Insurance Settlements

Heather D. Lee ESQ, The Life & Property Insurance Lawyer, Featured in Philadelphia Style Magazine’s “Dynamic Women”Spotlight

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Each year, Philadelphia Style Magazine recognizes Philly’s most “Dynamic Women” – those who are industry experts going above and beyond in their respective industries. We are proud to announce that our very own Heather D. Lee, ESQ. has been recognized in the 2022 September issue. 

Attorney Lee was selected for her extensive insurance law knowledge and her ardent advocacy on behalf of life and property insurance beneficiaries who are facing delayed or denied claims at the hands of big business insurance. Congratulations, Heather!

The Life & Property Insurance Law Offices of Heather D. Lee is a multi-state life insurance and property insurance law practice best known for representing victims of wrongfully delayed and denied life insurance claims, accidental death and dismemberment (AD&D) claims, and ERISA claims.  We also handle life insurance beneficiary disputes, denied renters and homeowners insurance claims, auto theft claims, premises liability and other property insurance claims. 

​Since 2011, life insurance lawyer Heather D. Lee has dedicated her career to helping insureds and beneficiaries stand up to big insurance, collecting millions in delayed and denied life and property insurance benefits on behalf of her clients.

If a life insurance or property insurance company has delayed or denied your claim,  Contact Us today at (800) 403-5710 or visit www.life-insurancelawyer.com for more information about our law practice. The Law Offices of Heather D. Lee offer free case evaluations as well as low contingent fee arrangements on all cases.

Florida’s Road to Recovery – What You Need to Know About Hurricane Insurance Claims 

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Hurricane Ian recently caused an estimated $25 billion – $40 billion in damages across the State of Florida, much of which is not fully protected by insurance. If your property has been damaged or destroyed as the result of this ferocious storm, the difficult and uncertain work of rebuilding now begins.

What do you do first? And how do you make sure you’re receiving every dime you deserve from your insurance company? 

It’s going to be a long road ahead but you’ll want these basics to start the process.

Immediately After the Storm:

Report the Damage

Instead of jumping straight into clean up and repair mode, it’s best to contact your insurance company before doing anything else. This allows your agent to advise you on a repair plan that adheres to the terms of your policy. Gather as much information as you can about your policy, including how much time you have to file a claim. It’s going to be a busy time!  Most insurers will advise that once you file a claim, you’ll likely wait a few days or even weeks before an adjuster contacts you to schedule an inspection. The earlier your claim is in, the better, as claims are prioritized by first-filed and most severe.

Make Temporary Repairs

After contacting your insurer, you should begin making temporary repairs to secure your property. This might include boarding up broken windows, placing tarps over holes in the roof, and/or drying out wet items to prevent mold. Take photos and video of all damage both inside and outside of your home or property before any clean-up or repair efforts are made. Keep receipts for materials used and keep a record of all repairs made. It is important to know that payments for temporary repairs come out of the total settlement amount of your claim, so now is not the time to make extensive or permanent repairs. Property insurance policies typically require that you make repairs to mitigate further loss.  BUT, you will not want to start those renovations before the insurer can conduct an inspection of the property.  It is critical that you wait until after meeting with your claims adjuster to begin final repairs.

If You Need to Relocate/Evacuate

If you are unable to live in your home due to the storm damage, your insurance policy may cover reasonable additional living expenses. These expenses can include hotel rooms, gas, meals and even clothing and other necessities. Be sure to keep records and receipts from all expenses you pay out-of-pocket while you are displaced. Sometimes insurance companies will advance the money to you but regardless, you will be required to provide proof of how the money was spent.

Filing a Claim

Once you’ve notified your insurance company of your claim, the insurer will assign and send out an adjuster to inspect your property.  Generally, an adjuster will inspect your property within 2-4 weeks. In the meantime, you will need to thoroughly document your losses and get ready for their visit.  And don’t forget, make emergency repairs and mitigate any further damages, if necessary, but do not complete unnecessary repairs before the insurer’s inspection takes place!

You will want to begin making a list of damaged items, along with specific product description information and estimated value, immediately. The more detailed the information you can provide, the smoother the process is likely to go. Again, take photos and/or video of all damage and do not throw anything away until the adjuster has seen it. During their visit, the adjuster will inspect the damage, take photos and measurements, and provide instructions on submitting receipts for emergency repairs and reimbursements. They should also go over the claims process and an itemized claim estimate with you. Be sure to ask any and all questions you have, and do not be afraid to contact them to follow-up.  

