my mother passed away unumprovident denied our claim?

Question

my mother passed away had 2 life ins. policy with unumprovident they denied our claim for a paper that was not filled out her job told me she was told about form my mother had brain cancer she had bad memory at times i want to to know why didn't they send a notice by mail or the ins. company but they still got her money for
policy now i have to pay funeral, and all bills they say i need to write appeal letter do i need to hire lawyer or file appeal 1st had anyone gone through this or any help you can give me thanks

Answer 1

I'm very sorry about the loss of your mother. Please accept my condolences.

You didn't specify what purpose the form served, so I can only guess: was it an election form to convert her group coverage to an individual policy after she left employment? If so, there is a policy provision that governs how the notification must take place and how long the person has to elect to convert.

Many states, such as mine, even have a law that says that a person who dies during the election period is considered to have elected the coverage, and a claim cannot be denied for the failure to fill out the form. In order for a law like this to be applicable, your mother must have been within the election period.

It is also important to investigate whether her employer and/or UnumProvident complied with the group policy's notification provisions. If proper notification wasn't given to your mother, this MAY be a basis to insist UnumProvident pay the claim, or (if it's the employer's fault) the employer pay damages equal to the policy proceeds (depending upon which party was required to provide the notification).

Although some here suggest you seek the guidance of an attorney, I think your best bet at this time is to file a written complaint with the insurance commissioner in the state where your mother lived and worked. An investigation will be performed and a determination made as to whether or not UnumProvident's decision complied with the law.

At least one answerer mentioned a class action lawsuit. This matter wouldn't fall under the class action because 1) the claims were denied after the class action cut off date; and 2) the class action lawsuit doesn't pertain to this issue. So I don't think you should be worried about this.

I hope this helps.

Answer 2

Insurance policies have what is called a "contestable period". Most are for the first 2 years. If you lie or omit something on your application, the company has the right to refuse to pay the claim. I'm not saying that was the case, but if your mom had cancer when she took out the policy, it is unlikely they will pay the claim, since she had a pre-existing condition. I would call the insurance agent and find out exactly what "form" they are talking about and then call an attorney. And unfortunately, if there is a specific form that was required but not submitted, they don't have to pay. So sorry for your loss, God bless.

Answer 3

What is the official reason the claim was denied??

If they claim the policy is invalid, they will return all the premium she paid to her estate. That should help with the funeral bills.

Meanwhile, go to your personal insurance agent, ask them to help you write the letter of appeal (no charge!!) and file the appeal before you hire a lawyer - hiring a lawyer means they'll take a big chunk of the payment, if you get one.

Answer 4

Sorry about your Mother. I sell life insurance and I know that the law is very strict on life insurance companies. If she was making the payments she was covered and the court will decide in your favor. Get a lawyer and sue the company. Sorry that you had to go through this. Good luck and God bless

Answer 5

Insurance companies never want to pay a claim if they can get away with it.
You should definitely get an attorney and ask their advice.

Good Luck

Answer 6

Yes you should definatley hire a laywer, and I am sorry for the loss of your mother.

That is what innsurance companies do....they wait for you to make one small error so that they can deny your claim

(the Ba$tards)

Answer 7

Call them and find out exactly what you need to do so that you can take care of this. I don't think you'll need a lawyer. Speak directly with them and ask what to do.

Answer 8

Looks like you aren't the only one. Check out this web page about a class action suit against this company.

Answer 9

That is just sorry, call an attorney

Answer 10

yes