The Law Firm of J.P. Gonzalez-Sirgo, P.A. Helps Insurance Policyholders Recover What They Are Due On Their Insurance Claims, Zealously Advocates On Behalf of Victims of Catastrophic Personal Injuries or Wrongful Death and Fights for the Rights of Consumers and Small Businesses in Miami and Throughout Florida.

Tips for Fiing a Life Insurance Claim

Life insurance can provide family and loved ones with some financial security in the event the policyholder dies.  Filing a life insurance claim can be difficult considering you are still mourning the death of your loved one.  Filing a life insurance claim as early as possible will help alleviate some of the financial burden the deceased wanted his beneficiaries to avoid when he/she decided to purchase the policy.  This is especially true in cases where the deceased was the primary bread winner. 

Below are tips to help a life insurance beneficiary file a life insurance claim, and hopefully make the process a little easier.

• 1. Locate the life insurance policy.
• 2. Contact the life insurance agent that sold the policy. Inform the agent about the death and try to engage his/her assistance.
• 3. Contact the insurance company and file the claim. Be prepared to answer questions about the policy.
• 4. After contact, wait for necessary paperwork to arrive. Fill out the paperwork. Accurately answer all questions. Call insurance company if you don't understand a question.
• 5. Obtain a copy of the death certificate.
• 6. Mail the insurance company all the completed paperwork along with the death certificate. Send the package certified mail, return receipt requested.
• 7. The insurance company may contact you for further questioning or clarification. Answer all questions to the best of your ability.
• 8. Follow-up with the insurance company to obtain status of the claim process.
• 9. Contact an experienced life insurance lawyer if your claim is delayed or denied.

Following the above tips will help beneficiaries cope with the additional responsibility of filing a life insurance claim at a difficult time.

The “Effective Date” of a Life Insurance Policy

The "effective date" of your life insurance policy is the official and legal start date of your policy.  This is a very important date since benefits can be triggered while an application is in process.  In addition, this date also affects the contestability clause and the suicide clause of the policy.

Since a life insurance policy is a contract, the "offer and acceptance" rule applies.  With life insurance, offer and acceptance means that both parties have agreed to be bound by the terms and conditions of the contract.  During the application process, the offer is started when the applicant mails the application and initial premium to the insurance company.  The life insurance company accepts the offer when formal notice is sent to the applicant accepting the applicant's life insurance policy and premium.  It is important to note that without the initial premium attached to the application there exist no offer.  If no premium is initially sent to the insurer, acceptance occurs when the applicant sends the required premium after receiving notification of application approval from insurer.  The effective date is set when the insurer receives the initial premium. 

It is recommended that an applicant mail the initial premium along with the application since one's health can deteriorate during the underwriting process and before the policy is issued.  If your health changes or the applicant dies during underwriting, the effective date will prove to be very important.  The effective date can also be established by the date the policy is actually delivered or received by the applicant.  This can include a manual delivery or via email receipt since so many policies are actually purchased online. 

While choosing a life insurance carrier, understanding how the insurer establishes the effective date is important especially if faced with health issues or even death during the underwriting process.

Michael Jackson’s $17.5 Million Dollar Policy Quickly Settled for $3 Million

Michael Jackson's $17.5 Million Dollar Policy Quickly Settled for $3 Million

According to entertainment news website HollyScoop.com, in a rush to cash in on "something" from Michael Jackson's $17.5 million dollar insurance policy, a quick $3 million dollar settlement was reached with Lloyds of London.  The insurer provided coverage in the event losses were sustained due to cancellations of any of the 50 planned concerts.  However, the policy did not cover any losses due to illegal or illicit taking of drugs.  Due to the fact that rumors have been circulating that Michael may have died due to a massive drug overdose, the representatives of Michael's estate decided it would be best to settle for something rather than nothing in case the LA County Coroner's office ruled that indeed Michael's death was caused by a drug overdose.

Now that we all know that Michael's death was the result of lethal levels of "acute propofol," the estate representative's decision to quickly settle the life claim proved correct.

