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Following a death in the family, you could easily find yourself facing a stack of bills and insufficient income to cover them. This can happen even if you have been a careful money manager. If a life insurance payout does not come quickly enough, you could experience severe financial stress on top of everything else. But how do you know when you need the intervention of a lawyer to help you collect on a life insurance policy? Here are a few warning signs to watch out for:

Has it been more than 30 days since you submitted your claim?

Following a death, you must contact the life insurance company and open a claim. Then, you must submit the death certificate and any other documentation and signatures required by the insurance company. When you have completed the claims process, the company should deliver payment to you within a few weeks. If you have contacted the insurance company several times and still have not received payment after 30 to 60 days, and you have not received a clear explanation for the delay, you may need an attorney’s help to cut through the red tape and put some pressure on the company to approve your claim.

Did you buy the life insurance policy less than two years ago?

Life insurance policies typically include a “contestability” clause that allows for policy cancellation and claims denial if, within two years of issuance, the insurer discovers that any material fact was not disclosed during the application process. If the insured dies within two years of obtaining the insurance policy, their original application and other documentation may be carefully examined to see if there were any “material misstatements or omissions.”

While few people like to think about death, the fact remains that everyone will die at some point, and many people make plans for this eventuality and ensure that their loved ones will be provided for after their death. A life insurance policy can offer peace of mind in this regard, providing the promise that one’s family members will receive benefits after their death. However, it is important to be aware that insurance companies may deny life insurance claims for a variety of reasons, including:

- Unpaid premiums - If a person fails to pay the premiums on their policy, the policy may lapse, and the insurance company may terminate the policy and deny any claims. However, insurance companies are required to send notice to a policyholder and provide a 30 day grace period before canceling a policy.

- Type of death - Some policies include exclusions for deaths that occur in certain situations. For instance, many policies exclude suicides from coverage for a certain period of time, and policies may also contain exclusions for a death which occurred as an act of war or when a person was participating in high-risk activities such as skydiving or mountain climbing. A claim may also be denied if someone died while participating in criminal activity.

- Health issues - Life insurance policies often contain a period of contestability, which is usually the first two years after the policy was initiated. If a person is found to have certain health issues, such as high blood pressure, after dying within the contestability period, the insurance company may deny the claim.

- Living outside the U.S. - Many policies only provide coverage if a policyholder is living in the United States at the time of their death.

The primary reason claims are denied is because of material misstatements made by a policyholder on their life insurance application. These types of statements may include incorrect or omitted information about a person’s health, including any chronic conditions, unhealthy habits (such as smoking), or other medical issues. To avoid the denial of a claim, it is important to be truthful on an application and provide complete answers to all medical questions.

Contact a Buffalo Grove Life Insurance Attorney

When your family has a life insurance policy, you expect to be able to receive the benefits from this policy in the event of a family member’s death. If your claim has been denied, the attorneys of Drost, Gilbert, Andrew & Apicella, LLC can help you understand your rights and work to ensure that you receive the benefits you deserve. Schedule a personalized consultation with an Arlington Heights insurance dispute lawyer today by calling 847-934-6000. 

In some instances when a claim is made on an insurance policy, an insured may believe that the insurer has acted in bad faith in settling that claim. Bad faith may occur through a delay in settling an insurance claim as well as the outright denial of the claim. An insurance company that acts in bad faith in the settlement of a claim may be forced to pay the insured for those actions. 

Claims under the Insurance Code 

Under the Illinois Insurance Code (§155), it is possible to recover a statutory penalty, attorney’s fees, and other costs if an insurer fails to fulfill its obligations in an unreasonable manner after a claim is made. 

Specifically, an insured must prove that there was a delay in settling the claim that is vexatious and unreasonable. Determining if the delay is vexatious and unreasonable requires an examination of the totality of the circumstances. Some of the factors that are considered include the attitude of the insurer, whether the insured had to file a lawsuit to recover, and whether the insured was deprived of his or her property for a period of time. 

The amount that may be recovered as a penalty under §155 violations cannot exceed any of the following: 

- Sixty percent of the amount which the court or jury finds the insured is entitled to recover against the insurance company;

- $60,000; and

- The excess of the amount that the court or jury finds the insured is entitled to recover, exclusive of costs, over the amount that the insurance company offered to pay to settle the claim before the action. 

The primary defense to a bad faith claim is that there is a bona fide dispute as to whether a policy provides coverage for the claim. If a bona fide dispute exists, denying or delaying in the handling of the claim is not considered a violation. Further, it has been held in Illinois that conduct of insurers is also vexatious and unreasonable when the insurer presents a legitimate policy defense, a genuine legal or factual issue as to coverage exists, or the insurer takes a reasonable legal position based on an area of law that is unsettled. 

Action that Results in a Violation of §155 

Conduct that leads to a violation of the duty of good faith and fair dealing includes, but is not limited to, the following: 

- Knowingly misrepresenting relevant facts or insurance policy provisions;Not maintaining prompt and regular communication with the insured;

- Refusing to pay a claim (either in whole or in part) that the insurer acknowledges as being due;

- Settling a claim for less than what it is actually worth; and

- Failing to properly investigate a claim. 

Insurance Dispute Attorneys 

If you believe that your insurance claim has been delayed or denied in bad faith, it is important to reach out to an experienced Crystal Lake insurance dispute attorney. Our firm represents individuals in communities such as Schaumburg, Crystal Lake, Palatine, Des Plaines, Buffalo Grove, Rolling Meadows, Barrington, Arlington Heights, Inverness, and Deer Park. 

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.

Source:

http://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=021500050K155

People 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.