Murder Victim's Claim Denied for 'Pre-Existing Condition'

Stephanie McCraw, widow of Curtis McCraw, is suing Settlers Life Insurance after they refused to pay because Mr. McCraw had a "pre-existing condition," unrelated to the cause of his death. Curtis McCraw, who had hepatitis C, was gunned down by unknown assailants last April in Knoxville, Tennessee. "Mrs. McCraw lost her husband and wants this life insurance company to pay what is owed her. The policy is not specific as to whether there is a difference as to how you die. It does not even say you won't get paid if you have a pre-existing condition. Yet, the company is denying this claim because her husband had Hepatitis C, something totally unrelated to the way he was killed," said Curtis's lawyer, William Hotz.

Comments

And yet...

[meerling]

It was apparently unknown even to the dead guy that he had HepC until the autopsy was done.

Doesn't the law include certain 'good faith' clauses so that someone can't be penalized after the fact for failing to reveal information they didn't even have in the first place?

Basically, it just boils down to a cheap@zz insurance conjob, err, company trying to find any excuse not to have to fulfill it's end of the contract.

Re:And yet...

[Anonymous Coward]

The company is going to lose BIG TIME on this one.

--A Lawyer

Re:And yet...

[Forge]

They will lose big time if, and only IF the court awards full compensation, legal expenses AND punitive damages. Anything less and they win just by paying the claim a couple years late and discouraging other customers from pursuing claims that were unfairly denied. Some insurance companies just flatly reject all claims and pay only after you file a lawsuit if the legal teem says there is no way in hell they are going to win, otherwise they pay court ordered damages. Because most people are just looking for a little cash to ease pain and send the kids to school, they give up and go grumble about how nasty company X is. The insurers have to pay so few claims, they are forced to buy banks and real estate, just so the huge piles of blood money won't start gathering taxes.

Re:And yet...

[juiceboxfan]

The company is going to lose BIG TIME on this one.

Not if Settlers Insurance can prove that the late Mr. McCraw knew that he had Hepatitis C. This isn't really about the cause of death it's about lying on the life insurance application. From TFA;

"The law in Tennessee is clear that the cause of death is not relevant," [Company President] Lowe said. "What is relevant is whether the insured truthfully informed the company of his health at time of his death. If an applicant lied, the company has a right to deny the claim."
Under state law, Lowe said, insurance companies have a two year period to contest the information in a policy holder's application. If in that time, the company "discovers the applicant did not tell the truth about his health, the company can void or rescind the policy even if the person has died."

Still the policy was only for $25k - it will cost the company more than that in bad press. They should just settle (it's in their name after all;-).

The pre-existing condition is a claim of fraud.

[bombastinator]

Hepatitis C eats your liver. It's incurable and fatal. This guy had numerous drug convictions and had really low chance of getting a liver transplant even if he could afford it, which of course he couldn't, him being a junkie and all. He was a walking dead man. If he knew he had hep C, or even merely that his liver was failing, not that hard since it turns your skin bright banana yellow, the chances that this is insurance fraud is very very high. I'm with the company on this one.

Re:The pre-existing condition is a claim of fraud.

[tritonman]

yet the company had no problem taking his money???

Re:The pre-existing condition is a claim of fraud.

[Fallen Kell]

It all comes down to whether or not he knew of his condition before he signed up for and received the insurance policy. But I would say from the sounds of it, he didn't know most likely because he would not have gone to a doctor to be tested for something like this as he probably could not afford it, and most likely did not have health insurance. So if the insurance company did not require a health screening, it is their fault for not properly vetting people who are taking out a policy, not his.

Re:The pre-existing condition is a claim of fraud.

[rmadmin]

He couldn't afford a test but he could afford the insurance? Why is everyone assuming that he doesn't have money if he's a junkie.. I've known a few junkies with some serious cash.

Disclaimer: I really don't know what I'm talking about, just hit some weird red flags. :)

Re:The pre-existing condition is a claim of fraud.

[DynaSoar]

Hepatitis C eats your liver. It's incurable and fatal.

Hepatitis C is curable. Depending on the variant, treatment with alfa interferon + ribavirin is effective in 50% to 90% of cases. I got it from a finger stick when I was working in neurosurgery. I was put on a 24 week treatment series. My viral load was zero after 16 weeks, but the treatment continued in case there were dormant viruses. I'll always carry the RNA of the virus, much like carrying the antibodies against a previous infection, but I am cured. There are people getting treated successfully after carrying Hep-C for 25 years or more. So, bottom line, you're as wrong as a football bat, which calls into doubt your other assertions.

Actually, no it doesn't, they're also wrong as a football bat on their own. This story is either mistaken, or complete bullshit. It says the life insurance was denied for pre-existing condition. Life insurance pay out does not depend on conditions, other than many not paying out for suicide, and if that's the case it's stated in the policy. It's health insurance claims that get turned down for that. TFA is not about a health insurance claim. The summary and the relevant portion of TFA is therefore crap, and so is any argumentation pro or con regarding its claims.

The company is not attempting to deny based on pre-existing, it is claiming the policy was obtained fraudulently because they were not informed that he had Hep-C. They can deny to insure or insure at a higher rate based on state of health, but must do so at the time, and the insuree must disclose such in the application or they're conducting fraud. The company can rightly negate the policy if they find out, no matter when (before or after death) or how (due to the undisclosed condition or something else), that it was obtained fraudulently.

The ABC writer should be canned for being a dipshit. He even says the company acknowledged denying for pre-existing, yet goes on to quote the company president explaining the denial based on fraudulent application. He has no clue what he's talking about, and is attracting a dogpile of similarly clueless respondents. The issue to be worked out is if he (or his wife if she was the applicant) knew about the Hep-C when applying. If, as it seems, the Hep-C was not known until the autopsy and there are no records he was tested or treated for it, she'll get her money. If he knew about it before, she'll get nothing. If she knew about it before, she could face jail time, but most likely won't.

Re:The pre-existing condition is a claim of fraud.

[bombastinator]

They can cure Hepatitis now? Wow! That's what I get for spouting things I learned way back in college without looking to see if they changed. Could someone mod dynasoar up please? I tried but I lack mod points atm.

Re:The pre-existing condition is a claim of fraud.

[v1]

not that hard since it turns your skin bright banana yellow

Not trying to be racist, just making an observation, but I don't think that particular person's skin was going to turn "bright banana yellow". But if it did, then I'd agree it would tend to draw serious attention.

lawyers lining up for this one

[schwit1]

If the situation is as simple as it sounds I would not be surprised if the widow has serious legal muscle asking to represent her.

Re:lawyers lining up for this one

[NonSequor]

http://en.wikipedia.org/wiki/Uberrima_fides

She would have to prove that he had no knowledge of any relevant risk factors that he did not disclose when obtaining the insurance.

Even if he hadn't been tested for Hepatitis C at the time, his drug use alone may be enough to invalidate the claim.

Re:lawyers lining up for this one

[Anonymous Coward]

http://en.wikipedia.org/wiki/Uberrima_fides

She would have to prove that he had no knowledge of any relevant risk factors that he did not disclose when obtaining the insurance.

Incorrect. It's impossible to prove that he didn't know of a relevant risk factor, just as it's impossible to prove Santa Clause doesn't exist.

The insurance company retains the burden of proving - to whatever standard the court requires - that he was untruthful when he entered into contract.

Copying articles wholesale?

[Anonymous Coward]

The whole text of the article, and the image too. A new low in Slashdot reporting.

Re:Copying articles wholesale?

[petermgreen]

They did copy a lot of text but it seems that TFA does have more than the /. summary