Life Insurance Company slow to pay

Submitted by Anonymous (not verified) on Wed, 07/02/2008 - 14:40

My mother died in January. She had 3-4 small policy's which paid me (beneficiary) quickly. Their is one large policy that is dragging their feet in paying.

Mom was an accidental death; the insurance company has received all the paperwork from us (copy of death certificate, authorization to obtain medical records from hospital, physicians etc).

They've had all this since April. We were told they need "to check out the accidental death" more... When we call the company, the person "we are to speak with" is never available and does not return calls.

Is there a set time limit to receive claims? Also, I'm confused on this next part, as my sister has the policy not me (payable to us both though). The policy is for $20,000; but if she died within a certain age (which she did), it's only half value?

Thanks for any help!

Posted: 02 Jul 2008 04:38 Post Subject:

Maybe I can help you here. Life insurance death benefit settlements can often be confusing...and I'm sorry for your loss...

First of all, let's address this:

Is there a set time limit to receive claims?

Most states have laws and rules that address how quickly claims must be paid. In most states, once the insurance company receives the proper forms, which are normally a death certificate and a properly completed claim form, the "clock starts ticking." For example, in about 10 of the states in which my company operates, they have a "30-day" rule. This means that once the proper forms are received by the insurer, the carrier has 30 days in which to pay the claim. If the claim is not paid within that time frame, then the insurer is required to pay interest on the death benefit payable to the beneficiary from the date of death.

Next, let's look at this:

Also, I'm confused on this next part, as my sister has the policy not me (payable to us both though). The policy is for $20,000; but if she died within a certain age (which she did), it's only half value?

This sounds like what's called a "lien" policy. They're all over the place. This means that if the insured dies within a certain period of time after the effective date of coverage, then the death benefit paid will be less than the purchased face amount. These policies are normally sold to persons that cannot prove high levels of health or insurability when the policy is purchased, and don't typically require high-end medical exams period. You answer some health questions, and usually that's about it. The carrier will issue the policy, and there will be a period of time after issuance where if the insured dies, the death benefit will be reduced. This is called the "lien period" and can last (as far as I've seen) as long as 7 years. So, it sounds as if your mom died within the lien period, and therefore the death benefit will be reduced.

Lastly, as far as the company dragging their feet on the accidental death benefit coverage, you need to DEMAND to speak with the adjuster's supervisor. Remember, the squeaky wheel gets the grease!

Good luck with this, and please let us know if there's anything else that we can help you with!

InsTeacher 8)

Posted: 02 Jul 2008 08:54 Post Subject: Thanks

Thanks for the quick response!

Posted: 02 Jul 2008 10:42 Post Subject:

In addition to InsTeacher comments.....

Make life easy on yourself...DON'T bother with phone calls.

Write a letter demanding resolution... and the claim be paid and/or asking what's the delay. Send the letter Certified Mail Return Receipt. That way they can NEVER say they didn't get your letter and you receive the signed Return Reciept back as evidence they did in fact get your letter.

State in your letter the amount of time you're allowing them to reply, say 30 days, then if they don't, or the claim is not paid, file a complaint with your state department of insurance.

Now the company may play phone tag with you, or they may or may not respond to your letter, however, they have to reply to a compliant filed with the deaprtment of insurance usually within 30 days.

What that does is move your claim to the top of the pile and a department head or supervisor or in house counsel will have to get involved and BELIEVE ME they don't want the state department of insurance breathing down their necks. Plus complaints related to legitimate claims look really bad on the insurance company.

So......they'll pay the claim if everything is in order,... then write a letter to the department of insurance saying the claim has been paid and the issue is resolved.

This can all be accomplished with just one maybe two letters that can be generated in less time than it takes to navigate most insurance company's computer menu phone system and listen to elevator music for 30 minutes while on hold....and/or tell your same story to 5 different persons from 3 different departments....

Make life easy on yourself...DON'T bother with phone calls....write a letter.

Posted: 03 Jul 2008 12:06 Post Subject:

I'm an adjuster not an agent, or teacher so will be of zero help...just wanted to pop in and say, I'm sorry you lost your mama...hope you get this part cleared up soon..

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