denial

[snb]

I live in Pa. I feel that my life insurance co. is about to deny my claim on my wife's death due to material misrepresentation.
They claim that they have it in their legal dept. and still awaiting medical records from the hospital. They already received them from the doctor.
What is my legal recourse if I'm denied. Do I have any chance of recovering any monetary claim?

 

[ALawyer]

If she truly made what a jury and judge would say is a material misrepresentation, and that would have caused the insurance company to reject her application, or in some states make a materially different underwriting decision, you should not collect a dime. People are not entitled to rip off insurance companies.

BUT, if the misrepresention was not material, or the policy would still have been issued as applied for (or in some states, substantially as applied for) then the company is engaging in "post-claim underwiritng", and/or the company is acting in bad faith and desereves to pa[y the claim plus exemplary and punitive damages.

But this should go to a lawyer who knows insurance law to evaluate. Most would take the case on at least a partial contingency basis if they felt it had any merit.

 

[Donna32669]

Denial

Snb, you don't indicate the date the policy was effective. The prior post states it perfectly on the misrepresentation, and the
fact that no one should be able to rip an insurance company off,
which is what occurs when a fact that is concealed that would have resulted in a declination of the contract. However, in some cases after a two year period of time, the insurance company can not contest the claim for any cause, even self inflicted injury that
results in the death. My condolences on the loss of your wife.