a heart condition that could result in his death.
If the decedent honestly had no prior knowledge of the condition that resulted in his death, it cannot be held against him or his beneficiary and used as the basis to deny a claim.
Is there any hope or way that these companies will pay His life insurance benefits?
This could be a matter you want to put in the hands of your state's Dept of Insurance through a consumer complaint for unfair claims practices. Visit their website for more information on how to file a complaint. Some states allow you to do that over the Internet, all states allow you to do that in writing, usually on a specific complaint form. If nothing else, the form will be available online for download or by request via email, telephone, or in person at one of the Dept's offices.
A last resort would be an insurance "bad faith" lawsuit against the insurance company(ies). That means lawyers and costs, and could result in the beneficiary receiving even less than they might be entitled to right now -- perhaps even having to PAY the lawyer in a losing battle.
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