bad faith life insurace claim?

[marollyn]

My husband was killed in an auto accident when another car crossed a median and hit him head-on. There were three witnesses to the accident. My husband's blood alcohol was found to be just over the legal limit as he had been out with two friends that evening, but was seen to be driving "normally" right before the accident happened. He was found to have had no responsibility for the accident by the police. My AD&D life insurance policy had denied payment stating that it will not pay the claim if the loss was contributed by or caused by alcohol intoxication. I asked for a reconsideration, which they again denied. I contacted the Department of Insurance, which stated there was nothing they could do. This is an individual policy and I am wondering if it could constitute a bad faith claim and if so, what type of compensation should I be looking for? The policy was for $25,000.

 

[cherri hairston]

bad faith lawsuit

my husband had a liver transplant and our insurance company is not paying some claims "deemed not medically necessary"or exceeds corviews allowance fee.please help

 

[Donna32669]

Bad Faith Insurance Claim

First, I am sorry for your loss. I am not sure where you feel that there is any Bad Faith? Did you read the policy? It should state clearly in it what they will and will not pay for. Unless you can not find this exclusion, I don't see how you have any recourse against anyone other than the person who was responsible for the accident. Don't they have insurance? From an insurance stand point I don't see how your husband was negligent, based on what you have stated. So, I would think that they should be paying policy limits to you, in addition do you have Uninsured Motorists Coverage....in case the 3rd party has no insurance, or if they are "Underinsured", you can use Uninsured Motorists for this too in some states. Best of luck to you.

 

[Donna32669]

Liver Transplant

my husband had a liver transplant and our insurance company is not paying some claims "deemed not medically necessary"or exceeds corviews allowance fee.please help

I hope this will start a new post for you.....your post was in a reply to the prior one.....there should be a procedure for an appeal in the insurance policy, find it - read it - and then follow the steps. How on earth an insurer can feel someone would have a liver transplant, unnecessarily is beyond me. When you find the procedure for appeal/arbitration COPY IT, and send it in writing in the form of a complaint (your State insurance dept. should have a form for you to use). And, have the insurer to send you in writing THEIR reasons for the determination and let your husbands doctor answer them. It will take some time, but I really believe you can get this taken care of, provided your health insurance WOULD have paid for it had it been "medically necessary" in their opinion. In other words, if you don't find that they specifically exclude Liver Transplants etc. You don't mention it, but find out where the insurance co. is based (what State) and complain there too if in a state other than yours.