Options for a Life Insurance Claim Payout

Web Admin - Thursday, June 28, 2018
Rolling Meadows life insurance claim lawyerA life insurance policy can provide a family with the reassurance that they will be able to maintain financial security if tragedy strikes and a family member dies. Life insurance benefits can account for the income that a deceased person would have provided for their family, as well as expenses such as the costs of medical care prior to a person’s death or burial and funeral expenses. When filing a claim, it is important to understand the options for receiving a payout of life insurance benefits.

Payout Options

After the death of a person covered by a life insurance policy, the beneficiaries of the policy should file a claim with the life insurance company, and they must provide a copy of the deceased person’s death certificate. If the claim is approved, the beneficiaries may receive a payout in one of several ways, including:

- Lump sum - The entire amount of the benefit may be paid at one time, allowing beneficiaries to use these funds to pay outstanding expenses or invest them as they choose.

- Annuity - A benefit may be paid to beneficiaries in installments, providing regular income for a certain number of years. This allows beneficiaries to not only receive the money they need on an annual basis, but they will also receive interest on funds that have not been paid out. However, while life insurance benefits are not taxable, interest earned on these benefits is considered taxable income.

- Payout checkbook - Some insurers will hold benefit funds for beneficiaries while allowing them to withdraw money as needed by writing checks. Funds held by an insurer may also generate interest until they are withdrawn.

- Life income - Some plans may allow beneficiaries to receive a fixed monthly income based on the amount of the benefit, their age, and their life expectancy. The beneficiary will receive a guaranteed amount for the rest of their life, regardless of whether they die before or after they reach the age to which they are expected to survive.

- Pre-death payments - While life insurance benefits are usually paid after a person’s death, in some cases, they may be available while a person is still alive to offset the costs of medical care for a terminal illness.

Contact a Des Plaines Life Insurance Attorney

After a person’s death, the prompt payout of life insurance benefits is essential, allowing a family to cover their costs and meet their ongoing needs. If a life insurance company has denied your claim or delayed the payout of your benefits, Drost, Gilbert, Andrew & Apicella, LLC can work with you to help you receive the benefits you deserve. Contact our Palatine life insurance claims lawyers at 847-934-6000 to arrange a personalized consultation.

Ken ApicellaAbout the Author: Attorney Ken Apicella is a founding partner of DGAA focusing in the areas of personal injury, employment, insurance coverage disputes, and civil litigation. Ken earned his J.D. from DePaul University College of Law in 1999. He has been named a SuperLawyers Rising Star and a Forty Illinois Attorneys Under Forty to Watch. Ken has written and lectured for the Illinois Institute for Continuing Legal Education and regularly serves as a moderator at Northwest Suburban Bar Association's Continuing Legal Education seminars.


What to Expect When Suing an Insurance Company

Web Admin - Thursday, September 11, 2014

insurance lawsuit, Palatine insurance lawyerPeople purchase insurance with the goal of protecting themselves in the event that something unfortunate happens. However, no matter how hard people try to understand their policies and the limitations on them, many people face situations where they feel that the insurance company should be compensating them, but the company refuses. When this happens, people have a variety of options.

First, they can enter into an internal appeals process. Most insurance companies have a function that allows other employees of the company to review refusals and determine if they were warranted. If that fails, then the Illinois Department of Insurance also investigates some insurance-related issues. Alternatively, people with issues that neither of those strategies can solve may need to sue their insurance company if they want to see the compensation that they have already paid for. It is important for people to understand the process of a lawsuit and the length of time that it may take. Insurance companies are expert litigators, and they may drag the process out.

Understanding a Lawsuit

The beginning part of the process for filing a lawsuit against your insurance company involves hiring a lawyer and filing a complaint against them. The complaint is a legal document that triggers a lawsuit, and lays out the general allegations against the insurance company. Once this happens, the insurance company is allowed to respond with a document called an answer. The answer takes each fact asserted by the complaint and either confirms or denies them, so that both parties understand what is in dispute. Once this happens your lawyer and the insurance company lawyers will engage in discovery.