Obtain written estimates from licensed contractors on repair costs. You ALWAYS want at least one (preferably two or three) independent estimates, as insurance companies make their profits by delaying, denying, and/or low-balling claims.  Ensure the bids are detailed and include information such as materials to be used and prices on a line-by-line basis. Once you find a contractor and a bid you like, your adjuster will need to approve the cost. Never pay in advance of work being performed, and never sign your insurance check over to a contractor. 

Get Help from a Legal Professional

If you need help navigating the difficult maze of delayed or denied property insurance claims after Hurricane Ian, the Law Offices of Heather D. Lee may be able to assist you.  

Often, when a property insurance claim is denied, people turn to a public adjuster for help. However, most public adjusters charge contingent-fees similar to an attorney’s fees. And when your public adjuster cannot get a fair settlement of your claim? Well, they’ll leave you looking for an attorney to file a lawsuit. Don’t waste your time and valuable funds. Go directly to the assistance you need now.

The Life & Property Insurance Law Offices of Heather D. Lee provide free consultations on all potential cases.  As a Florida native, Attorney Lee knows how devastating the aftermath of hurricanes and other major storms can be. You don’t have to go through this nightmare alone.  We are here for you, Florida. 

#floridastrong

Life & Property Insurance Law Offices of Heather D. Lee Now Serving Colorado & Florida

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The Life & Property Insurance Law Offices of Heather D. Lee is now serving clients throughout the States of Colorado and Florida.  If you are an insured or beneficiary whose life insurance proceeds are being withheld during a difficult time, let us handle the life insurance company so that you can focus on recovering, and on your family.

Attorney Heather D. Lee offers free case evaluations and low contingent fee arrangements on all cases.  That means you can obtain quality legal representation without worrying about how to afford an attorney.  If we are unsuccessful in collecting your delayed or denied life insurance claim, you will owe no legal fees whatsoever.  Contact Us today at (800)403-5710 or visit www.life-insurancelawyer.com for more information about our law practice.

The Life & Property Insurance Lawyer Expands to the Great State of New York

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We are proud to announce that the Life & Property Insurance Law Offices of Heather D. Lee is now serving New York.  Founder and life insurance attorney Heather D. Lee visited Albany this week to attend the Supreme Court of New York’s admission ceremony.

New York Life Insurance Lawyer

The more we expand, the greater number of people we can protect against wrongfully delayed and denied insurance claims.  If your life or property insurance claim has been delayed or denied, the Law Offices of Heather D. Lee may be able to assist you.  We provide free consultations on all potential cases, so you have nothing to lose and everything to gain by contacting us.

Visit our websites at www.life-insurancelawyer.com for more information, or call us at (800)403-5710 to speak to a life insurance lawyer now.

Insurance Consumers Win As Companies Are Made To Pay For Unfair Practices

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Insurance consumer advocates have won another big battle recently, as the insurance regulatory agencies from Illinois, Indiana, Texas, Pennsylvania and Florida finalized a settlement with Bankers Life and Casualty Company.  Pursuant to the terms of the settlement agreement, the insurance company must pay a fine of $3.2 million for its failure to comply with regulatory recommendations imposed following an investigation of its practices in 2007.

The investigation found fault with many aspects of Bankers Life’s policies and procedures, including the company’s claims handling practices, and it ultimately led to the issuance of various recommendations to bring Bankers Life into compliance with states’ insurance regulations.  The 2012 review of the company’s progress revealed that it had failed to bring claims investigation, denial, and settlement procedures into compliance with the 2007 recommendations, specifically in the annuities, long-term care, and life insurance lines of business.

The settlement agreement reached with Bankers Life is just one of many recent settlements between state insurance regulatory agencies and insurance companies.  This trend is an important step forward for insurance consumers, as it shows that states are no longer willing to let insurance companies get away with unfair and misleading claims handling practices.  If your claim has been delayed or denied, you should consult with an experienced life insurance attorney to ensure that you are not a victim of non-compliant or abusive insurance practices.

To review the 2007 and 2012 agreements, visit http://insurance.mo.gov/Contribute%20Documents/conseco-bankers_Stip.pdf and http://insurance.illinois.gov/newsrls/2012/11/BankersExecutedRSA.pdf.

Don’t Let the Not Necessarily Limiting ‘Suit Limitation’ Clause Deny Your Rightful Claim

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Insurance policyholders face many hurdles when a loss occurs.  One such hurdle involves the time in which a law suit must be filed after the insurance company denies your claim.  Suit limitation clauses greatly reduce the time-period to pursue even an illegitimate insurance claim denial.  While the Statute of Limitations for a breach of contract claim typically runs for 6-10 years (depending on the applicable state law), suit limitation clauses may reduce this window to as little as 12 months.  This is particularly problematic because limitation provisions are buried deep within lengthy, complex insurance policies and fail to provide actual and sufficient notice to policyholders.

