 Posted: Thu Nov 10, 2011 1:09 pm Post subject: ex spouse //spousal life insurance |
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| In 2007, I was divorced. The MA Probate court ordered me to keep any existing Life insurance (and health ins.) policies on my ex spouse. I had a small Spousal life policy thru my job. I inquired with Human resources of my co at the time of the divorce, and was told that I could still keep this ins. and I have been paying the premium ever since. Spouse is now deceased. Insurance Co. denied the claim saying that spousal ins. doesn't cover ex spouses. What can I do? |
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jbradshaw
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| Posted: Fri Nov 11, 2011 7:28 pm Post subject: |
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| Quote: | | The MA Probate court ordered me to keep any existing Life insurance (and health ins.) policies on my ex spouse. |
A couple of issues to deal with here. First, it would not have been the Probate Court that ordered your spouse to remain covered, but the Family/Civil Court. Second, if your employer has 20 or more full time (or full time equivalent) employees, the benefit is governed under ERISA, not state law, and the court's order might be preempted under federal law. Everything in such a case is governed by the ERISA plan document.
The insurance company is possibly wrong to have denied your claim. If the ERISA benefit plan document that governs your employer-sponsored benefit plans (life, health, retirement) does not address the issue of continuing coverage for spouses following a divorce, then they must cover the claim -- notice to the insurance company (as anonymous007 suggests) is unnecessary, and notifying your employer at the time was the proper thing to do. If the document requires dropping coverage for your spouse, then they may have been right to deny the claim. Without seeing the Plan Summary Description document, there is no way to tell you for sure.
However, if your employer, who is responsible for properly administering the benefits according to the plan document, continued to take the premiums from your pay, it may very well have created a de facto acceptance of liability for the claim, regardless whether covered by the plan or not or the insurance company pays the money or not.
You need to get the most recent copy of the Plan Summary Description that applied to the life insurance prior to your spouse's death. Read it (or forward it to me) to determine what is or is not permitted when it comes to the group life insurance.
Understanding what it says will determine the manner in which you need to proceed. This could end up requiring the assistance of legal counsel.
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MaxHerr
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