Claim Made Years after Death of Insured
January 18, 2016
I am handling a claim for a daughter who lost her mother multiple years ago. The daughter informed her mother's agent of her mother's passing and has since kept up with the premiums. She had a covered loss happen and now the insurance company is trying to deny the claim because she never had the policy put in her name. Shouldn't coverage still be provided since the premiums were still being paid?
Pennsylvania Subscriber
You have a few different things working here. The ISO HO 00 03 05 11 insures the legal representative or those in custody of the property until the legal representative is appointed. Was the estate settled and the house put in the daughter's name? Who was the executor of the estate? Technically the legal representative is covered for the premises and property. Did the agent notify the company of the death of the first named insured? You may have an agent's E&O issue if he did not notify the company. Technically notification to the agent is notification to the company, but he still has to do his duty and advise the carrier of the change and advise the insured to follow through on titling the property. The policy does not state that the coverage upon the death of the insured terminates at the end of the policy term, although in most cases the estate is settled and names changed on property and the like.
Without the property being in her name, unless she is the appointed legal representative, they can deny the claim, although they have been collecting premium on this for years; if they deny the claim, they should at least refund the premium. It really sounds like there is an E&O issue here with the agent not advising his insured or the carrier.
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