Can someone olease help me with this, You are an attorney a client comes to you
ID: 467662 • Letter: C
Question
Can someone olease help me with this,
You are an attorney a client comes to you and advises you that her spouse applied for life insurance underwent the physical and died prior to the receipt of the policy. The insurance carrier refuses to pay any benefits. The client was informed by the insurance agent at the time of application that coverage was in effect. How do you advise the client of her potential for a recovery. I have raised the point value of this assignment because of the difficulty.
Explanation / Answer
Answer:
In the given case, if the first premium towards the policy initiation is paid and the effective date of the policy is a date before the death (as the agent told that the policy has come into effect), then it is not ethical or justifiable on the part of the insurance company to refuse the benefit. Once, the contract of insurance becomes effective, the insurance company cannot deny the benefits to the the family of the dead even if the receipt of the policy is pending. Provided that the death caused is not an exceptional death which is not covered under the policy.