Discovery is a legal process in which both sides ask the other side questions to better understand the facts. This is mainly done through requests for documents, written questions called interrogatories that the other side has to answer, and depositions, which are in-person interviews. The majority of lawsuits end at some point during this phase. As more information comes out, both sides begin to understand their chances of winning at trial, and they likely reach a settlement. In the event that there is no settlement, the case moves to trial where both sides' attorneys present their arguments to the judge, who eventually makes the final legal decision.

Your Part in the Process

Not every step in that process will require the client's involvement. Initial interviews will need to be done for the attorney to get a picture of the case, and there will also be periodic conferences as new facts appear or the case moves forward. The most intensive piece that the client will need to do is prepare for a deposition in case the insurance company wants to depose them. This may require working with the client's attorney to better understand the types of questions that they company may ask, so that the deposition goes smoothly.

If you are currently having an issue with an insurance company and would like to file a lawsuit against them, contact a dedicated Illinois insurance dispute attorney today. At Drost, Gilbert, Andrew & Apicella, LLC, we represent clients in many northwest suburban towns including Inverness, Palatine, and Schaumburg.

About the Author: Attorney Ken Apicella is a founding partner of DGAA focusing in the areas of personal injury, employment, insurance coverage disputes, and civil litigation. Ken earned his J.D. from DePaul University College of Law in 1999. He has been named a SuperLawyers Rising Star and a Forty Illinois Attorneys Under Forty to Watch. Ken has written and lectured for the Illinois Institute for Continuing Legal Education and regularly serves as a moderator at Northwest Suburban Bar Association's Continuing Legal Education seminars.

How to Handle a Denied Insurance Claim in Illinois

Web Admin - Tuesday, May 13, 2014

illinois denied insurance attorneyPeople purchase insurance coverage to protect themselves when something goes wrong. Depending on the type of insurance, claims can be paid out for health issues, auto accidents, home repairs, or deaths in the family, among other things. These are already stressful events. A denied insurance claim merely serves to add more stress and difficulty to an already trying situation. The reasons for such a denial can be varied and depend on the type of insurance in question, but in these situations consumers have options available to them to contest the insurance denial.

Reasons for a Denial

The reasons for an insurance company to deny a claim on a policy vary greatly between different types of insurance. For instance, a company providing a life insurance policy may reject a policy claim based on a belief that the person’s death was actually a suicide, or a company providing health insurance could reject a claim made for a specific treatment by arguing that the treatment was not actually medically necessary. However, there are also some grounds for a denial that span across the insurance industry. One of the most common is a “material misrepresentation,” which means that the company believes that the policyholder lied or withheld important information during the application for a policy.

Exactly what qualifies as a material misrepresentation changes from industry to industry. Health or life insurance companies would argue that hiding a prior medical condition may be a material misrepresentation, while an auto insurance company would be more concerned with a past accident. Furthermore, any of these reasons could just be a pretext for a “bad faith” denial, which means that the insurance company privately believes that the policyholder has a valid claim, and simply does not want to part with its money.

Contesting a Denial

Policyholders facing a denied claim do have options available to them. The process will likely begin with the insurance company’s internal appeals process. This may involve letter writing, phone calls, or in-person interviews where the policyholder explains their position. It can be advantageous to consult a lawyer at this point for two reasons.

First, the insurance company may have lawyers involved at this stage, so it evens the playing field. Second, if the issue does proceed to a lawsuit, the lawyer will already know the case’s history and they may be able to prevent early missteps that would cause problems in litigation, which would be the next step if the internal appeals fail. The one exception to this is in the case of health insurance. Illinois recently passed a law allowing policyholders to apply for an independent external review in the case of a denied health insurance claim.

If you are dealing with a denied insurance claim, you do not need to do it alone. Reach out to a skilled Schaumburg insurance dispute attorney today. Our team represents clients across the northwest suburbs, including in towns such as Crystal Lake, Arlington Heights, and Buffalo Grove, Illinois.

About the Author: Attorney Ken Apicella is a founding partner of DGAA focusing in the areas of personal injury, employment, insurance coverage disputes, and civil litigation. Ken earned his J.D. from DePaul University College of Law in 1999. He has been named a SuperLawyers Rising Star and a Forty Illinois Attorneys Under Forty to Watch. Ken has written and lectured for the Illinois Institute for Continuing Legal Education and regularly serves as a moderator at Northwest Suburban Bar Association's Continuing Legal Education seminars.

