Life Insurance Claim & Medical Records

[Zigner]

I have not refused to supply documentation. The funeral home provided them with a certified copy of the death certificate 2 months ago. The cause of death on the DC says "pending" & we are awaiting the results of further testing. This policy is 6 years old & as far as I know there is no contestability clause in the policy, especially after all this time. I understand that the insurer may be concerned over foul play in my daughter's passing. But do they actually think someone caused my Daughter's death then turned around & signed the policy over to the funeral home to cover the funeral costs? On a $10,000 policy? The idea is preposterous. The M.E.'s office has agreed to provide the insurer with a statement saying that there was no foul play involved here. But, the insurer has refused to request it from them. And the M.E. will not provide it to anyone else. I asked if they would send it to me or the funeral home.

All you will get here is guesses. The only entity that can tell you why they are asking for the information is the insurance company. I'm sorry.

 

[adjusterjack]

Probably because the OP has not provided anything to prove a covered incident has happened. (ie death if the insured policy.)

He's refused to send the non-final death certificate, a copy of the obit or access to medical records.

That's a great point. At this time, the insurance company has no documented official proof that the covered individual passed away.

Which is why I said what I did. Whether it's the medical records, the death certificate, an obituary, or something else, the claim is not going to get paid as long as the OP refuses to submit any documentation. He's going to have to give them SOMETHING if he wants them to pay, and they're on firm ground refusing until he does.

That is a refusal of information.

Jeez, people, you're blowing this way out of proportion. OP's not refusing anything. What part of "pending" don't you understand? Once the revised death certificate lists the official cause of death, that's all the insurance company needs for the claim to be paid. So, yeah, it's not going to be paid until then. Meantime, nobody's doing anything wrong by waiting.

And the insurance company isn't going to deny benefits just because there's a delay with the death certificate. The claim will just be on hold until that happens.

 

[adjusterjack]

Jack, isn't there also a possibility that the insurer thinks there may have been a misrepresentation about the insured's medical condition at the time the policy was first written?

I explained that already. It's only an issue if death occurs within the two year contestability period.

 

[Zigner]

Once the revised death certificate lists the official cause of death, that's all the insurance company needs for the claim to be paid.

I don't believe any of the people you quoted were saying anything different. I know I wasn't

 

[cbg]

No one said otherwise. But if he is looking for a payout prior to the death certificate being amended, which is how I read the question, he's going to have to provide something else. Maybe I misread what he is looking for and if so, I apologize. But a life insurance policy simply cannot pay out without some evidence of the cause of death.

 

[adjusterjack]

We're kicking a dead horse here.
Thread closed.