Life Insurance

Life Insurance – ERISA And Misrepresentation

April 30, 2011 | Mark S. Humphreys

Here is a case for insureds in Grand Prairie, Weatherford, Mineral Wells, Arlington, Dallas, Fort Worth, and other places in Texas to think about.

This case was decided by the United States Court of Appeals for the Fifth Circuit, on April 13, 2011. The style of the case is, Araceli Medina Garcia v. American United Life Insurance Company. Here is some background.

In January 2006, Salvador DeReza Garcia died in a car accident. At the time of this death, Salvador was covered under a group life and accidental death insurance policy issued by American United Life Insurance Company (AUL) and subject to the Employee Retirement Income Security Act (ERISA), 29 U.S.C. Sections 1001-46. Salvador’s wife, Araceli Medina Garcia, submitted a claim under this policy following his death. AUL denied her claim because Salvador was living illegally in the United States and made material misrepresentations regarding his identity during the application process. A lawsuit was filed, the district court ruled in AUL’s favor. This appeal followed. This appeals court affirmed the ruling of the trial court.

Mortgage Accidental Death Policy

April 12, 2011 | Mark S. Humphreys

Mortgage holders in Grand Prairie, Weatherford, Arlington, Aledo, Azle, Fort Worth, Dallas, Irving, Hurst, Euless, Bedford, Pantego, and other places in Texas would find an interest in the case discussed below.

The United States Court of Appeals for the Fifth Circuit, issued an opinion on March 18, 2011, styled, Brenda LeMeilleur v. Monumental Life Insurance Company: Trustees of the National Homeowners Group Insurance Trust, c/o Countrywide Insurance Services, Incorporated. This case is an appeal from the district court where a ruling was handed down in favor of the insurance company. That ruling was affirmed by this appeals court.

Here are some facts:

Life Insurance Denials

March 20, 2011 | Mark S. Humphreys

When someone in Grand Prairie, Arlington, Dallas, Fort Worth, Mansfield, De Soto, Duncanville, Ennis, Weatherford, Aledo, or any other place in Texas, buys life insurance they expect that when they die, the life insurance company will pay the benefits of the policy to their named beneficiary. However that is not always what happens.

The Washington Post published an article on March 5, 2011, titled “Death of a loved one can be beginning of hard fight with life insurer.” The article is written by David Evans of Bloomberg News.

The article tells of a lady named Jane Pierce who spent nine years struggling alongside her husband, Todd, as he fought cancer in his sinus cavity. The treatments were working. Then in July 2009, Todd died in a fiery car crash. He was 46. That was the beginning of a whole new battle for Jane, this time with Todd’s life insurance company, MetLife.

Who Buys Life Insurance?

January 11, 2011 | Mark S. Humphreys

Most people in places like Arlington, Grand Prairie, Dallas, Fort Worth, Mansfield, Benbrook, Burleson, Crowley, Granbury, and other places in Texas will have some sort of life insurance. But how true is that statement?

The Wall Street Journal published on article on October 3, 2010, titled, “Shift to Wealthier Clientele Puts Life Insurers in a Bind”. The article was written by Mark Maremont and Leslie Scism.

This article tells how the life insurance industry has enjoyed beneficial tax treatment for its products for most of the century. Whenever Congress tried to change the tax treatment enjoyed by beneficaries of the policies the life insurance companies could always holler: We protect widows and orphans.

Incontestibility In Life Insurance Policies

January 2, 2011 | Mark S. Humphreys

People with life insurance policies in Fort Worth, Dallas, Grand Prairie, Arlington, Hurst, Euless, Bedford, Lake Worth, Benbrook, Burleson, and other places in Texas may wonder if the life insurance company can contest their life insurance after purchasing it. Here is some guidance on this issue.