Though a suit limitation clause functions much like a Statute of Limitations, in that both provide a specific time-period in which a suit may be brought, the difference between the two is important to note.  Significantly, a suit limitation clause is a condition imposed by contract, rather than by statute or law.  Therefore, the application or enforcement of a suit limitation clause may be challenged.

Like most issues relating to insurance policies, the law governing a contract’s suit limitation clause differs from state to state.  The majority of jurisdictions uphold such provisions, though some have not.  In those states where limitation clauses are considered valid, certain restrictions may be imposed on their use, with some states providing more protection for insured parties than other states.  Illinois, for example, extends the contractual limitation by the amount of time the insurance company takes to process the claim.  In other words, the period of time in which an insured may bring a law suit “tolls” for the number of days that pass from the filing of the claim to the date of the denial.

Further, states may provide additional protection against statute limitation clauses in the form of applying a notification requirement.  In Illinois, an insurance company waives its right to impose a time limitation clause if the denial notice does not include the remaining time-period for bringing a law suit.  The rules in Pennsylvania are less protective, on the other hand, with courts finding that a denial letter does not necessarily need to specify the amount of time to bring suit in order for a limitation clause to apply.

The effect of suit limitation clauses can be devastating to policyholders whose claims have been illegitimately denied, giving an insurance company the incentive to delay processing of the claim, and ultimately, the ability to escape liability.  If your insurance claim has been delayed or denied, you should speak to an insurance attorney immediately.  Even if you think too much time has passed to dispute your wrongfully denied claim, we may be able to help collect the life or property insurance proceeds you deserve.

The Insurable Interest Doctrine and Its Effect on Your Life Insurance Claim

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It may seem surprising that life insurance claims are commonly denied, and for many different reasons.  Life insurance companies reportedly refuse payment on approximately 5,000 policies each year, although we believe this figure is much higher.  One interesting reason that life insurance claims can be denied involves the lack of an insurable interest.  According to the insurable interest doctrine, in most states an individual cannot take an insurance policy out on the life of another person without having a legally-recognized insurable interest in that person’s life.  In other words, one cannot insure the life of another unless he or she derives some benefit or advantage from the continuance of the insured’s life.  The law does not want to encourage the practice of “wagering” on the life of another.  Allowing an individual to procure a policy on someone’s life without requiring the existence of an insurable interest may open the door to crimes being committed against the insured person.

The rules setting forth what constitutes a sufficient relationship differ amongst the states.  Generally, states consider the insurable interest requirement to be satisfied by blood ties or other affection-based relationships.  In many states, a monetary tie such as a business partnership is sufficient to create an insurable interest.  The line drawn by the various state statutes remains fuzzy, to say the least.  The majority of courts have found that determining whether a relationship gives rise to a sufficient insurable interest is a fact issue, meaning it is determinable on a case-by-case basis.

Whether an insurable interest exists is relatively easy to determine in some relationships.  For example, a husband and wife will almost always be found to have an insurable interest in each other’s lives.  But what about an unmarried couple?  Or grandparents and grandchildren?  Even the relationship between parent and child is treated differently depending on the state where the policy is issued.  For example, Illinois courts have found that the blood tie alone can be insufficient and have, in some cases, required a showing of monetary interest in order to bolster the insurable interest.  In New York and Pennsylvania, on the other hand, the parent-child relationship alone establishes an insurable interest sufficient to take out a life policy.

To further complicate the insurable interest doctrine, courts have held that expiration of the contestable period for life insurance policies does not defeat a claim denial for lack of an insurable interest.  Typically, insurance companies have a 2-year period to challenge the validity of a policy.  The vast majority of jurisdictions have held, however, that a lack of insurable interest can be raised to challenge a policy’s validity at any time, even after the contestable period has passed.  In New York, an outlier state, life insurance companies cannot refuse payment on such a basis unless the challenge was raised within the contestable period, which begins to run on the policy’s date of issue.

The lack of uniformity with respect to what constitutes an insurable interest can cause a great deal of confusion for beneficiaries.  Without the assistance of an experienced life insurance attorney, a proper beneficiary may lose the right to collect against a policy based on an insurance company’s arbitrary determination that a sufficient insurable interest does not exist.  If your life insurance claim has been delayed or denied, you should speak to a life insurance lawyer about the facts specific to your case immediately.

