GEICO claim denial. So easy a caveman can do it!
Driving a motor vehicle any time can be dangerous, but there are some times that are statistically more dangerous than others. The Insurance Institute for Highway Safety spokesman, Russ Rader recently noted, “getting behind the wheel of a car is the riskiest thing most people do every day.” However, there are certain times driving is riskier than others. The following information is compiled from reports from Forbes.com and WebMD Medical News. Some of this information is common sense, such as driving at night is more dangerous than driving during the day and more crashes occur on the weekend than mid-week. With that said here are some crash facts to keep in mind:
– The National Highway Traffic and Safety Administration reports the most dangerous month to drive is August.
– Saturday is the most dangerous day to drive followed by Friday and Sunday.
– Tuesday and Wednesday are the safest driving days of the week.
– The most dangerous hours to drive on any given day are between 5:00pm and 7:00pm.
– The safest time to drive during the day is between 4:00am and 5:00am.
– July 4th is the most dangerous driving day of the year. Followed by: July 3rd, July 2nd, December 23rd ,January 1st and September 2nd.
– New Year’s Day and Halloween are the most dangerous days for pedestrians, and
– Almost half of all fatal motorcycle crashes occur in June, July and August.
Everytime you get behind the wheel of a car you are at risk. Please be a safe and courteous driver. Please use your seat belt and insist that all occupants in your vehicle use their seat belts and make sure all children are properly restrained.
EVEN A CAVEMAN IS SMART ENOUGH TO KNOW THAT BEING SUED CAN ADVERSELY AFFECT HIS CONSUMER REPORTS. In a recent poll of auto-negligence lawyers across America, numerous attorneys who represent auto-collision injury victims say they are having to file more lawsuits to recover restitution for their clients when GEICO is involved. Steve Moore from M&W participated in the informal poll conducted through a national listserve for auto-negligence attorneys. “When we take on an auto-negligence claim for the victim, we explain it’s in their best interest if a fair settlement can be reached without having to file a lawsuit,” said Moore. He explained that lawsuits and litigation are expensive and time consuming for victims who are often in a difficult financial situation because of lost wages, co-pays and deductibles. “Companies like GEICO know Alabama procedural, regulatory and substantive laws are in their favor and they are really taking advantage of this situation,” he said. Moore went on to say that not only is GEICO taking advantage of the victim by making “ridiculously low” claim settlement offers but their own insureds as well. He explained that not only are lawsuits difficult for victims but it also means the at-fault drivers insured by GEICO are going to suffer. In Alabama even though the insurance company gets to control the payment, or non-payment, of a liability claim it’s their insured that must be named as the Defendant in a civil lawsuit for damages. Moore referenced the recent claim of one of his clients against GEICO as an example of just how unreasonable and difficult GEICO is being. The clients were rear-ended by a GEICO insured as they were stopped in traffic. GEICO’s last offer to settle the claim before litigation was less than the clients’ medical expenses and lost wages. “This is not a big case,” said Moore, “but GEICO has left our clients with the option of incurring an out-of-pocket loss of several hundred dollars or filing a lawsuit to try and recover full restitution.” He noted that not only is GEICO re-victimizing the victim, but they are subjecting their own insured to the various adverse consequences of a civil lawsuit and possibly a civil judgment. “Being a Defendant in a civil lawsuit may have adverse consequences to consumer reports and is a factor to be disclosed on credit applications and job applications,” explained Moore. In closing he said, “I think the real cavemen at GEICO are the ones making these kind of unfair and unjust decisions.”
IMPORTANT INFORMATION ABOUT LIFE INSURANCE CLAIMS©
By: Mark Wolfe, Attorney at Law
While most of us hope that a life insurance claim arising from the death of a loved one will be a simple and hassle free process, the fact is many life insurance claims are initially denied. These denials can be for many reasons. Some times the reasons for such a denial are legitimate, but many times they are wrong. In fact many insurance industry experts say that up to 40% of life insurance claim denials are done so wrongly.
This article will help you with some basic information about life insurance claims and locating policies. Then the article reviews common reasons why life insurance claims are initially denied and concludes with important information for claimants if the claim is denied.
I. LIFE INSURANCE CLAIMS & LOCATING OTHER POLICIES
Notify the Company of the Claim. While this is a very basic step it can be a little difficult if the policy is older. Mergers and acquisitions of life insurance companies can make locating the correct successor or remainder company a little difficult. However, internet searches can usually help you quickly identify the correct company name and location for claim notification. Also, many life insurance agents or attorneys who handle life insurance claims have this information available or access to the correct resources to help identify where and how the claim should be submitted.
