First Policy Recission Contestable Claim

rousemark

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Niota, TN
Just had my first contestable claim not paid and policy rescinded during my 49 year career. 62 year old male died of bladder cancer in October, 2019. The husband of my niece. 100,000 SI 15 YR Term with Columbian issued in March, 2019. We paid $19,992 on a cancer claim with Washington National. That Policy was 25 months old at the time of this diagnosis. When we got the Dr. records I knew there was a problem. About 5years earlier he had surgery for a bladder problem. The Drs report said the client was advised of a malignancy but did not follow up on treatment. When the client saw that he said don't' even send the claim (cancer) in because it would not pay. I told him it would because the policy was over two years old. I did not tell him the life policy might be a problem but I did advise my niece of that fact.

I understand the company's decision based on the info they received. However, the fellow was a bit of a hypochondriac and I just cannot imagine him not following up with a cancer diagnosis if he knew about. He swore he was never told and his wife says the same. Columbian's app ask about cancer in the last 10 years so there is no doubt the original diagnosis was within that time frame. However, the questions are also answered "to the best of my knowledge and belief" but how in the world would we prove he had no knowledge of the cancer diagnosis?
 
Your in a tough spot because of the paper work. Just had a life case that went south in less than the 2 year period. Client passed with major cancer but was unaware of it, and there were no doctor reports to say other wise.

That will end up in court if you take it that far... and deeper pockets in this case usually prevail. However; if the company knew it had to fight the case they might be willing to settle for something less rather than drag it through court. Just a thought.

So sorry for your family...
 
That is rough.

However, the questions are also answered "to the best of my knowledge and belief" but how in the world would we prove he had no knowledge of the cancer diagnosis?

The doctor records, which I am sure are dated and in chronological order. However, I would guess Columbian checked that. It does not hurt to get the records.
 
That is rough.



The doctor records, which I am sure are dated and in chronological order. However, I would guess Columbian checked that. It does not hurt to get the records.
We have copies of the records. Obtained them for the cancer claim. That is the reason I understand Columbian's decision. The only way I see it can be challenged is to claim the DR did not tell him but I don't know how you could prove that. Would be a "He said, He said" situation and one of the "hes" is dead..
 
how in the world would we prove he had no knowledge of the cancer diagnosis?

You probably can't. And the fact that he took out a cancer policy a few years after the bladder surgery certainly looks suspicious.

; if the company knew it had to fight the case they might be willing to settle for something less rather than drag it through court.

Unlikely. If word got out that insurance companies were reluctant to drag things through the courts, people would lie on applications figuring their beneficiaries could file suit and get a quick settlement.

I think the guy knew he had it, figured he was a goner and figured he could beat the insurance odds better than the cancer odds. He was right on one, wrong on the other.

I saw that kind of thing with AIDS victims when I was investigating contestable death claims about 30 years ago. Back then AIDS killed right about the two year mark after contracting it. I had a couple of claims where AIDS victims died within the two years and managed to avoid any mention of HIV in any records anywhere despite my thoroughness.
 
You probably can't. And the fact that he took out a cancer policy a few years after the bladder surgery certainly looks suspicious.



Unlikely. If word got out that insurance companies were reluctant to drag things through the courts, people would lie on applications figuring their beneficiaries could file suit and get a quick settlement.

I think the guy knew he had it, figured he was a goner and figured he could beat the insurance odds better than the cancer odds. He was right on one, wrong on the other.

I saw that kind of thing with AIDS victims when I was investigating contestable death claims about 30 years ago. Back then AIDS killed right about the two year mark after contracting it. I had a couple of claims where AIDS victims died within the two years and managed to avoid any mention of HIV in any records anywhere despite my thoroughness.

The cancer plan was not his idea, it was mine... and it was a couple of years after he had the first surgery.. And, I can almost guarantee you he did not know he had it. He would have been telling everyone about it and certainly gotten treatment. Whether the DR did not tell him or he just did not understand what the DR had to say, I don't know. You shouldn't make such accusations when you have no idea what you are talking about.
 
Columbian gave me my first denied claim. If the policy was issued March 2019 it was only 7 months old and any carrier would have contested the claim.
 
35 years in the insurance industry. Yeah, I do know what I'm talking about. But I accept that you believe what you believe and that's OK.
You do not know what you are talking about in this situation.. I believe what I believe because I know the facts specific to this case of which you have absolutely no knowledge... And, btw, 35 years in the industry is nothing.. I have 49..
 
Columbian gave me my first denied claim. If the policy was issued March 2019 it was only 7 months old and any carrier would have contested the claim.

All the claims will be contested. Contested does not mean it will necessarily be denied. I've had two deaths recently, on at 8 months one at 9 months. Both were contested and both were subsequently paid. One with Liberty Bankers Life, and the other with Americo.

Clean business gets paid.

I question Columbian's ethics as a company, as I have heard multiple agents telling of many denied claims. I won't sell them myself on account of all the denied claims I've heard about from them.
 
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