Question
In Denver ()
My mother was run over & killed 6 month ago.
Life ins. Policy paid & up to date. She had policy for 5 months.
Within 4 weeks I sent all requested document to life Ins. Co.
Called last month to get info on claim, they said that the claim is being contested.
Question:
How long can a major ins. co. "Contest" the claim before they need to render a decision?
Thank you for your help.
SteveReno
Answer
Until you sue them.
I would suggest that you complain to the state insurance department and contact a lawyer, NOW.
If there was no material omission, and you think they are just doing "post-claim underwriting" in an effort to beat back the claim -- or intimidate you, is far better to try to get a lawyer to make it clear to them you are serious and that it is in their interets to pay rather than fight. Once a decison is made, companies get rather intransagent and highly defensive. And if they act in bad faith, punitive damages are available to you, plus, in many states, attorney fees.
Answer
Look at the application for the life insurance policy and ask if it reflects the health conditon of your mother at the time.
What did your agent say?
For what medical conditions had she seen a doctor for in 12 months prior to application date? What meds was she taking?
If the company had an accurate description of her health, then the delays you experience is for the time it takes for them to get answers to above questions.
If they determine NOT to pay, then it will be based on a material omission--and you should get some written info from doctors/hospitals and statements from agent so you know asw much as they do about the health history.
Answer
Thank you both for your replies to my questions.
As an update...
They "Ins. Co." have finally retuned a phone call.
The call consisted of, the "Case" will be coming to a close soon, they now have enough info to evaluate & finish the contested policy. They will inform us soon of there answer, When asked how much more time, “within 1 week"
It's been 1 month & no reply.
The police report also closed with their investigation. Grand jury found no reason to prosecute anyone & conclude that it was an unpreventable accident.
The driver(s) wasn’t charged with anything, which we know of?
Description of accident:
(3) Vehicles involved.
Location: Directly in front of my mother’s house on small service road “35 MPH limit”.
Vehicle #1 “our Relative” Backed out on to road “facing north”. Vehicle #2 coming from the south. Hit Vehicle #1 from rear.
After accident, small space in between both Vehicles 8 feet. Vehicles rested on opposite sides of service road
My mother went “walked” to see about accident & relative’s condition.
About 3 min after, vehicle #3 From the south” drove through both Vehicles #1 & #2 hitting one of them & preceded to hit my mother. Vehicle #3 finnaly came to a full stop 122 feet past the location of accident.
Driver of Vehicle #3 said “I never seen the accident” her age 71.
bowler87,
My mother's condition at the time of & prior to the fatal accident was normal "mild chest congestion, Lower back pain "due to ruptured disk" both conditions reported on policy with Doctor's names & address.
ALawyer,
I feel that I should have took your advice immediately, Just on the fact that their exercising their right to contest the policy, I should also exercise my right to be counseled & represented "If need be"
Answer
Thank you. The fact that he death resulted from something apart from health is not really relevant if they seek to contest the calim based on a "material misrepresentation" on her application. It is usually much easier to get a company to pay a debatable claim if a lawyer is in the picture, and once a decison NOT TO PAY is made by the company it oftne takes a jury trial to get them to cough up money, and that is expensive to you and time consuming.