What You Need to Do. Once you’ve contacted the company you must complete the claim form. Many of these claim forms can now be downloaded from the company’s web site. At the very least you will have to submit a copy of the death certificate and the company may require additional records related to the claim. Always reference the claim number or policy number (or both) on all documents or material submitted. Until the claim is paid in full: Keep copies of all correspondence and documents sent to the life insurance company. Keep all letters and material sent from the life insurance company. If a claim is denied, make sure you understand and comply with the requirements for an appeal. (IMPORTANT: Please make sure to read more about appealing a denial below.) Why are so many life insurance claims denied? Most life insurance claims adjusters recognize that many life insurance claimants do not question or challenge a denial of life insurance benefits. This means that if there is a “close call” on whether or not benefits should be paid, they automatically opt for denial first in hopes the claimants will just “go away.”
Locating Additional Policies. It’s a fact, many life insurance benefits go unclaimed because beneficiaries do not realize a policy exists. Below are some tips for locating additional life insurance policies.
1. Review the decedent’s check book or bank statements looking for premium payments,
2. Review the decedent’s tax returns for the last several years to see if interest or cash dividends from a life insurance policy were listed. There should be a corresponding 1099-INT from the life insurance company. These payments will be reported directly on form 1040, 1040A and 1040EZ or on Schedule B if an itemized tax return was filed,
3. Contact the decedent’s employer and/or former employers to see if any type of life insurance was offered through the company’s benefit plan program and if the decedent purchased a life insurance policy or was provided a life insurance policy through employment,
4. Review all disability policies for the decedent to see if death benefits are also provided,
5. Review any known life insurance policy to see if additional benefits such as double indemnity for accidental death may apply.
6. Check with the decedent’s auto insurance company or homeowner insurance company. Many of these companies will also offer life insurance policies for their customers.
II. DENIAL OF BENEFITS AND APPEALS
Standard life insurance claim denials. Many times if a basic life insurance claim is denied, it is done so based upon a process known as “retroactive underwriting.” This is a claim investigation technique that allows the insurance company to more fully and completely examine the deceased’s prior medical history. These prior medical records are reviewed thoroughly to see if the deceased left out or failed to disclose a pre-existing medical condition when completing the life insurance application. This “failure to disclose” is then used as grounds to deny the life insurance benefits. However, most claimants are not aware that such a denial must have materially effected the underwriting risk associated with issuing the policy. Simply put, the company must be able to legitimately argue that “but for” the undisclosed prior medical condition, the policy would not have been issued or the rates for the policy would have been significantly different. The issue of “material risk” is a complex issue that is often legally debatable.
Accidental death or double indemnity benefits. Some companies issue stand alone accidental death life insurance policies or some standard life insurance policies have a “double indemnity clause” which pays twice the face value of the policy if the death is caused by an accident. Yet the policy language concerning the term “accidental death” is often drafted so vaguely that it gives the company lots of “wiggle” room to initially deny accidental death benefits. Terms like “sole and only proximate cause of death”often involve complex medical and legal analysis but give the company a very legalistic sounding excuse not to pay.
BEFORE YOU FILE AN APPEAL OF A DENIAL. If you have questions about the denial of any life insurance benefits, make sure you fully understand your rights and obligations under the policy. Most life insurance policies allow claimants to file an appeal of the decision to deny benefits. Yet many times claimants are unaware of the potential consequences of simply “appealing” the denial. Generally, once a company has denied the life insurance claim, the claimant has the burden of identifying specific reasons for the appeal and providing supporting documents or records to support the appeal. If the life insurance policy in question has been provided through the decedent’s employment or through a group, the failure to comply with the appeal requirements can be extremely detrimental. In one recent example a Federal Court determined that the claimant’s failure to submit any “new evidence” during the appeal process provided for in the plan, precluded the claimant from presenting that new evidence at trial. [See Hancock v. MetLife, 590 F.3d 1141 (10th Circuit 2009).]
NOTE: If the claim is denied consider consulting immediately with an experienced life insurance claims attorney in your State. Note: Most attorneys who handle life insurance claims for beneficiaries do not charge for a consultation and work on a contingency fee (no benefits = no fees). Also, many times an experienced attorney can help resolve a denied claim before having to resort to filing a lawsuit.
While life insurance claims should be simple and easy, they can often times become arduous and legally complex. The simple fact is insurance companies do not like to pay claims and have tremendous resources to fight claims. With many claimants of life insurance benefits in a state of grief and mourning, the insurance company knows it has the upper hand and this often results in the wrongful denial of life insurance benefits. If you believe your claim for life insurance benefits has been wrongfully denied, please consider consulting with an experienced attorney who knows and understands this area of the law.
Note from the author: If you are reviewing this publication or link during a time of loss, please accept my condolences and sympathy for your loss. I pray that you find comfort and understanding for your loss and that the passage of time will replace the sorrow of your loss with the joy and blessing of the memories of moments shared. – Mark