Negligent, bad faith, or fraudulent practices with respect to insurance policies, insurance coverage, or insurance claims can take many forms:
- Life Insurance Claim Denials
- Coverage Disputes Regarding Claims Brought Under Homeowners’ and Small Business Policies
- Errors and Omissions Claims Against Brokers for Inadequate Coverage
With attorneys licensed in New York, New Jersey, and Massachusetts, Trief & Olk specializes in bringing claims against insurance companies for failing to pay or underpaying in accordance with the provisions of the insurance policies. As part of our practice, our firm represents life insurance beneficiaries, where a life insurance company has denied payment based on the company’s claim that the deceased misrepresented some fact on the insurance application. We also bring claims against and defend insurance brokers for claims relating to errors and omissions that limit policyholders’ abilities to collect under their existing policies.
Trief & Olk’s years of experience litigating claims against insurance companies have given us in-depth knowledge of insurance principles, practices, and terminology, in addition to insurance law. This expertise enables us to properly evaluate and litigate insurance matters.
LIFE INSURANCE CLAIM DENIALS
Trief & Olk has extensive life insurance litigation experience. Some examples of our successful representations in life insurance denial matters are:
- In January 2019, Trief & Olk obtained the full $1 million owed under a life insurance policy issued by Protective Life Insurance when the notice was mailed 11 days prior to the date the premium was due, in violation of Section 3211(a)(1) of New York insurance law, which requires such notices to be sent at least 15 days prior to the deadline. The notice of premium due apparently did not reach the insured prior to the payment deadline, likely due to a recent change of address, and the follow-up notice was received after the policy had been cancelled. He sought reinstatement but he passed away before the process was finalized. After a close review of the documents, Trief & Olk recognized that the premium notice had been sent 11 days from the due date, which was outside the timeframe provided by the statute. Protective Life Insurance agreed that the premium notice did not comply with Section 3211 and agreed to pay the policy proceeds to his beneficiaries in full, along with the interest that had accrued since the death.
- In November 2018, Trief & Olk prevailed after a judge trial in a suit claiming that William Penn Life Insurance Company had wrongfully denied $3 million in coverage. The life insurance company claimed that the insured allegedly misrepresented material information in the application for the life insurance coverage. The court found that the insurer had not met its burden of establishing that the insured materially misrepresented his medical and social history, awarding the beneficiary the full $3 million plus nearly five years in interest. See settlement summary and memorandum here.
- In 2018, Trief & Olk represented the widower of a physician employed by a large healthcare provider in New Jersey. Under the terms of the life insurance policy (paid by the employer), she was insured for a death benefit of $500,000; however, the life insurance company misinterpreted the terms of the policy and only paid $150,000. Without having to file suit, Trief & Olk obtain the full amount of coverage owed, with the client receiving the additional $350,000 to which he was entitled.
- A family was denied payment of two life insurance policies totaling $1.5 million from Metropolitan Life Insurance Company after the death of the family matriarch. MetLife declined to pay the benefits by claiming that the decedent misrepresented her net worth when applying for the policy. After a lower court found in favor of the insurer, Trief & Olk was able to successfully overturn the lower Court’s decision and was granted summary judgment for the full amount of the policies, $1.5 million.
- In 2014, Trief & Olk obtained a $675,000 settlement on a life insurance policy worth $699,000. The insured was denied coverage due to alleged lapses in payment, but by conducting brief discovery, we were able to create triable issues of fact as to whether the decedent received the grace period notice and whether there were representations by the insurer that payment was sufficient.
- In 2013, we successfully settled a life insurance beneficiary dispute on behalf of a decedent’s mother. The case involved an argument as to whether a judgment of divorce nullified a properly executed beneficiary form. We were able to settle the case for several hundred thousand dollars.
- In 2013, we were able to reach a substantial confidential settlement with two insurance companies in the District Court of New Jersey in an ERISA action. The insurers initially denied accidental death benefits due to the pre-existing illness exception.
- In 2012, beneficiaries of a public school teacher’s assistant were denied benefits under a Public Employees’ Retirement System (PERS) Policy. We were able to obtain the full policy amount after successfully arguing before the Division of Pensions and Benefits Board of Trustees that the decedent was on an official leave of absence at the time of death.