State Probes Into Wrongful Life Insurance Practices May Lead To Your Lost Policy

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The nation’s largest life insurance companies are feeling the heat as some states investigate wrongful insurance practices, particularly with respect to locating beneficiaries after an insured has died. In fact, it is estimated that tens of thousands of life insurance beneficiaries have been deprived of approximately $1 billion (or more) in unclaimed proceeds. Many of the life insurance companies currently under fire continue to claim that it is the sole responsibility of the beneficiary to notify the company of an insured’s death.

Life insurance beneficiaries often do not know a policy exists, however, and may not be in the best position to find out. Sometimes beneficiaries know about a loved one’s policy but do not know which life insurance company to contact and are unable to locate the policy documents.  Even worse, life insurance companies may mislead a beneficiary who does not have a copy of the policy and deter them from filing of a claim.  When thousands of policies go unclaimed every year, insurance companies just sit on the money.

But a life insurance company does not know when an insured has died, right? Wrong. State probes revealed that these companies have routinely checked the Social Security Administration’s ‘Death Master File’ for decades to discontinue annuity payments.  Until recently, life insurance companies never used the same source to notify beneficiaries of unclaimed policies.

In the past several months, multi-state settlement agreements have been reached with leading life insurance companies, including Prudential, John Hancock, and Metropolitan Life. The States of Pennsylvania, New Jersey, Colorado, New York, California, and Florida are among the leaders of these probes. As a condition of the agreements, participating life insurance companies will be required to improve their practices and make better attempts to locate the beneficiaries of unclaimed policies. The problem with locating past unpaid beneficiaries, though, remains.

The issue that state regulators are not addressing is the inability to locate older records of unpaid policies. Life insurance companies are only required to keep records of “terminated” policies for a certain period of years. Consider that when an insured dies and a life insurance company no longer receives premium payments, the policy will be treated as “terminated.”  Years later, because these policies are not properly held as unclaimed property, the records are destroyed, leaving the beneficiary responsible for proving the life insurance company’s liability. Of course, if the beneficiary had such proof, the claim would not have been delayed.

If you believe that an insurance company owes you money, speak to a life insurance attorney about your options right away.  The Life & Property Insurance Law Offices of Heather D. Lee can assist you in filing your life insurance claim, demanding that the company pay you immediately and with all applicable interest accrued as a result of the delay.  We work aggressively to collect wrongfully delayed and denied life insurance claims and do not charge any fees whatsoever unless we are successful.

Common Reasons For Delaying & Denying Life Insurance Claims

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At least 5,000 life insurance claims are denied in the United States every year, and even more policies go unclaimed.  People are usually surprised to discover that life insurance companies can delay or deny claims for many different reasons.  In fact, most people believe that when an insured passes away, the beneficiary receives a payout immediately.  Unfortunately, this is too often not the case.  Like most businesses, life insurance companies are motivated by profit, having a strong financial incentive to collect premiums but later deny as many life insurance claims as possible, or to delay claims as long as possible.

DELAYED LIFE INSURANCE CLAIMS

If a life insurance company has failed to promptly issue payment of your life insurance proceeds, you may have a claim for breach of contract and bad faith insurance practices.  Life insurance companies must investigate your claim within a reasonable period of time, usually within sixty (60) days of the claim being filed or in accordance with the life insurance policy terms.  An insurance company may attempt to discourage you from hiring a life insurance lawyer by wrongfully delaying your life insurance claim, offering a reduced settlement amount, or making other efforts to avoid paying the full claim.

Some common tactics that life insurance companies will use to wrongfully delay your claim include but are not limited to the following:

Insured’s Death Occurring Within Contestable Period
Hospital Records/Medical Documentation Not Yet Received
Hospital or Medical Provider Refuses to Release Records
Failure to Provide Income Tax Returns
Failure to Provide Non-existent Medical Documentation
Independent Investigation Based on Suspicious Cause of Death
Independent Medical Review to Dispute Evidence
Beneficiary Dispute Based On Divorce
Beneficiary Dispute Based On Suspicious Cause of Death

No matter how badly you need the insurance proceeds, you should never accept a settlement offer without the advice of an experienced life insurance attorney.  An offer to settle your claim for a reduced amount may indicate that the insurance company’s reason for delaying or denying your claim is illegitimate.

