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Searching For Loopholes – How Will Your Insurance Company Deny Your Claim?

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After losing his brother to the war in Afghanistan and watching his parents suffer through the loss of one child, Andrew White, a Marine in the war in Iraq, took out a $50,000 AIG life insurance policy to prevent any further financial burdens on his parents. Andrew underwent an AIG mandated medical examination and received a life insurance policy the following month. As a smoker, Andrew timely paid his increased premiums for fourteen and-a-half months. When Andrew died in February 2008, AIG denied his family the $50,000 life insurance policy.

One may ask, “what justification does an insurance company have to deny a life insurance policy to a family who clearly seemed deserving of it?” AIG told the family that “had they known that Andrew White was in a car accident when he was 16-years-old, they never would have written the policy to begin with.” Andrew died within two years of obtaining his life insurance policy. This put Andrew’s death in the Contestability period of the insurance policy, which indicated that misrepresentations made during the medical examination would void the policy. A war veteran, who passed the necessary physical requirements to obtain the policy, was denied coverage because of a car accident in which he was involved when he was 16-years-old. AIG Life denied Andrew’s claim all the while making record breaking profits.

Health insurance claim denials are becoming increasingly familiar. Susan Kristoff, a breast cancer survivor, was denied benefits until she went public with her battle to obtain disability payments from Cigna. Since her story aired on Good Morning America, the news station has been flooded with e-mails from people who were facing similar difficulties in obtaining coverage.

After compiling years of court documents, SEC and FBI reports, the American Association for Justice (AAJ), discovered a pattern amongst the top insurance companies. “The rankings show a distinct pattern of insurance industry greed amongst 10 companies that refuse to pay just claims, employ hardball tactics against policyholders, reward executives with extravagant salaries, and raise premiums while hoarding excessive profits.” The essential question one must ask is where this unfortunate reality leaves the supposed insured. It leaves them in an uphill battle in which experienced insurance companies will look for the most immaterial event to justify claim denials, while leaving the insured to fight for their much deserved policy.

Don’t let insurance companies get out of their responsibilities. Keep them accountable – if you need help, contact us.