Here is a life insurance claim denial that is interesting factually and legally, and a must read for lawyers handling life insurance claims. This is a case handled by the Law Office of Mark S. Humphreys.
The opinion is a December 10, 2021, summary judgment ruling from the Northern District of Texas, Dallas Division. It is styled, Pham v. TransAmerica Premier Life Insurance Company. Johnny Pham sues in his own right and Kim Van Bui sues on behalf of minor children SKB and BDB.
This case has been presented in multiple blogs with this being the last.
In looking at this summary judgment case the Court stated:
Because we have concluded that there is a genuine dispute as to whether the application was amended, we must decide whether that fact is material to determining the Effective Date. This is an easy task, however, because Transamerica concedes that it is. At oral argument, Transamerica agreed that that the phrase “all parts of the application” in the Conditional Receipt’s definition of the Effective Date would include an amendment to the application, if there was such an amendment. In other words, Transamerica concedes that if Bich’s application was amended, then the Effective Date is February 26, 2018. Because the parties agree that an amendment to the application would alter the Effective Date—and therefore determine if Bich was covered at the time of her death—whether the application was amended is, indeed, a material fact.
Because there is a genuine dispute of material fact that should be resolved by a fact finder, the district court’s grant of summary judgment on Plaintiffs’ contractual claims is REVERSED. In addition, because the district court’s grant of summary judgment on Plaintiffs’ statutory, extra-contractual claims was based on the conclusion that Transamerica had legitimately denied Plaintiffs’ claim for benefits, the grant of summary judgment on the statutory, extra-contractual claims is similarly REVERSED. This case is REMANDED to the district court for further proceedings.
This is the end of the four part Blog showing what happened in this tragic case.
Any time a person has a claim for life insurance benefits that is denied, it if vital that contact is made with an Experienced Insurance Law Attorney.