To discourage beneficiaries from pursuing a wrongfully denied life insurance claim, life insurance companies will mail complex denial letters designed to confuse you.  Life insurance companies know that you are likely unfamiliar with the life insurance contract itself, or with your rights as the beneficiary.
Some common tactics that insurance companies will use to wrongfully deny your claim include but are not limited to the following:
Policy Lapse Due to Nonpayment
Misrepresentations Regarding Age, Employment and/or Income
Failure to Disclose Immaterial Pre-Existing Medical Condition
Failure to Disclose Medical Appointments/Regular Check-Ups
Failure to Disclose Unknown/Unofficial Medical Diagnosis
Failure to Disclose Condition Requiring Future Treatment
Failure to Disclose Prior Alcohol, Drug, or Tobacco Use
Failure to Disclose Criminal History on Application for Insurance
Accidental Death Related to Independent Medical Condition
Accidental Death Actually Self-Inflicted
Accidental Death Caused by Alcohol/Drug Use or Crime
Accidental Death Not Occurring Within Specific Time/Date
Accidental Overdose Caused by Misuse of Medication
Policy Not Active Due to Death Occurring Prior to Effective Date
Policy Not Active Based on Period of Limited Activity Exclusion
Independent Investigation Based on Suspicious Cause of Death
Insufficient Evidence to Show Heart Attack
Independent Medical Examiner Disputes Evidence
Change In Health After Policy Lapse Due to Nonpayment
Change In Health Condition Prior to Effective Date of Insurance
Handwriting Expert Claims False Application Signature
Failure to Elect and/or Qualify for Employment Coverage
Failure to Convert Employment Coverage to Individual Policy
Insurance Company Not Responsible for Agency Errors
Insured Not Resident of United States on Date of Death
Failure to Properly Change Beneficiary
Policy Lapse Due to Depleted Cash Value
Many insurance companies have large legal departments prepared to defend denied life insurance claims, which can discourage a beneficiary from hiring a life insurance attorney, appealing a denied life insurance claim, or filing a law suit.
The Life & Property Insurance Law Offices of Heather D. Lee, Esquire are familiar with the various tactics used by life insurance companies to delay and deny claims, and we are experienced in pressuring insurance companies to quickly complete the claims process and pay all proceeds due under their life insurance policies.  If your insurance claim is being wrongfully delayed or denied, Contact Us for your free case evaluation today.

Heather D. Lee, Esquire Wins Reinstatement Of Policy When Life Insurance Company Failed To Give Notice Of Payment Lapse

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Insurance companies must generally notify an insured when a policy is at risk of lapsing due to nonpayment.  Such notification may be required by statute, as a term in the insurance contract, or by customary practice.  Policies commonly provide for a grace period of thirty-one (31) days, which allows an insured to avoid cancellation of insurance coverage if premiums are paid within the specified time-frame.  This is especially important with respect to life insurance policies because coverage is based on the applicant’s health at the time the policy becomes active.  In other words, if a life insurance contract lapses after the grace-period expires, reinstatement is subject to the same medical underwriting requirements as an application for a new policy.

Consider the following example: Larger-Than-Life Insurance Company (LTL) issues a life insurance policy to Youthful Yolanda, who faithfully pays her premiums for 15 years by monthly automatic withdrawals from her bank account.  Last month, though, Yolanda’s premium payment was returned due to insufficient funds in her account, triggering a 31-day grace period.  Despite LTL’s customary practice of notifying insureds when automatic premium withdrawals are returned, it fails to notify Yolanda that her policy will soon lapse. Unfortunately, Yolanda did not realize the payment was returned, resulting in the cancellation of her life insurance policy.  Since Yolanda is not so youthful anymore, and her health has changed over the past 15 years, she is no longer eligible for a new life insurance policy.  Even though LTL is entitled to keep all of her previous payments, Yolanda no longer has coverage and LTL refuses to reinstate her lapsed policy.

This is a fairly common story, with variations.  Sometimes insurance companies mail the appropriate notification too late, or to an incorrect mailing address because it has failed to process an address-change request.  Just this month, the Life & Property Insurance Law Offices of Heather D. Lee, Esquire successfully fought for reinstatement of a life insurance policy that lapsed when a major insurance company mailed notification of an overdue premium payment after the grace period had already expired.  Even a timely mailing may not contain the proper information to provide sufficient notice, such as the amount due or the date a policy will terminate.

If your life insurance policy has lapsed for nonpayment, or if you are a beneficiary whose claim has been denied because a policy lapsed prior to the insured’s death, you should speak to an experienced life insurance lawyer about your rights.  Heather D. Lee, Esquire offers free consultations on all life and property insurance cases.