life insurance claim

[baristaboss]

What is the name of your state? Oregon

My husband recently passed away. We both had a life insurance policy issured on a pre-paid funeral plan, purchased in 2001. When My husband (Bob)Died, the Ins Co asked for His medical records for the past years, then denied us benifits stating that we answered no on the question concerning having either surgery or treatment during the past 5 years. To the best of our knowledge there had been no cancer. After checking Bob's medical records I saw there indeed had been a bladder cancer removal in 1998. Bob had previously had a cancer removed from his bladder in 1988, 1990 and 1991. After a valve replacement in his heart in 1994, each time Bob had his cancer check-up it had to be in a medical facility due to anti-biotics needed. The cancer removal in '98 was done just like his check-ups and we thought it was just a regular cancer check-up. We did answer this in good faith. Is there anyway to collect the benefits and fight their denial?

 

[CIAA]

Probably not. However, if the application that you and your husband signed specifically stated that the statements or representations made were being made " to the best of my knowledge and belief" then it is likely that the insurance company will have to also show knowledge in order to rescind. If this is the case you should contact and discuss your case with a good insurance attiorney.

You will also need to have a "heart to heart" with your husband's doctors to find out what their records say, and they will no doubt be called upon to testify that they withheld this information from your husband, something that they may not be willing to do.

Please keep in mind that it is not unusual in these type cases to find that the husband did not want the wife to know of the reoccurance.We are not attorneys and do not give legal advice or legal opinions. Any opinions or comments in our response are based solely on our insurance administration and claims experience and should not be regarded as a substitute for professional legal advice.

We are not attorneys and do not give legal advice or legal opinions. Any opinions or comments in our response are based solely on our insurance administration and claims experience and should not be regarded as a substitute for professional legal advice.

 

[ALawyer]

It would be essential to review the exact application to determine the language used on it and his response. If it asked -- like most applications for policies ask -- "Have you consulted or been treated by any doctor, hospital or health facility in the past 5 years" and he said NO, it would not matter if he had been treated for tonsils and not a cancer, so long as he had been treated or consulted. Quite frankly, a history of cancer would likely have made him uninsurable at standard rates.

This is reallly highly language specific.

If the policy was for a very small face amount, it may not make sense to pursue it if the language looks clear. The insurance company would make a full premium refund.