Recently, it was reported that a man was denied life insurance benefits after his wife died from a three-month bout with breast cancer. The policy, for $200,000, was taken out six years before the wife’s sudden and unexpected death. The man’s claim for benefits was denied on the basis of the wife’s death due to illness not constituting an accident under the life insurance policy. Assuming that he had filed a valid claim for benefits, the man was shocked and furious to learn that insured denied his claim. The life insurance company was able to rely on a policy exclusion against illness and other unforeseen occurences to avoid paying benefits. A common tactic frequently utilized by life insurance companies.
It is important that you read all of the provisions contained in your life insurance policy. Insurers carefully craft these policies to hedge their bets and ensure they reduce their risk of payment on claims. As a result, these policies often carve out narrow exclusions for illnesses and other occurrences lay people assume are covered. These exclusions can have an enormous impact on whether you are entitled to benefits. Typically, an accident must occur in order for an insurer to pay death benefits. The term “accident” is frequently litigated in cases involving denials. An insurer will try to narrowly define “accident” to reduce its liability. It is important to know what your life insurance policy covers and what it does not so always read your policy carefully.