Contestable claim for murder victim

[shonceman]

Actually, they may be holding it up because the beneficiary or owner could theoretically be the murderer. Watch any dateline NBC and you will see at least 1 story a week about someone murdering for the insurance money.

Not saying that is the case in this case, but saying it can be a reason for delay.

Also, they can also be investigating whether the application was valid in terms of providing coverage in the 1st place.

Had a $2m claim where the insured was murdered by the insurance agents secretary. She had started dating the client, changed beneficiaires on 1 policy to her & had more coverage applied for. She was convicted of having him murdered. The claim was denied & policies rescinded not only because of the murder, but also the fact that he was grossly overinsured based on actual income & he in fact had no wife or children & merely was set up to have policies bought on him.

A niece of the victim who was named as a partial beneficiary sued & won in court that her share to the claim should be paid. jury sided with her even though the carrier would have never issued the policy had the true income, true beneficiary relationship been disclosed

I'm sure that's part of the reason for company policy about waiting for the ME report to be conclusive. But in this case, it's just $10k, so I'm doubting any money motive involving the beneficiary. (As a matter of fact, they all mistakenly thought grandma was the beneficiary until I helped them with the claim paperwork.)

However, I do remember a case from about 30-40 years ago where a grandfather murdered a grandson in order to get the measly $5,000 that he owed a drug dealer or bookie or some such.

 

[Newby]

Don't you guys think it's being held up just because they haven't verified that he health qualifies for it yet? Thats the most common thing on contestable claims.

 

[shonceman]

Don't you guys think it's being held up just because they haven't verified that he health qualifies for it yet? Thats the most common thing on contestable claims.

There is one medical report outstanding, so maybe. But they told me that they won't be able to determine final disposition on the claim until they receive all requirements, including the ME report. I asked since that report's probably going to be pending for quite a while, could they possibly process the claim without it. The person handling the claim said she'd never seen this company pay a claim without that report. Maybe it's time to talk to somebody with more authority.

 

[Allen Trent]

grandfather murdered a grandson in order to get the measly $5,000 that he owed a drug dealer or bookie or some such.

Wow. That is terrible.

I have seen drug overdose claims be held up for 30 days until the drug tests come back. Even though policies are way past 2 yr contestibility, they await toxicology for ME report to assure beneficiary not involved in the supply of the drugs

 

[DonP]

Alan was that $2 million claim in the contestable period? Even if the guy lied like crazy about his income and was overinsured they'd still have to pay the claim . Fraud outside a murder is irrelevant outside the contestable period.

 

[Allen Trent]

Alan was that $2 million claim in the contestable period? Even if the guy lied like crazy about his income and was overinsured they'd still have to pay the claim . Fraud outside a murder is irrelevant outside the contestable period.

There were 2 policie involved & both were outside the contestible period. The contention of fraud was that the person charged for the murder orchestrated the purchase, application of the policy. She was the secretary for the agent.. she slowly came on to the client making him believe they were boyfriend/girlfriend. Also obtained forms to pull money from his employer 401k plan as loans, etc.

Because she made the policies initially seem more legitimate by involving the listing of a niece as a partial beneficiary, the carrier approved the policy believing there was insurable interest stating he provided her with income and support and property ownership. None of that was true.

Even though it was deemed fraud from the get go, the jury awarded the niece her share of the policy as she was not a party to the fraud.

There was belief that the murderer may have even staged the application, phone interview & exam by having another man go through that process.

Crazy stuff.

 

[Todd King]

That is a health insurance exclusion.. not life.

It may be health too, but it is on life as well.

 

[rousemark]

It may be health too, but it is on life as well.

May have been years ago but the only exclusion I have seen in the last 30 years or so on the base life coverage in TN is Suicide during the first two years.. Of course, there is the standard constable clause but I am not sure that would be termed an exclusion.. When I first started some companies had an act war exclusion but that went away not long after I started. The company I was with made a big deal of having no war exclusion since the Vietnam war was going on.. However, we would not issue coverage on guys that had low draft lottery numbers..

 

[Todd King]

May have been years ago but the only exclusion I have seen in the last 30 years or so on the base life coverage in TN is Suicide during the first two years.. Of course, there is the standard constable clause but I am not sure that would be termed an exclusion.. When I first started some companies had an act war exclusion but that went away not long after I started. The company I was with made a big deal of having no war exclusion since the Vietnam war was going on.. However, we would not issue coverage on guys that had low draft lottery numbers..

I could be very wrong on it, but I did quickly check Google and it pulled up a few things on it. So, without doing a thorough search, I went with what I've always thought.

 

[Allen Trent]

Of course, there is the standard constable clause

They don't play claims if you are a constable?