Denied Claim? Premium Problem? You Need an Expert Witness
Lean on My Experience to Create a Favorable Outcome
Lean on My Experience to Create a Favorable Outcome
A claim denial may just be the opening gambit of the insurance company. It might be a feeble excuse to get off a claim (the applicant did not disclose an ear ache two years before the application for insurance); it might be based on a solid reason (the non-disclosure of a previous heart attack); or it might be based on the fact that the policy had never been delivered or had lapsed for non-payment.
It is imperative that an insurance expert reviews the file before accepting the denial and the loss of the insurance benefit. In many of the files I have reviewed as an expert witness, I was able to demonstrate that the proximate cause of the problem was agent negligence or incompetence. In over 100 cases the agents’ E & O insurance paid for the lost benefits.
Invite me to review your file. If I find any evidence of agent negligence we can discuss options to sue the agent.
Premium problem?
I have been retained over twenty times to assist in cases involving premium problems. The most common issue was premiums that were supposed to pay up a policy in a specific number of years – but more premiums were required. If the agent did not disclose the true nature of the policy or if he used inaccurate sales literature, he can be held accountable for the increased costs.
Call me to discuss your file. 416 518-2075
Claims are denied for specific legal reasons. As I review files I will report them here, with a brief synopsis of what happened. Reports will be filed under the headings…
I've been retained in a number of cases when the insurance agent did not disclose the true premiums over the life of the policy.
I have been retained over 140 times to prepare an Expert Report opining on the competence of a life insurance agent. In all but three cases, the lawsuit was settled favourably for the plaintiff.
I have been a licensed life insurance agent for over 40 years. I am the co-author of an insurance text book used in the common law provinces by prospective life insurance agents preparing to write their licensing exams.
I served on a number of Ontario Insurance Commission committees, including the committee that drafted the Code of Ethics for Life Insurance advisors. The Superintendent of Insurance appointed me to the founding Board of Directors of the Life Insurance Agents Council, the proposed new regulator for Ontario life agents.
As the President and then Executive Director of the Life Insurance Brokers Association of Canada I had the opportunity to review many E&O claims involving alleged agent negligence.
I work with CBC Marketplace on segments devoted to the problem of denied insurance claims. Another program is in production.
There is no charge for me to discuss a file with you and to review some key documents.
I would like to know the name of the agent and agency and the life insurance company involved.
I need to know the reason(s) given for the denial and to see the denial letter. And I need to see the copy of the application form (found at the back of the life policy).
Jim Bullock
Jim Bullock - Insurance Expert
13898 Mississauga Rd Caledon, ON L7C 1W4 CA
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