What do I do if I can’t get the physician records an insurance company demands to pay out on a life insurance policy?

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What do I do if I can’t get the physician records an insurance company demands to pay out on a life insurance policy?

I recently found out that a distant relative took out a life insurance policy and listed me as a beneficiary. She died 5 years ago but I was only informed of the policy now. The claim form demands medical records for the last 5 years of the person’s life before paying out because the policy was less than 2 years old at time of death. Due to privacy laws and time passed, I can’t get that information, plus my relative never saw a doctor. Is there anything I can do? I don’t think it’s fair they took the person’s money without requiring a medical exam but won’t pay out because she never had one.

Asked on August 16, 2011 Pennsylvania

Answers:

M.T.G., Member, New York Bar / FreeAdvice Contributing Attorney

Answered 11 years ago | Contributor

There are a whole lot of issues here and you may need to seek legal help in your area from someone who is an expert on life insurance coverage issues.  Laws vary from state to state but that provision about dying within a certain time of the issuance and providing supporting documentation is fairly standard. Was there a probate or an administration proceeding filed for your Aunt?  The personal representative has the ability to give authorizations for the medical records, if any, or to provide an affidavit of some sort for the insurance company as to the lack of same.  They have a right to question and if they do not pay out then they have to reimburse the premiums but to her estate, not you. Get legal help.  Good luck.   


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