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Category Archives: Life/AD&D Claims

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Life Policies Bought Through Church Group Plan Not Covered by ERISA

picture of church steeple

Insurance Through Religious Groups Is Not Covered Under ERISA An Alabama federal court has ruled that life insurance policies bought by church members were not covered under a federal benefits law called ERISA, the Employee Retirement Income Security Act.  This is significant, because an insured covered under an ERISA plan has fewer rights than someone […]

What Does Accidental Death and Dismemberment AD&D Insurance Cover?

copy of Life Insurance Policy with calculator and glasses

We are often asked what AD&D – Accidental Death and Dismemberment – Insurance covers.  AD&D is one type of insurance that is governed by the rule that you have to read your policy to know exactly what it covers.  Why? AD&D policies are written by many different insurance companies.  Whether they are individual or group […]

Life Insurance Company of North America Uses Interpleader Procedure to Resolve Life Insurance Dispute

A Utah court approved the use of the federal interpleader procedure for Life Insurance Company of North America in a dispute over life insurance benefits.  Life Insurance Co. of North American (LINA) is a Cigna company which issues group insurance benefits to employers.  Interpleader is a type of lawsuit used by a party who has […]

Court Considers Whether “Substantial Compliance” Applies in ERISA Life Insurance Beneficiary Designation

A U.S. District Judge in Massachusetts decided that he could not decide who the beneficiary was in a dispute over life insurance benefits based on the facts presented to his court.  Using a process called remand, the Judge sent the case back to Prudential (the insurer and plan administrator of the group life insurance plan) […]

Who is the Life Insurance Beneficiary In an ERISA Life Insurance Claim?

copy of Life Insurance Policy with calculator and glasses

One of the thorniest issues in life insurance law is how courts decide who is a beneficiary for purposes of being paid life insurance benefits.  For insurance policies that were sold to individuals outside of their work, state law applies to this question.  States have varied law on this subject, but if it makes it […]

Aetna Denies Life Insurance Premium Waiver and Terminates Coverage – No Appeal by Employee – Survivors Claim Denied

Life Insurance Waiver of Premium Due to Disability When Laura Hawkins became disabled in 1982, she made a claim for a benefit under her employer’s life insurance plan called a “Waiver of Premium.”  Life Insurance Premium Waivers are available under many employer sponsored group life plans.  When an employee can no longer work due to […]

Life Insurance Companies Not Paying Billions of Dollars in Claims Despite Knowing About Death of Policyholders

copy of Life Insurance Policy with calculator and glasses

On April 17 2016, the CBS television show 60 Minutes ran a story titled, Life Insurance Industry Under Investigation:  Audits of leading life insurance companies have uncovered a systematic, industry-wide practice of not paying significant numbers of beneficiaries, which reported on a multi-billion dollar settlement agreement that 25 life insurance companies have entered with state regulators.  The story […]

How Do You Know if You Are An ERISA Plan “Participant” or “Beneficiary”?

picture of U.S. Code book with words for ERISA definitions of participant and beneficiary highlighted

Definitions of “participant” and “beneficiary” found in the federal statutes, 29 U.S.C. Sec. 1002. Your insurance company told you they would not consider your claim because you are not a plan participant…or they said you were not a beneficiary of a plan participant.  Can they do that? First, you need to know what ERISA is.  […]

What is “First Party” Bad Faith and How Do You Sue Your Own Insurance Company for Bad Faith?

“First party” bad faith is when your own insurance company does not act in good faith toward you in terms of paying or settling a claim.  That might be an unreasonable claim delay, an improper interpretation of a policy term that unreasonably favors the insurer, or another bad faith action.  In Florida, the law did […]

What to Do When a Life Insurance Claim is Denied

Choosing to purchase a life insurance policy helps ensure the financial security of your loved ones in the tragic event you pass away. The last thing you want is the insurance company to deny a valid claim when your loved one tries to collect the compensation owed. If your spouse or close relative has died […]

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