Can insurance co. deny survivor's benefit due to prior overpayment of benefit to policyholder before death?
-
Recently applied for a one time death benefit from Mother's disability/supplemental insurance policy. I provided all the necessary info. and forms to prove she was in fact disabled and died as a result of her illness. Insurance co. refuses to pay my survivor's benefit due to the company's prior overpayment of benefits to my Mother before her death. The insurance company has applied my survivor's benefit to the overpayment of claims and states that they will not pursue reimbursement of the overpayment of benefits @ this time and there are no additional benefits due on that account. Isn't it their loss that they made the error in payment of benefits to her before she died? Am I still entitled to to survivor's benefit?
-
Answer:
No, it's not "their loss". They can actually attach her estate for any ADDITIONAL amounts that might be due. It's part of the policy conditions - she agreed to it when she got the policy in the first place.
chellebe... at Yahoo! Answers Visit the source
Other answers
This is really a matter of contract law. My initial impression is they cannot do this. If the insurer overpaid LTD benefits to your mother, it has every right to go after her estate and try to obtain reimbursement. This often happens when a person is approved for SSDI after having received many months (if not years) of LTD benefits. However, the insurer cannot ignore one portion of its contract with your mother in order to pursue another -- this would be a contract violation on their part. On the one hand, your mother agreed to enter into a contract with the insurer, promising to repay LTD benefits if they ever overpay her; on the other hand, the insurer agreed to pay a death benefit to her beneficiary when she passes away. While a contract generally operates as one instrument, a single instrument can have many guarantees; both parties are required to abide by all guarantees they make -- otherwise, there's a contract violation. To my understanding, the legal and correct resolution of this matter is this: repay the insurer from your mother's estate, to the extent the estate is able to do so; then, insist that the carrier abide by its contract to pay the survivorship benefit IN FULL. If your mom's estate is very large, doing it this way is actually more advantageous to you. However, if her estate is small, there may not be enough funds to repay the insurer -- in which case, you should pursue this matter through legal means, since the insurer would undoubtedly deduct what is "owed" from your payout. Before you seek the services of an attorney, send a written complaint to your state's insurance commissioner's office. They will investigate to see whether any state laws or the contract have been violated. If they rule against you, you should speak with a private attorney.
Suzanne: YPA
Insurance companies will and do what ever they can to deny claims. They will say no to you even when you have 100% right to get your money... They are hope-ing you will go away, there probably was never even a payment to the policy holder... If it is a decent amount of money or you want to prove a point go see a lawyer, or take it to the nearest college with a law department...
Brad I
You are not entitled to receive more than the contract specifies will be paid. So if the insurance company overpaid your Mother and can prove it, they are within their right to reduce the overpayment amount from any remaining benefits owed you. Why would they pay you and then turn around to sue you for the overpayment to your dead Mom? Save the court and the taxpayer's a lot of money -- avoid lawsuits. And I'm sorry for the loss of your Mom.
kja63
I hate that word "entitled"-but you're not. They've already paid more than they should have...you're lucky they're not chasing you for repayment.
shelcom
Related Q & A:
- How can I change my friend's name in my friend list?Best solution by Yahoo! Answers
- How can I change a member's name?Best solution by Yahoo! Answers
- How can I find a person`s Yahoo ID just by name and place?Best solution by in.answers.yahoo.com
- Can I transfer my MP3's from a flash drive to my PS3?Best solution by Yahoo! Answers
- How can I remove a picture's watermark using Matlab's image processing toolbox?Best solution by Yahoo! Answers
Just Added Q & A:
- How many active mobile subscribers are there in China?Best solution by Quora
- How to find the right vacation?Best solution by bookit.com
- How To Make Your Own Primer?Best solution by thekrazycouponlady.com
- How do you get the domain & range?Best solution by ChaCha
- How do you open pop up blockers?Best solution by Yahoo! Answers
For every problem there is a solution! Proved by Solucija.
-
Got an issue and looking for advice?
-
Ask Solucija to search every corner of the Web for help.
-
Get workable solutions and helpful tips in a moment.
Just ask Solucija about an issue you face and immediately get a list of ready solutions, answers and tips from other Internet users. We always provide the most suitable and complete answer to your question at the top, along with a few good alternatives below.