Imagine a situation where a claim made under a life or disability insurance policy is denied because a policyholder allegedly lied in the policy application regarding a health-related matter.
Unsurprisingly, that happens all the time in Oklahoma and across the country (in fact, with numbing regularity), with insurers disputing a claim for payment by responding that a response to a health inquiry was materially misleading in the application or, alternatively, not mentioned at all when it needed to bet set forth in detail.
Denial is also accompanied in many instances by insurers’ claims that select application provisions were answered in a fatally ambiguous way.
It is far from coincidental that such responses predominantly occur during the early years of a policy term. As we note on our plaintiffs’ insurance law website at the long-established Oklahoma City law firm of Mansell, Engel & Cole, “life insurance disputes often arise during the first two years after someone has purchased a policy.” Insurers have greater license during that early period to challenge applications, and they often do so aggressively and, sometimes, without full regard for truth and accuracy.
As we note on our site, it is not enough for an insurer to simply claim the right of so-called “rescission” in terminating a policy on stated grounds that one or more inaccurate responses were rendered on an application. Given the complexity and great subjectivity inherent in many medical-related queries, applicants often provide good-faith answers that seasoned insurance pros can easily enough state were incomplete, inaccurate or otherwise wanting. If they were given full rein to do that without any checks or balances, policy denial/rescission would stand at a truly alarming rate.
Many people think that it already does, and in a manner that disingenuously promotes the interests of bad-faith insurers while simultaneously undermining the rights of well-intentioned policyholders.
We duly note on our website that Oklahoma law responds to denial/rescission by requiring insurers “to prove that [a policyholder] intentionally provided deceptive or inaccurate information.”
That standard levels the playing field for insureds, especially when denied policyholders seeking to gain justice and a meaningful remedy in a given matter turn to a proven insurance law attorney for assistance.