Accidental death payout

[anonymous108723]

I don’t know where else to ask this..my husband passed almost a year ago and I finally made a claim back in November as he had AD&D. The process has not moved and I have not received a decision almost a year to his death. (He passed in August of 2021 and I didn’t not file a claim until November 2021). Is this good or bad? He was killed in a hit and run and there still is no lead or suspect..just trying to figure out if MetLife is doing everything they can to NOT pay out..I read somewhere there is a 2 year time limit for them to make a decision, not sure if that applies here. Thanks for any advice.

TLDR; husband was killed in hit and run and have not received payout for AD&D after almost a year.

 

[frenchyriff]

@anonymous108723 They should definitely pay out due to a hit and run. Have you tried calling the carrier? Will they provide you updates

 

[anonymous108723]

@frenchyriff They’ve asked for a police report however the police report is incomplete due to it being an active investigation. That is the only update I keep receiving is them wanting a police report.

 

[frenchyriff]

@anonymous108723 Have you sent them the report even though it’s incomplete? Even if incomplete, and the cause of death is a motor vehicle accident by way of a hit and run, it should be paid out with that info.

When you send the incident report, are you asking if anything else is needed or if the incomplete report will suffice? Do you have a death certificate that you can provide them?

 

[anonymous108723]

@frenchyriff I have not sent the incomplete report or asked if it would suffice. I’ve sent in the death certificate with cause of death as accidental. You’re right that I can try to send in the incomplete report and see if that will work.

 

[frenchyriff]

@anonymous108723 I would send it, just ask any and all questions to that claim examiner. Ask for a turn around time, threaten getting a lawyer involved if they do not rule on the payout soon. It’s been far too long. Also, ask what other documents you can provide. Just keep calling every day. It should pay out. I see no reason why they should hold this

 

[anonymous108723]

@frenchyriff Will do thanks so much for the advice. I feel far too young to deal with something like this so I appreciate it.

 

[frenchyriff]

@anonymous108723 Or course. Just keep badgering them. Get the names of the claims examiners that you speak to, keep a list of calls, and just continue to follow up. Like I said, threaten legal action to get this resolved. It may help move the process along.

 

[tabinek]

@frenchyriff Legal action is premature at this point. They probably need to see the report to make sure he (the insured) wasn’t under the influence and caused the accident (which may cause a claim not to be paid).

If they balk after seeing the report (complete or incomplete). Then you write a letter explaining the steps you’ve taken (death certificate showing it was an accidental death and the police report showing he wasn’t under the influence) and suggest to them that further delay of payment is a bad faith claim practice that you plan to discus with the department of insurance and your lawyer. Give them two weeks to respond to that then follow through with your threats.

 

[frenchyriff]

@tabinek Agreed. I mean just threaten legal action.

 

[jwalk33]

@anonymous108723 What does the death certificate state as the cause of his death? Sorry for your loss.

 

[williamjwilson]

@anonymous108723 Just be polite but firm with the claims reps at MetLife. Ask specifically which documents they need to move forward. If they need the police report, send them a copy - it doesn't matter that the investigation isn't complete. Then follow up weekly. You don't need to threaten legal action yet.

 

[fendertele52]

@anonymous108723 Sorry for your loss. The insurer doesn't not want to pay out, they just want to ensure they are paying out --or not-- according to the terms of the policy.

Was he a pedestrian in the hit and run, or driver of another vehicle? Many AD&D plans have an exclusion for insured drivers who are intoxicated at the time of an accident, regardless if they were at fault. The ins co needs the ensure that the exclusion doesn't apply. The may want the police report to see of he was the driver or passenger, if it wasn't clear on the death certificate.

They may also want the toxicology report. If you can get that and send in with the crash report you have, it should help move things along...even if that means they request something else.

Also with Covid deaths over the last 2 years, many ins cos claims depts are still struggling with immense backlogs and claims may be backed up. Continue to follow up with them regularly via phone. If you have the contact for the investigators or medical examiner, provide those as well.

 

[lnb]

@anonymous108723 I would contact your states Insurance Commissioner ASAP and get them involved to help you get an answer.

 

[jtjr]

@anonymous108723 I know this was posted a year ago so I'm sorry to open old wounds, but as someone who is now going through something similar with my father's recent death in a plane crash, I'm curious how this resolved for the OP?

In my case, the NTSB says it could be 2 years of an investigation. AD&D has asked for the death cert and report made by the medical examiner. Should I be expecting this will be drawn out for a couple years? No idea what I'm supposed to be doing...