Life insurance claim issues after brother's death in MI; company requests medical access.

Question

My brother passed away a couple of weeks before the end of the contestability period, and I submitted a valid life insurance claim with the original death certificate. However, the insurance company is asking for permission to contact his doctors and review his medications, although my brother had given them permission when he got the policy. They are unwilling to honor the claim until I grant them access to his medical history, despite my brother having disclosed a pre-existing condition in the initial health questionnaire. The company has not provided any specific reason for the request, nor will they communicate directly via email, preferring verbal communication. I am concerned they are trying to find a loophole to avoid payment and threaten to refund only the premiums or put the claim on hold. I refuse to violate HIPAA by complying. I'm unsure whether to consult with a lawyer in Michigan, Kansas where the company is based, or in my state. What are my options?

Rabih Hamawi · Answer

If the policy was issued in Michigan, or the decedent resided in Michigan when he purchased the policy, then you should consult a lawyer in Michigan.

Tim Akpinar · Answer

I agree with my colleague. However, it's possible you could have other venues that avail themselves (such as based on defendant location, others - or depending on whether there are forum selection clauses in the policy). An attorney consult with a copy of the policy handy could be beneficial here. I'm sorry for the loss of your brother. Good luck

James L. Arrasmith · Answer

I'm sorry to hear about the challenges you're facing after your brother’s death. It sounds like the insurance company is requesting access to your brother’s medical records as part of their review process, likely due to the fact that the death occurred close to the contestability period. While it’s true that your brother gave prior consent to the insurance company to access his medical history when he applied for the policy, that doesn’t mean they automatically have the right to bypass your rights as his beneficiary.  
 
In Michigan, as you know, HIPAA privacy protections are strict, but since your brother previously authorized the company to obtain his medical records, it is likely within their rights to request those documents. However, you can demand that they communicate their request in writing and clarify exactly what they are looking for and why. This might help you better understand their position and whether they are truly attempting to find a loophole or simply following standard procedures. 
 
As for legal representation, you might want to consult a Michigan-based attorney with experience in insurance claims, as the policy and legal proceedings are tied to the jurisdiction in which the policy was issued. While the company is based in Kansas, the issue and your claim are governed by Michigan law, where your brother lived and where the claim was filed. A lawyer can help you navigate the situation without violating HIPAA and ensure that your rights as a beneficiary are protected. Keep documentation of all your communications with the insurance company and consider contacting the Michigan Department of Insurance if you believe the company is acting in bad faith.

Q: Life insurance claim issues after brother's death in MI; company requests medical access.