| False Claims by Insured |
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| Various statutes prohibit the submission of false or fraudulent claims or evidence in connection with insurance claims. A person who commits such fraud may be subject either to civil liability to an insurer or to prosecution for a crime.
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| Killing of Insured by Beneficiary |
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| A beneficiary of an insured's life insurance policy who kills the insured may not be entitled to recover the policy proceeds. The denial of benefits may be based either on language included in the life insurance contract or on the basis of public policy. More... |
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| Employers Entitled to Life Insurance Proceeds |
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| A beneficiary of a life insurance policy must have an insurable interest in the life of the insured in order to collect the policy proceeds upon the insured's death. An insurable interest is usually found where there is a blood or marriage relationship between the beneficiary and the insured or where the beneficiary has a direct or contractual relationship with the insured. More... |
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| Unfair Claims Settlement Practices Act |
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| When an insured or a beneficiary submits a claim to an insurer, the insurer has a duty to respond and to do so in a certain manner. The Unfair Claims Settlement Practices Act (UCSPA), a model act adopted in over 40 states, provides industry guidelines for the insurer to follow when paying or denying claims. In general, the UCSPA requires the insurer to act promptly and fairly in response to a claim with a reasonable basis for any denials. More... |
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| The Duty of Reinsurers to Follow the Fortune of Cedant Insurers |
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| Most reinsurance contracts by which an insurance company cedes or reinsures a portion of the coverage for policyholders to a reinsurer call for the reinsurer to "follow the fortune" of the insurer. Thus, the reinsurer is expected to pay the reinsured percentage of a claim without questioning how the insurer handled the claim. The follow the fortune doctrine is an extension of the "utmost good faith" that by tradition has governed the relationship of the ceding insurer to the reinsurer. More... |
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