- In 2012, Trief & Olk secured a settlement for a Minnesota widow denied benefits under her husband’s life insurance policy. The dispute centered on the insurance company’s claims of material misrepresentations on the application for coverage, as well as prescription drug use contributing to death. We were able to successfully settle the case after other law firms were unable to reach a resolution.
- In 2011, Trief & Olk represented a plaintiff denied life insurance benefits by First Penn-Pacific Life Insurance Company, because of an alleged failure to pay premiums. After commencing litigation in the United States District Court for the District of Connecticut, Trief & Olk was successfully able to reach a confidential settlement within a matter of months.
- A widow and her two teenage children were denied payment of a one million dollar life insurance policy held by her husband, who died of stomach cancer, on the grounds that he made a material misrepresentation by failing to disclose a history of hepatitis B in the application. Extensive discovery conducted by our firm in Massachusetts, California, and Canada was necessary to show that the hepatitis B did not pose a mortality risk. The case settled in mediation for a confidential but substantial sum.
- We represented a family of a deceased physician when the life insurance company refused to pay the family’s claim due to missing premium payments. We were able to defeat the insurance company’s position by establishing that the company had failed to properly send out the premium notice. We won at trial; and the jury trial was affirmed by the appellate court.
- In another life insurance case, we succeeded in winning a claim for payment of proceeds where the insurance company alleged misrepresentations in the insured’s application.
If you have suffered losses from an insurance company’s denial of a life insurance claim please contact our attorneys, who are licensed in New York, New Jersey, and Massachusetts, for more information or to discuss your case. For more information about life insurance claim denial litigation, please click here.
INSURANCE COVERAGE DISPUTES INVOLVING FIRE, THEFT, CASUALTY, AND OTHER TYPES OF COVERAGE
- In 2017, our clients’ home was destroyed by a flood caused by a burst pipe. They submitted a claim for repairs to the residence and replacement of damaged contents, but the insurer, Allstate, declined to pay the claim, arguing that the pipe burst because heat had not been maintained in the home and therefore that the policy did not cover the loss. In 2018, we successfully resolved the claims, recovering for both the repairs to the home and the contents for $320,000.
- Following a fire, the owner of a bed and breakfast was denied payment on portions of her insurance policy. The insurance company, Vermont Mutual, declined to pay any loss of income and disputed payment on the contents and additional living expense portions of the claim. We were able to successfully resolve all three matters by obtaining reimbursement on the disputed contents items, payment for loss of income, and the full amount of additional living expenses.
- We brought an action on behalf of a wholesale jeweler against an insurance company that denied coverage for a loss suffered when a shipment of diamonds was stolen by a person claiming to be employed by the intended recipient of the diamonds. This matter was taken successfully to New York State’s highest appeals court, where we won.
- When a driver was killed when the rear wheels of a truck broke free and struck his car, the truck company’s insurer claimed that it was not liable because the trailer of the truck was not owned by the truck company at the time of the accident. We successfully defeated the claim and the deceased’s family was paid under the truck company’s liability policy.
If you have suffered losses from an insurance company’s failure to pay a claim, please contact our attorneys, who are licensed in New York, New Jersey, and Massachusetts, for more information or to discuss your case.
ERRORS & OMISSIONS CLAIMS AGAINST BROKERS
- In 2016, we represented an insurance broker whose client sought to recoup the replacement cost of an antique vase that cracked. When the homeowner’s insurance obtained through our client did not fully cover the loss, the insured attempted to blame client for supposedly failing to obtain proper insurance coverage. As a result of our vigorous defense, the plaintiffs withdrew their claims against our client without payment by our client.
- In an action brought on behalf of a client who lost her business in a fire, in 2014, we were able to secure a jury verdict finding the insurance broker negligent in undervaluing the client’s property and failing to procure adequate insurance coverage.
- We represented a national beverage corporation in a case against an insurance broker for failing to obtain the proper insurance. Although the client had specifically requested that the policy include coverage for stolen goods, when the client’s merchandise was stolen, it turned out that the broker had failed to obtain the requested coverage. Our client prevailed in this matter and the broker’s Errors and Omissions policy paid the claim.
If you have suffered losses from a broker’s failure to obtain the proper insurance, please contact our attorneys, who are licensed in New York, New Jersey, and Massachusetts, for more information or to discuss your case.
Prior results do not guarantee a similar outcome.