Geller Law
Life insurance policies are meant to provide financial security to families in the event of a loved one’s passing. However, sometimes, insurance companies deny these claims, leaving families in a difficult situation. One such case came to us at Geller Law, where a life insurance death benefit was denied due to non-disclosure of a medical test.
Our client, the family of the insured, was denied their rightful death benefit claim by the insurance company. The reason? The insured had failed to disclose a medical test. The insurance company argued that this non-disclosure was a breach of the policy terms and conditions, and thus, they denied the claim. The family was confident that their deceased relative did not know of that the test was for the alleged medical condition. The relative had not had the disease and the relative, obviously had not died of the disease. From a legal perspective, most importantly, the deceased had passed over 2 years after the policy had been sold.
Non-disclosure cases can be complex. Insurance companies often have vast resources at their disposal, including experienced legal teams. Often doctors order tests without telling the patient all of the tests being run. Often patients forget the details of medical appointments and tests. This is not fraud, it is human behaviour and the failing of our memory. But at Geller Law, we believe in fighting for justice, no matter how big the opponent.
We meticulously reviewed the insurance policy and the circumstances surrounding the non-disclosure. We found that the medical test in question was not directly related to the cause of death and had alternative uses including what the patient had attended for. Moreover, the insured was not aware of the significance of this test, and thus, the non-disclosure was unintentional. Finally, as the policy had been in place for more than 2 years, the insurer had to prove civil fraud - a very high threshold in the absence of any evidence of intent to lie/mislead.
Armed with these findings, we challenged the insurance company’s decision. After a tough legal battle, we were able to convince the insurer that the non-disclosure was not a valid reason to deny the claim. The insurance company paid the death benefit to the family of the insured.
At Geller Law, we understand the emotional and financial stress that comes with losing a loved one. We believe that no one should have to fight with an insurance company during such a difficult time. If you or someone you know is facing a similar situation, reach out to us. We’re here to help.
