Wrongful denial of benefits claims cover a broad range of problems ranging from clerical errors to misreading of plan documents to outright refusal to pay a benefit you know is due. We file both administrative claims and lawsuits against insurance companies that fail to pay life insurance benefits to beneficiaries. Administrative claims, however, are not public information and we cannot disclose them here. Therefore the following is an example from a recent administrative claim:
- Your spouse's employer offers its employees various benefits - including life insurance. The Company decides to cut the amount of coverage in half (from $100,000 per employee to $50,000). However, the Company never tells you or your spouse about this. Your spouse continues to participate in the life insurance program, not knowing the coverage is substantially less than you and your spouse thought was needed to support your family if your spouse passed away. Unfortunately, your spouse passes away without learning that the benefits were cut or after learning of it only when it was too late to get replacement coverage. Your family seeks to collect the life insurance from the company, but the company, citing the reduction in coverage, refuses to pay the full amount. Under federal law your employer has a duty to promptly and directly inform your spouse that his benefits were cut.
Under most circumstances, your employer or its designee can be held liable for the money you should have received plus your attorney's fees, interest, and costs.
The following is a list of lawsuits handled by our firm against life insurance companies for failure to pay benefits:
· Barletto v. UTC, plaintiff a beneficiary of her son’s life insurance benefits sued United Technologies for wrongfully denying payment claiming decedent’s death was not an accident.
· Reynolds v. MetLife, plaintiff a beneficiary of her husband’s life insurance benefits sued her employer Xerox Corporation, the Xerox Corporation Plan, the claims administrator Metropolitan Life Insurance Company and third party agent Hewitt Associates for wrongfully denying payment, multiple breaches of fiduciary duty and promissory estoppel for representing that the decedent was covered by the plan and only notifying the plaintiff after his death that he was not covered.
· Leyda v. AlliedSignal, plaintiff claimed life insurance benefits on her husband’s life based upon breach of ERISA summary plan description rule. Courtside trial. Judgment for plaintiff. The decision was affirmed by the court of appeals.
Generally, lawsuits take from two to five years to complete. While usually a settlement can be reached, sometimes trials are required. While we cannot assure positive results, we have a proven track record of success. Further, our lawyers and staff will be with you at every step to help you through the process, answer questions and address concerns.