Monthly Archives: December 2018

What Happens to Life Insurance Proceeds if the Primary Beneficiary Dies Before the Insured?

Dec 4, 2018 | Blog |

If you’re a life insurance beneficiary — primary, secondary, or tertiary — then you may be wondering how proceeds will be distributed if one of the other beneficiaries has died before the insured.  When a primary beneficiary die before the insured, this can cause a significant shift in the distribution of proceeds and may impact the claims that various beneficiaries have to the death benefit. Let’s explore. Unclaimed Proceeds are Paid to the Estate Suppose that the life insurance policy listed only a single, primary beneficiary, and that beneficiary died before the insured, or perhaps simultaneously — for example, the […]

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Common Life Insurance Beneficiary Disputes

Dec 4, 2018 | Blog |

In the context of life insurance, it’s not at all that uncommon for the beneficiaries to be in conflict with one another — after all, the benefits amounts may be significant, and there may be inconsistencies in the distribution of benefits that were not known to the beneficiary prior to the death of their loved one.  For example, the spouse of the deceased may be surprised to find that the first wife of the deceased was actually the beneficiary at time-of-death, and therefore has a legitimate entitlement to the benefits at-issue.  This can quite clearly give rise to a dispute. If […]

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Seventh Circuit: ERISA Plan Can Be Penalized for Failure to Disclose Fee Schedules and Rate Tables used to Determine Usual, Reasonable, and Customary Rate

Dec 4, 2018 | Blog |

By: Andrew B. Bryant How insurance plans determine “usual, reasonable, and customary” pay rates for healthcare claims submitted by out-of-network (“OON”) providers is a frequent bone of contention in medical reimbursement disputes.    In the recent matter of Griffin v. Teamcare, the Seventh Circuit addressed the issue of whether a medical provider who had obtained an assignment of benefits from a patient was entitled to request, and receive, the data underlying the Plan’s decision-making process as to rate of pay for OON services.   In the case, Dr. W.A. Griffin contacted the Plan prior to delivering treatment to the insured patient.  The […]

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