Question about my life insurance police

[Gianjo]

I am losing track of what happened because of the communication skills. What is "lack of substance"? Was the person old, underweight, had the flu? How close to the application date was the first visit and how close was the second visit? Did the person die in the hospital? Did the person see a physician out side of the hospital visit?
The insurance company will most likely say that the person withheld medical information which may have been the cause of seeking life insurance. The agents will probably say that they had no knowledge of the information

Im so sorry, im not from the US and ive never talk about health stuff in english (english isnt my main language neither) and i dont know the right words to explain insured's condition.

The initial problem was she had a gastric pain which result to a seizure hence the family brought her to hospital at the 1st,
After checking with specialists (brain,internist,lungs and end up with a neurologist) all of her organs was fine and then the neurologist diagnosed her body was in need or lacks of sodium which caused her to had a seizure.
She was 66y.o,
The insurance was signed 1 week after she was allowed to leave the hospital, and she passed away probably 1month after the insurance policy came out due to lungs/breathing problem which was the cause she went back to hospital, and doctor who handled it wrote down that the initial history have nothing to do with the cause of death.
Yes she died in hospital,
Yes she initially went to a doctor outiside hospital which eventually also took care of her during her time in the hospital, since she was hospitalized they always went to the same doctor who was also taking care of her treatment in hospital.

What type of Life Policy was it? It does not sound like a fully underwritten policy and must be a Graded Benefit. What company is it?

Good question... the type of policy is the first place to start. Also, what company?

I dont really know how to answer this but what i know is (after i saw the policy) ;
Theres a fix amount to be paid to the beneficeries if insured passes away, theres nothing else in the policy that could determine how much they should pay.
Its Sequis but i think its a local company, im not sure.

Thanks alot for your replies!

 

[fed up]

The family will get the premium back and the company will deny the claim. This is most definitely a graded benefit policy. The person would have to have lived for 2 years past the date of issue in order to get the death benefit. She made it 1 month

 

[Gianjo]

The family will get the premium back and the company will deny the claim. This is most definitely a graded benefit policy. The person would have to have lived for 2 years past the date of issue in order to get the death benefit. She made it 1 month

Yes, i think you are correct.

So the outcome will be either what you said or they completely reject the claim and pay nothing, and theres nothing that the family could do about it (e.g ask for under-writting/reconsider given the initial condition and determine the premium's price and re-calculate it from there etc)

 

[Life Hawk]

The above is correct...

Look back would have cause of a rescinded policy regardless.

 

[fed up]

(e.g ask for under-writting/reconsider given the initial condition and determine the premium's price and re-calculate it from there etc)

That would never happen. They need to wait for the determination from the carrier but if it is a Graded Benefit policy it would not matter anyhow. They should get back whatever premium was paid and that's all.

 

[Gianjo]

The above is correct...

Look back would have cause of a rescinded policy regardless.

That would never happen. They need to wait for the determination from the carrier but if it is a Graded Benefit policy it would not matter anyhow. They should get back whatever premium was paid and that's all.

Alright all clear now, thank you so much for your time and answers!

 

[Life Hawk]

You are very welcome.

The forum is a place filled with tons of years of knowledge and experience. A great place to ask questions and get a frank and honest answer.

@fed up is one of the best. He's in 80's but his mind is still sharp as a tack.

 

[somarco]

May i know what are those claim for E&O against the agent?

The situation you describe is neither an Error or Omission . . . unless you count WILLFUL omission.

In that case it is fraud.

 

[fed up]

@fed up is one of the best. He's in 80's but his mind is still sharp as a tack

????????? 61, but thanks for the compliment

 

[Life Hawk]

????????? 61, but thanks for the compliment

But you type so young.