Insurance Agent Negligence: The Duty Agents Owe to Their Customers

Web Admin - Tuesday, March 04, 2014

illinois insurance agent negligence lawyerInsurance agents often act as a person’s main point of contact throughout the process of procuring an insurance policy. This means people are relying on insurance agents to do their job thoroughly, carefully, and professionally. To that end, the law imposes a duty of reasonable care on insurance agents to ensure that they perform their jobs accurately. 

The fact that agents have this duty means that if the agent harms a customer through their negligence, they may be liable to that customer in court for the damage that their insurance negligence caused. Generally speaking, these sorts of claims for negligent errors and omissions come in two forms: improperly filing or filling out insurance paperwork, and failure to properly counsel the client on the type of insurance they need.

Types of Insurance Agent Negligence

Insurance agent negligence often occurs in an agent’s clerical capacity. An agent must exercise reasonable care in the filling out of insurance paperwork to make sure that the insurance company provides coverage and that the policies are properly updated. An example of this sort of negligence in the realm of car insurance would occur if a person wanted to add someone to their insurance policy, and yet after informing the agent, the agent never properly filed the paperwork to add them to the policy. If the new person, who should be covered under the insurance, was in a car accident, the agent would be liable for the person’s lack of coverage.

Insurance agents also have a duty to exercise ordinary care when advising clients about the types of policy they need, along with possible limits and exemptions of the policy. This claim comes up often in the case of policy exclusions, which are special circumstances in the insurance policy for which the company refuses to pay. These exemptions can often be long and complex, which means that the insurance agent may be liable for negligently advising the customer if they do not make the exclusions clear. 

For an example of this, consider a person buying homeowner’s insurance who explicitly wants coverage for every item in their home in the case of a fire. If an agent provides them a policy that excludes jewelry or some other class of property, the insured might have a claim against the agent for negligent errors and omissions.

The Statute of Limitations

Statutes of limitations are time limits that the law places on people looking to file lawsuits. In the case of insurance agent negligence, Illinois law limits people to two years to file the suit once the person has a cause of action. However, that time limit can be deceptively complicated since it does not say when a person has a cause of action. Generally, courts start the clock running once the insurer first takes a position that runs against the insured’s expectations. That can mean in some cases the insured needs to act quickly, since it is possible that their underlying insurance case will not even be finished before the statute of limitations related to the agent expires.

If you believe you have been the victim of insurance agent negligence, find an Illinois insurance attorney near you. They can help protect your rights in court and ensure that you recover fair compensation for the harm done by negligent insurance agents. Our firm represents people across the northwest suburban area, in towns like Rolling Meadows, Buffalo Grove and Barrington.

About the Author: Attorney Ken Apicella is a founding partner of DGAA focusing in the areas of personal injury, employment, insurance coverage disputes, and civil litigation. Ken earned his J.D. from DePaul University College of Law in 1999. He has been named a SuperLawyers Rising Star and a Forty Illinois Attorneys Under Forty to Watch. Ken has written and lectured for the Illinois Institute for Continuing Legal Education and regularly serves as a moderator at Northwest Suburban Bar Association's Continuing Legal Education seminars.

Appealing a Denial of Accidental Death Benefits

Web Admin - Tuesday, February 18, 2014

illinois denied insurance benefitsMany people carry life insurance or accidental death and dismemberment (AD&D) policies. These policies, which people can acquire through their employer or on the open market, may pay benefits in cases of accidental death. Unfortunately, life insurance policies comprise an industry worth hundreds of billions of dollars, according to a report by the U.S. Treasury, and insurance companies have strong incentives to pay out as little as they can in benefits.

Often, that means denying legitimate life insurance claims on the basis of a “policy exclusion.” Policy exclusions are exceptions that insurance companies place into contracts that exempt certain situations from qualifying for payment. Common policy exemptions include suicides and deaths occurring within one year of the policy’s start. Companies can use these sorts of exemptions as pretexts for denying the payment of benefits.

Contesting a Denial

Even after the insurance company denies the claim, beneficiaries do have tools to appeal the decision. However, depending on the law governing the insurance policy, the tools may be expansive, or more limited in nature. For instance, plans through a person’s employer are often covered by the Employee Retirement Income Security Act (ERISA). ERISA places strict limits on how appeals take place.

