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It is one of the more common life insurance problems – You are the beneficiary trying to make a claim on a life insurance policy. The insured died within two years of taking out the policy and the claim is within the contestability period. They want medical records on the person who died and won’t evaluate the claim without them. The problem is that you can’t get the medical records. So, what can you do?

Options to obtain medical records on a deceased person in Florida

There are two main ways to get medical records on someone who died in Florida – subpoena and medical authorization. Without one of these, the life insurance company may either deny the claim or stall payment until they obtain the medical records.

Getting medical records with an authorization

In order to get medical records on someone who died in Florida, you generally need to open a probate estate and have someone appointed as the personal representative of the estate. The personal representative then has the authority to obtain medical records on behalf of the estate.

Sometimes this may not be an option or may not be a good option. For example, a beneficiary who is not related to the decedent may have no authority to open an estate.

Obtain a subpoena for medical records

A subpoena is another way of obtaining the insured’s medical records in Florida. To do this, a lawsuit must generally be filed first. Once the discovery phase has started in the lawsuit, the Florida life insurance attorney can issue a subpoena to any medical provider where the insured treated. If you don’t know where the insured treated, the Florida life insurance lawyer can also send a subpoena to family members of the insured and health insurance companies. Depositions of family members can also be taken if necessary to obtain information.

Life insurance claim delay should not be tolerated

While a life insurance company may reasonably investigate, they should not stall without reason. If a life insurance company fails to pay a claim within a certain period of time, they may have to pay interest and possibly attorney’s fees and costs on top of the policy limit.

For more information or assistance, feel free to call our office at 800-337-7755 or contact us online for a free consultation.

They take your premiums, and promise to pay benefits when your loved one dies, but then they don’t. It’s an all too common phone call we get from heart-broken and frustrated beneficiaries who expected to receive life insurance benefits when their loved one passed away.

Unfortunately, life insurance companies often try to figure out any way to not pay the benefits after somebody dies.

The many reasons for life insurance denials

There are several reasons we’ve seen where beneficiaries thought they were entitled to life insurance benefits, but then the insurance company refused to pay. Some of the common life insurance denial claims are:

Material misrepresentation – this is where the life insurance company generally claims that the policy owner or insured lied on the policy application. Even though they easily could have cleared things up while the insured was alive, they instead often choose to do nothing and investigate the insured’s medical history if the person dies within 2 years of the policy’s effective date.

Child who died was not covered – life insurance companies often sell policies to cover both parents and their children. What they don’t always tell you is that children may only be covered to a specific age, and only in specific circumstances, like if they are a full time student. Sometimes, though, an agent or the insurance company may still tell you a child is covered. If you take out a policy and are told your children are covered, then you may still be entitled to benefits even if the policy language says otherwise. The insurance company cannot tell you one thing to have you rely on it to your detriment. That is not fair and often not legal.

General life insurance vs Accidental death and dismemberment – one common type of life insurance claim we see is where a life insurance company denies a claim under an accidental death and dismemberment claim. In order to qualify for coverage, the death must generally be the result of an accident. We had a case where the a woman was hit by a car and killed while crossing the street not at an intersection. The life insurance denied the accidental death claim by stating that she caused her own death by jaywalking. Rather than accept the denial, the beneficiary called our Florida life insurance attorneys for help. We proved the law to the life insurance company that the death was an accident and not intentional, and they paid the entire policy limit within 21 days!

Even if the life insurance company lied to you, you may still be entitled to the insurance proceeds

When a life insurance company fails to pay life insurance benefits, they may be in breach of the life insurance contract. Failure to pay the benefits is often looked at as a breach of contract. However, there are many intricacies of life insurance law that an experienced life insurance attorney can help navigate.

The law of promissory estoppel may entitle you to the insurance proceeds

Life insurance companies cannot lie to you. They cannot misrepresent facts and get you to keep paying life insurance on a policy which they never intended on paying out.

For example, we represented a beneficiary who was told that her son would be covered under the policy. However, after he died, the life insurance company denied the claim and argued that he was not covered under the policy because he was under the age of 25 but not a student. Our life insurance attorneys were able to request copies of the phone calls between the beneficiary and the life insurance company, and were able to prove that they made representations to her which she relied on to her detriment. The life insurance company reversed itself and paid the full benefit to the beneficiary.

For questions on any life insurance claim in Florida, feel free to call our FL life insurance lawyers at 800-337-7755 for a free consultation.