Articles Posted in Life Insurance

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:

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;

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 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:

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.

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;

Someone in Dallas, Fort Worth, Grand Prairie, Mesquite, Arlington, Cleburne, Aledo, Weatherford, or anywhere else in Texas, purchases a life insurance policy. They expect the policy benefits to be paid when the insured passes away. But that does not always happen.

The Los Angeles Times ran an article on November 21, 2010, titled “Flaws Can Cancel Life Insurance – After Death.” The article is written by Lisa Girion and Sandra Poindexter.

This article has tells of three examples where someone takes out a life insurance policy and then when a claim for benefits is turned in to the insurance company the company cancels the policy without paying the benefits.

Most people living in Arlington, Grand Prairie, Dallas, Fort Worth, Mansfield, Irving, DeSoto, Cleburne, Weatherford, and all the other places in Texas, will have some form of life insurance on their lives. It may be a policy from work, or a policy thru their bank, or a policy they have purchased through their insurance agent. The question becomes; Who can you take a life insurance policy out on and who can be named as a beneficiary in the policy? When a spouse is the person who is insured or the person who is the beneficiary under the life insurance policy there is not usually a problem. But what if it is someone else?

An insurable interest is what is required. Or an expectation of a pecuniary benefit. So, who has an insurable interest or an expectation of a pecuniary benefit?

The Texas Supreme Court in 1942, in the case, Drane v. Jefferson Standard Life Insurance Company, stated; “A person that has a reasonable expectation of pecuniary benefit or advantage from the insured’s continued life has an insurable interest.”

People living in Grand Prairie, Dallas, Fort Worth, Arlington, Carrollton, Burleson, Aledo, or anywhere else in Texas who have life insurance are usually going to have a place in the life insurance policy where they name a beneficiary. Things will happen after naming the beneficiary to make the insured want to change the beneficiary.

The person named as a beneficiary in a life insurance policy is the person who receives the benefits of the policy upon the death of the person insured by the policy. The named beneficiary is often times a spouse of the named insured or the children of the named insured. Other times it is a creditor or an estate. Sometimes it is a business partner.

It is well settled law that a life insurance beneficiary must have an insurable interest in the insured’s life. This was stated as early as 1894 by the Texas Supreme Court in the case, Cheeves v. Anders. It was restated in 1998 by the Houston Court of Appeals [14th Dist.] in Tamez v. Certain Underwriters at Lloyd’s, London International Acc. Facilities, and again in 1998 by the Tyler Court of Appeals in Stillwagoner v. Travelers Insurance Co.

If someone in Dallas, Fort Worth, Grand Prairie, Arlington, Carrollton, Garland, Mesquite, Grapevine, Duncanville, Burleson, or anywhere else in Texas, has a life insurance policy, how long does the life insurance company have before it has to pay the benefits to the beneficiary? The answer is, it depends. But the Texas Prompt Payment of Claims Act still applies.

There is a Waco Court of Appeals case decided in August of 2005, that explains how the Prompt Payment of Claims Act can apply in a life insurance situation. The style of the case is, State Farm Life Insurance Company and Lisa Martinez Paul v. Toni Wasson.

This is a case where the insurance company, State Farm Life Insurance Company, confused itself about who it was suppose to pay policy proceeds to. It is not that unusual for an insurance company to have some doubt about who the rightful beneficiary is under a policy of life insurance. When there is confusion the life insurance company will usually file an “interpleader action” in a local court and then let the court decide who should receive the proceeds of the life insurance policy.

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