life insurance claim

[Lisa Smart]

What is the name of your state? Georgia

When my brother bought his life insurance policy about a year ago he failed to tell his insurance provider about the knee surgery he had a year earlier. Now he has been diagnosed with cancer and only has a few months left. Since the knee surgery was not life threatening and is unrelated to his impending death will it interfere with is claim?

 

[HomeGuru]

What is the name of your state? Georgia

When my brother bought his life insurance policy about a year ago he failed to tell his insurance provider about the knee surgery he had a year earlier. Now he has been diagnosed with cancer and only has a few months left. Since the knee surgery was not life threatening and is unrelated to his impending death will it interfere with is claim?

**A: and what did his insurance agent say when he asked?

 

[Lisa Smart]

His hasn't spoken to his agent yet. He is afraid of what he'll tell him.

 

[Dandy Don]

I am only speculating, but I think the intent of the previous question was: Was your brother asked specifically to provide information about previous health problems or was he asked nothing at all about this by the insurance company?

Find this insurance company's website or look at the policy to see whether they are concerned about health history--call the company's toll free number and ask them any questions you want about this, of course anonymously, without revealing your name or your brother's name, to see what possible suggestions or solutions they might have to resolve this.

 

[ALawyer]

The issue will be whether the failure to tell them about the knee surgery and any related hospitalization would be deemed a "material misrepresentation" that might have caused them to deny the policy or do further investigation.

That in turn will depend on a combination of your state's laws and the insurer's underwriting rules, procedures and standards, and perhaps what else may have been uncovered if the insurer had investigated the knee surgery -- blood tests, symptoms, etc.

If the insured survives for 2 years from the date of the policy's issuance, and the insurer does not file suit seeking to rescind the policy before the policy is in force for 2 years (which is why you probably don't want to notify the company) then the benefits are payable regardless.

But if the calim is denied, don't just sit back and take it -- this certainly sounds like one I would take to an insurance lawyer in that case.