When to Call an Attorney to Solve a Life Insurance Dispute

Web Admin - Wednesday, October 17, 2018
Des Plaines life insurance claim lawyerFollowing 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.”
For example, if the insured person failed to disclose any medical conditions (e.g., a serious illness such as diabetes, high blood pressure, or depression) or habits (e.g., use of drugs, alcohol, or tobacco), this could lead to a denial of your claim.

The insurance company could spend months evaluating medical records, credit reports, motor vehicle reports, and so on, looking for evidence of a material misrepresentation and a reason to deny your claim. If the two-year contestability period is a factor in your claim, you may need an attorney to speak to the insurance company and convince them that your claim is valid.

Did the insurance company send you a letter of denial?

A life insurance claim may be denied for reasons such as “non-accidental death” or because the policy was rescinded. In many cases, a skillful insurance attorney can help get that denial reversed by conducting an independent investigation of the facts of your case and making a forceful argument to the insurance company.

Consult a Des Plaines Life Insurance Dispute Resolution Attorney 

If you are having problems collecting on a life insurance policy, the intervention of a knowledgeable Palatine life insurance lawyer can help. The attorneys of Drost, Gilbert, Andrew & Apicella, LLC will slice through whatever obstacles are standing between you and your insurance payout as quickly as possible. Contact us at 847-934-6000. We serve clients throughout the northwest suburbs, including Arlington Heights, Buffalo Grove, Crystal Lake, Barrington, and Schaumburg.

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.


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.


Potential Reasons for the Denial of a Life Insurance Claim

Web Admin - Monday, May 14, 2018
Deer Park life insurance claim attorneyWhile 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. 

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.


Avoiding Life Insurance Loopholes

Web Admin - Tuesday, November 25, 2014

life insurance loopholes, Illinois life insurance lawyerThe insurance industry is known for having incredibly complex contracts, and life insurance is no exception to this rule. As you might expect, the reason for this is money. According to statistics from the Insurance Information Institute, life insurance is a multi-billion dollar industry, and the companies want to keep it that way. 

One of the ways that life insurance companies do this is by fighting against paying valid claims. Money they do not have to pay out is money that they can ultimately keep for themselves, and even just delaying the payments can be profitable for them. Life insurance companies have two main tools for insurance claim disputes, policy cancellations and policy exclusions.

Policy Cancellation

A policy cancellation is exactly what it sounds like. The insurance company cancels a claimant's policy in order to avoid paying out a claim. This is a particular problem during the first two years of the policy's life, which is known as the contestability period. During this period, the insurance company may examine the policy looking for misrepresentations or omissions, and then cancel the policy if they find any. They even have the option of doing this after a person has already made a claim, and they are allowed to cancel regardless of whether the omitted information has anything to do with the actual cause of death.

A similar issue, but one that can last beyond the contestability period, is the material misrepresentation clause. This clause allows the insurer to cancel the policy at any time if they discover a lie or omission that would have caused them to not issue the policy in the first place. However, even people with perfectly accurate applications are not safe from having their claims contested.


In cases where the person's application cannot be contested, insurance companies may still attempt to avoid paying out for claims based on policy exclusions. These exclusions are specific events or actions that the insurance company has excepted from the policy. There are a variety of different policy exclusions that insurers may use, and they vary from policy to policy, but they may include:

- Dangerous activities like skydiving;
- Suicide;
- Alcohol and drug use; and
- Illegal activities.

The exact limits of these exclusions can depend on the precise policy language. For instance, some policies’ exclusions for alcohol and drug use exclude only illegal substances, while others exclude legal ones too. This can be especially complicated because some policies require the substance to be the cause of the death, while others only need the substance to be in the person's system at the time of death.

Life insurance contracts are complicated legal documents, and the insurance company is going to have a lawyer on their side. If you want to even the odds, contact a Palatine life insurance attorney today. Our firm assists people in insurance disputes all over the northwest suburbs, including in towns like Inverness, Deer Park, Barrington, Arlington Heights, Schaumburg, Des Plaines, Rolling Meadows, Crystal Lake, and Buffalo Grove.

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.

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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