Beneficiaries must appeal the decision through a special ERISA administrator before they can move into the regular court system. Beneficiaries with denied claims would do well to seek out a lawyer before filing their ERISA appeal because the actions that take place at that appeal can have strong impacts on a court case. Courts handling ERISA litigation often use evidence from the appeal when making their decisions. That means that if something is left unmentioned at that stage, it can be very difficult to convince the court to consider it later.

Plans purchased by an individual, rather than provided by an employer, will likely be governed by state law instead of ERISA. While this law is usually less restrictive, individuals should still be cautious when dealing with insurance companies. In state law cases, the beneficiary will likely sue the insurance company in an attempt to prove that their cases does not actually fall into the policy exclusion that the company is claiming.

If you have been the victim of a wrongful denial of a life insurance claim, get a written statement of the reasons for the denial, and seek help from an Illinois insurance attorney. Our firm serves clients across the northwest suburban area, including Schaumburg, Palatine, and Crystal Lake.

About the Author: Attorney Ken Apicella is a founding partner of DGAA focusing in the areas of personal injury, employment, insurance coverage disputes, and civil litigation. Ken earned his J.D. from DePaul University College of Law in 1999. He has been named a SuperLawyers Rising Star and a Forty Illinois Attorneys Under Forty to Watch. Ken has written and lectured for the Illinois Institute for Continuing Legal Education and regularly serves as a moderator at Northwest Suburban Bar Association's Continuing Legal Education seminars.

What to Do if Your Life Insurance Claim is Denied

Web Admin - Tuesday, February 04, 2014

illinois life insurance claim lawyer

The law provides insurance companies with a variety of methods to protect themselves against fraud. Unfortunately, insurance companies may attempt to use these tools to withhold payment on legitimate claims. Two of the common ways that life insurance companies may try to stop beneficiaries from collecting on their claims are by rescission of the policy and denial of the insurance claims
A policy rescission occurs when the insurance company alleges that the person who took out the policy misrepresented material facts about themselves. If successful, this allows the insurance company to withdraw the person’s coverage. Conversely, if an insurance company denies a claim, they do not contest the validity of the whole policy. Instead, they are simply saying that the person’s death fell into an exception in the insurance. While both of these tactics result in a non-payment of the claim, they require different strategies to handle them.

Dealing with Rescission

When an insurance company rescinds a contract, they declare that the entire policy is invalid. One of the most common reasons that an insurance company will give for such a rescission is a “material misrepresentation.” This means that the company claims that the deceased wrongfully answered questions on the application related to things such as their age or medical history. To fight a rescission of this sort, your insurance attorney must prove that the deceased either did not make such a misrepresentation, or that any misrepresentation was not material. 

Fortunately, Illinois law does provide some protection in these circumstances. First, the law requires that the alleged misrepresentation occurred on the actual policy application, and not simply in a conversation with the insurance company. Second, the law forbids insurance companies from rescinding policies more than two years after issuance, except in cases of non-payment of premiums.

Dealing with Denial

An insurance company can deny a claim for several reasons, often because they believe the death falls into a policy exception, or because they believe the person filing the claim is not the proper beneficiary. One common fight over policy exceptions occurs when the insurance company asserts that a person’s wrongful death was actually a suicide, as suicides are ordinarily not covered by life insurance. Overcoming this sort of denial often requires bringing forth evidence to prove that the death truly was an accident.

If you believe that your life insurance policy was improperly revoked or if you had a life insurance claim denied recently, then consider contacting an Illinois insurance attorney today. Our firm handles cases across the northwest suburbs, including in Arlington Heights, Rolling Meadows, and Des Plaines.

About the Author: Attorney Ken Apicella is a founding partner of DGAA focusing in the areas of personal injury, employment, insurance coverage disputes, and civil litigation. Ken earned his J.D. from DePaul University College of Law in 1999. He has been named a SuperLawyers Rising Star and a Forty Illinois Attorneys Under Forty to Watch. Ken has written and lectured for the Illinois Institute for Continuing Legal Education and regularly serves as a moderator at Northwest Suburban Bar Association's Continuing Legal Education seminars.

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