The Texas Insurance Code addresses incontestibility clauses in atleast two separate places in the insurance code. The first one is in Sections 705.101 and 705.105. Of these five statutes, four deal generally with this issue, while 705.104 is more direct. It says:

“A defense based on a mispresentation in the application for, or in obtaining, a life insurance policy on the life of a person in or residing in this state is not valid or unenforceable in a suit brought on the policy on or after the second anniversary of the date of issuance of the policy if premiums due on the policy during the two years have been paid to and received by the insurer, unless:

Life Insurance – Misrepresentation In Application

December 23, 2010 | Mark S. Humphreys

Anybody with life insurance in Dallas, Fort Worth, Grand Praire, Arlington, Weatherford, Garland, Mesquite, Mansfield, or anywhere else in Texas who has life insurance would have had to fill out an application for that insurance. So what happens if the life insurance company denies benefits under that policy and cites the reason as there being a misrepresentation in the application for the policy? Continue reading to get some guidance as to what might happen.

For a life insurance company to establish misrepresentation by the insured as legally sufficient grounds for denying benefits, the life insurance company must prove five elements in any lawsuit brought trying to get the benefits paid to the benficiary. Here are those five elements:

1) the making of a misrepresentation;

Life Insurance Exclusions For Pilots

December 21, 2010 | Mark S. Humphreys

Does anybody in Dallas, Fort Worth, Grand Prairie, Arlington, Irving, Mesquite, Garland, Cedar Hill, Duncanville, De Soto, Lancaster, or anywhere in Texas have a pilot’s license? The answer is yes. So the next question is, “Are they covered in their life insurance policy if they die in an airplane crash?” The answer to that is, “It depends.”

All insurance policies are going to have “exclusions”. These exclusions will limit the responsibility of the life insurance company to pay death benefits when these exclusions may apply.

This issue came up in the case, American Home Assurance Company v. Loretta Anne Brandt. This is an older case which was decided in 1989 by the Texarkana Court of Appeals. The exclusion in this case excluded coverage by the following provision: “LIMITED AIR TRAVEL COVERAGE: Insurance provided under the policy includes riding as a passenger, but not as a pilot or crew member in, including boarding or alighting from, or being struck by, any aircraft.”

Suicide And Life Insurance Claim Denial

December 12, 2010 | Mark S. Humphreys

Suicide by someone in Arlington, Dallas, Fort Worth, Grand Prairie, Keller, Roanoke, Aledo, Burleson, Granbury, or anywhere else in Texas. Does that negate an insurance policy?

The first thing anybody should know about life insurance and suicide is that if life insurance benefits are denied because the cause of death was a suicide, the intended beneficiary should seek the advice of an experienced Insurance Law Attorney.

The Texas Insurance Code, Section 1101.055(b), says in part:

Beneficiary And Life Insurance

December 11, 2010 | Mark S. Humphreys

Here’s a question someone in Fort Worth, Dallas, Arlington, Grand Prairie, Mansfield, Lake Worth, Azle, Grapevine, or anywhere else in Texas might ask. When is someone considered dead for purposes of collecting on a life insurance policy?

Let’s start with this. For an intended beneficiary under an insurance policy to collect death benefits the insured must be dead. But what if there is no body? Also doubt about the death may arise when there is uncertainty over the identity of a body. This was the case in a 1987 Texas Supreme Court case styled, Davidson v. Great National Life Insurance Company. This was also an issue in the 1892 United States Supreme Court case, Mutual Life Insurance Company of New York v. Hillmon.

Legal presumptions can aid in determining whether a death has occurred. In the Texas Civil Practices & Remedies Code, Section 133.001, some help is found. This section says, “Any person absenting himself for seven consecutive years shall be presumed dead unless it is proved that the person was alive within the seven-year period.

Life Insurance – Insurable Interests

December 5, 2010 | Mark S. Humphreys

Ask someone in Dallas, Fort Worth, Arlington, Grand Prairie, Mansfield, Duncanville, Azle, Crowley, Cedar Hill, Saginaw, Flower Mound, or any other place in Texas, what an insurable interest in a life insurance policy is, and the chances are that they will not be able to tell you. This has been discussed in a couple of earlier blogs.

As stated before, those who have an insurable interest in the life of another falls into three general classes:

1) one so related by blood or affinity that he or she wants the other to continue to live, irrespective of monetary considerations;