by Guest » Mon Jul 12, 2010 04:39 pm
I Hope I ask this correctly. My husband had a life insurance policy with his company that paid him 1.5x his previous year's W-2 if he died. The company paid for this policy. He had a stroke in 2007 and he is a survivor. When we were sitting down with his HR guy I asked about his life insurance. The HR guy told me it was null and void now. I have now found documents that say if he left the company he could have the right to conversion or if he was disabled, his life insurance would continue with a waiver of premium. Even though its 2.5 years later, I feel like we were entitled to the opportunity to continue this policy but were not given any information. We never received anything from an insurance company about conversion or waiver of premium, so I didnt think there was anything to it.
Can someone tell me if I am looking at this correctly or not?
Thanks
Can someone tell me if I am looking at this correctly or not?
Thanks
Posted: Mon Jul 12, 2010 05:47 pm Post Subject:
Probably too late to do anything now. If he is fully recovered from the stroke, he could still potentially be eligible for purchasing his own life insurance policy. You need an independent agent who can shop his medical history with 10-15 companies to find out what he may qualify for.
Posted: Mon Jul 12, 2010 06:26 pm Post Subject:
Hmmm, you mean HR doesn't have all the answers?
What company was the policy with at the employer? You could contact them directly and ask. Most likely you'll only get general information.
There is however, the potential for a law suit if you want to take it that far. HR has a responsibility to either advise you on these matters or refer you to the person who does know. I say potential because there's always the chance they mentioned something that you are forgetting. The problem for them is proving it.
Posted: Tue Jul 13, 2010 05:33 pm Post Subject:
There is however, the potential for a law suit if you want to take it that far. HR has a responsibility to either advise you on these matters or refer you to the person who does know. I say potential because there's always the chance they mentioned something that you are forgetting. The problem for them is proving it.
BNTRS has correctly summed up the situation.
The federal law known as ERISA governs plan sponsor responsibilities to plan beneficiaries. If your husband's employer-sponsored insurance was subject to ERISA (a group benefit provided to 20 or more full time employees, and not a "non-qualified" benefit provided to specific employees), the employer had a legal responsibility to fully disclose the continuation privileges of health insurance under COBRA (something the OP has not mentioned) and the conversion privilege of group life insurance. Their failure to do so exposes them to the liability of paying your husband's death claim.
In a court of law, you would have to prove that they did not provide the appropriate disclosures. They would have to prove they did make the disclosures. In an instance of he-said-she-said with absence of proof from either side, the court/jury is forced to throw up its hands and say something like, "Without clear and compelling evidence one way or the other, no judgment can be made in favor of the petitioner." A tie is equal to a lose.
However, merely employing the right labor law lawyer could obtain some sort of concession on the part of the employer instead of being exposed to the legal liability of appearing before a judge and jury which could cost far more.
The good news is that most lawyers provide an initial consultation free of charge to evaluate the aspects of a case and offer an opinion as to the likelihood of a "successful" outcome. The bad news is, like the stock market, there are no guarantees -- even the best lawyer does not always win.
Posted: Wed Jul 14, 2010 09:32 am Post Subject:
Can someone tell me if I am looking at this correctly or not?
You are totally correct on the issue but at the same time the issue is really pending for last 2-2.5 yrs.you need to provide a valid reason to the court about delay in filing the lawsuit.
Again I think you should give a try to this if the amount is significant enough.
DIMG
Posted: Wed Jul 14, 2010 04:54 pm Post Subject:
You are totally correct on the issue
One must choose one's words wisely. An attorney looking for a quick buck might make that comment, but I'd be slightly more cautious.
It's always possible that the company did inform of the right to convert, but it was overlooked, misunderstood, or ignored. While that cannot be established here with absolute certainty, it may very well be "likely" that the OPs view is correct.
A good federal/state labor law specialist attorney is going to be the proper person to advise this OP as to the "real world" aspect of her matter.
Posted: Wed Jul 14, 2010 06:28 pm Post Subject:
Companies very, very rarely make those type of mistakes....amazing how the insurance company is right 99% of the time when it comes to consumer complaints.
Posted: Wed Jul 14, 2010 08:29 pm Post Subject:
Companies very, very rarely make those type of mistakes....amazing how the insurance company is right 99% of the time when it comes to consumer complaints.
Have to agree with you 100% on that comment. But the "company" at fault in this case, if there is one, in the eyes of the OP is the former employer, not the insurance company.
Under group insurance, the insurance company normally leaves "administrative tasks" such as enrollments and conversion notification business to the employer rather than assuming it itself. Too much administrative hassle -- if the company has several hundred group policies in force with several hundred thousand insureds/covered persons, they couldn't possibly keep up with who's been terminated, or quit each month at all those employers. That's why they only require an annual census in most policies.
It would not be a stretch to say that an HR department employee failed to provide all the necessary documents. I've seen first hand examples several times.
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