Lack of Ownership Proof Disallows Life Insurance Recovery

Business entities, including small businesses, frequently purchase life insurance on key employees and owners.  Recently, a court case in Michigan proved how important it is for businesses to keep track of their policies and ownership documentation in order.  Unlike individually owned policies, business owned policies are affected through business ownership and shareholder changes, business dissolution, and other factors.  In the Michigan case, during the 1970's a small business purchased a life insurance policy for its owner from MetLife Inc.  The business was dissolved in 1975.  In 2000, Metlife converted from a mutual insurer owned by its policyholders to a publicly traded company.  This meant the policyholders were entitled to cash.  In this case, it meant nearly $200,000.  Since Metlife could not locate the business, the money was given to the State of Michigan.  The widow of the small business, now 80 years old, discovered the money was being held by the State of Michigan and filed a claim.  Her claim was denied because she could not provide adequate proof that she was indeed the owner of the policy and that the business had been dissolved.  The claim was denied despite the widow showing documentation about the family's ownership and status as corporate officers of the dissolved corporation.  A Michigan Court of Appeals agreed with the state.  However, the court did leave a reason for hope by stating that historic shareholders may be allowed to recover the proceeds.  The widow's attorney will continue to fight this case.  

This case is a good example of why businesses that are beneficiaries of life insurance policies must keep good control over their life policies.  As the case above shows, a business that is dissolved may encounter problems when attempting to claim life insurance proceeds on a key employee or owner.

Life Insurance Claim Been Denied? We Can Help!

The Law Firm of J.P. Gonzalez-Sirgo, P.A. has the experience, knowledge and skill required to handle your life insurance claim throughout the entire State of Florida.  If your life insurance claim has been denied, rejected, delayed or underpaid, we can help.

Your loved one met his or her responsibility to yourself and your family when he or she purchased life insurance to protect your family in the event of his or her death.  

Life insurance serves as financial protection against the unthinkable - it is a safeguard against the losses that are suffered due to a loved one's death. A life insurance plan can make certain that the policyholder's family can continue their lives even in the face of unexpected tragedy and ensure that they have sustained and consistent support even after their loss.

But what if the unthinkable does happen and the insurance company is giving you the run around? An insurance company has a right to perform a reasonable investigation of your claim.  But what do you do when the investigation is clearly unreasonable and is being used simply as a method of delaying payment.  In the meantime, your bills keep coming in but your loved one's earnings are not.  What happens as the weeks go by and your claim goes unpaid? What happens if your claim is outright rejected?

An estimated 10 percent of valid insurance claims are unfairly denied - but less than one percent of policyholders who make claims question the decision that their insurance company makes.

We Are Your Insurance Against the Insurance Companies
As a former claims adjuster, I understand why these situations come about. Insurance companies are in the business of making money.  By delaying claims, insurance companies get to hold on to their money a little longer.  Money that is invested somewhere earning them money.  As far as insurance companies go, the only thing better than delaying a claim is denying a claim.

In simple terms, when your family bought a life insurance policy your insurance company entered into a contract in which they promised to pay out the life insurance benefits in the event of the policyholder's death in consideration for payment of certain premiums.  Your family was responsible and sacrificed to make the insurance premiums.   Don't let your insurance company get away with taking your money but refusing to follow through with their half of the deal.

Case In Point
A wife was put in a terrible situation when her husband unexpectedly passed away leaving her alone to support their five-year-old son. Shortly after his death, the wife notified the employer and life insurance company about the tragedy, but one and half years later the wife had not yet received one cent from the life insurance company. As a single working mom of a young boy she suffered not only from the death of her husband but from her family's dire financial situation. The insurance company argued that no life insurance policy even existed and artfully dodged the wife's inquiries. 

The wife called our office and enlisted our help. Shortly after we became involved, we were able to prove that an insurance policy did indeed exist and we persuaded the insurance company to set aside many of the issues that they were claiming existed. Thereafter, the insurance company took the position that although a policy existed, the face amount of the policy was only $10,000.00. We proved that the husband had elected to purchase a supplemental policy for an additional $100,000.00. The case was resolved for $110,000.00. A guardianship was established for the minor that will pay for the son's education. 

Insurance claims lawyer J.P Gonzalez-Sirgo has nearly 15 years experience and along with an experienced staff we hold insurance companies to their word. We do exactly what insurance companies fear: We Hold Them to Their Promises.

We routinely represent individuals and life insurance beneficiaries who have lost their loved one and now are facing a life insurance claim denial or unexplained delays in the rightful processing of their life insurance claim.

Filing a Life Insurance Claim in Florida

Following the death of a loved one, the last thing you want to deal with is the life insurance company.  However, a life insurance settlement can provide the necessary money to cover funeral costs, medical expenses and can act as an income supplement for you and your family.  It is important to understand what is involved in filing a life insurance claim, so that you can avoid a delay in the process and denial of your life insurance claim.

You should review the details of the policy to become familiar with the benefits.  If you cannot locate the policy, contact the life insurance agent or company.  Not only will they be able to explain the benefits under the policy, but you will also be able to receive information on how to file the life insurance claim.

There will be forms that you will need to complete. Each adult beneficiary is generally required to fill out a proof of death form.  Other supporting documents will be required by the life insurance company, such as a certified copy of the death certificate and often a certified copy of the marriage certificate, if applicable.  A funeral director can provide the death certificate.  Once all of the forms are completed and the necessary paperwork is gathered, you will need to submit everything to the life insurance company.

It does not take long for the life insurance company to review the claim.  If some documents are missing, then it could cause a delay in the processing of the life insurance claim.  Occasionally, a life insurance company will deny a claim based on fraud or material misrepresentation.  In that situation, you need to contact a Florida life insurance claims attorney, such as J.P. Gonzalez-Sirgo, immediately.  He can help you if you have been denied a life insurance settlement or if you are in dispute with the life insurance company.

The article, Top 4 Things You Need to Do to File a Life Insurance Claim, has additional helpful information regarding filing a life insurance claim.

Can’t Find a Missing Life Insurance Policy?

When a loved one passes away, the last thing you want to spend your time doing is looking for the life insurance policy.  It is not uncommon for the surviving family members to be unaware of the details regarding the life insurance policy, including the company who issued it.  However, it is worth the effort to try to locate the missing life insurance policy, as the settlement can help pay funeral expenses, medical bills and household expenses. 

Before you start your search, you should consider what company may have sold the policy.  For example, is there a particular insurance agent you work with for your insurance needs?  Is it possible that this insurance agent also sold the policy to your loved one?  Employers, trade associations and unions also frequently offer life insurance to their members, so you should also check with these resources.

If you are still not sure what company issued the policy, you may want to look through your loved one’s file cabinets, storage boxes and bank deposit boxes, if applicable.  An address book may even be helpful as it could list the name of an insurance agency.  You might consider calling professionals you have worked with in the past, such as accountants, attorneys, insurance agents and financial advisors.

While there is no central database to locate life insurance policies, you can employ a private service to help you find the policy information.  These companies will search for lost insurance policies for a fee.

Another great source is the National Association of Insurance Commissioners, which can provide you with contact information for state insurance personnel who can help identify possible insurers that may have issued the policy.  Florida’s Bureau of Unclaimed Property is also worth looking into.  If the life insurance company is aware of your loved one’s death, but can’t locate the beneficiaries, then it has to give the death benefit to the state.

The article, Locating a Lost Life Insurance Policy, has more information and strategies regarding finding missing policies.  If you find the policy and your life insurance claim is denied, contact J.P. Gonzalez-Sirgo, a Florida life insurance claims attorney, at 866-71-CLAIM for legal advice.

Man drowns after canoe flips over

A man drowned off Mowery Point in Biscayne National Park in Miami, FL after the canoe he was on flipped over. On September 21, 2008 Air Rescue was dispatched to search for the missing swimmer. The man was found shortly thereafter and airlifted to a local hospital where he was pronounced dead. None of the men had been wearing life vests. Please click here to read more on filing a life insurance claim.

J.P. wants to remind everyone that life vests save lives. Please ensure to have a life jacket for every passenger on board. Remember, it’s the law!

No Insurable Interest Can Make a Life Insurance Policy Void

Have you ever wondered what would stop a complete stranger from purchasing a life insurance on your life and causing your death?  Courts and state lawmakers anticipated this potential problem and created an insurable interest requirement for life insurance policies.

Insurable interest exists when the purchaser of the policy will receive a greater benefit from the insured being alive, whether emotionally or financially.  Without insurable interest, a life insurance policy is considered void from the beginning.  Policies without insurable interest are also considered against public policy, as they increase the risk of murder for profit.  Even though insurable interest is mandatory at the time of application, it does not have to exist at the time of the insured’s death.

Courts and state laws have created certain criteria that must be met when determining insurable interest.  If you purchase your own life insurance policy, insurable interest automatically exists.  Insurable interest can also be created when the purchaser has a strong relationship with the insured.  For example, the relationship can be based on blood, marriage or money.  Spouses are considered to have insurable interest and generally so are parents, children, grandparents, grandchildren and siblings.  Depending on the state, some engaged couples are also considered to have insurable interest.

Insurable interest can also be established through monetary interests.  An example would be a purchaser who insures his or her business partner.  The partnership could stand to lose money if the insured passed away.  Creditors are also able to have insurable interest.  A creditor can purchase a life insurance policy on a debtor, with the debtor’s permission, up to the amount owed on the debt.  Examples include mortgage and credit insurance.

Life insurance companies bear the liability of determining insurable interest at the time of application.  If the life insurance company fails to meet this requirement, the insurer could be sued.

The article, Insurable Interest and Life Insurance Policies, has more information on this topic.