A Lubbock woman is suing a Pennsylvania insurer, alleging the company improperly denied a $200,000 death benefit claim because it said her ex-husband listed the wrong height on his insurance application.
The suit was filed Tuesday in Amarillo’s U.S. District Court by Michelle Sanders, who sued on behalf of her daughter, the biological child of Henry Sanders, who was killed in a motor vehicle accident in 2013. Carol Duncan Sanders, the surviving Amarillo spouse of Henry Sanders, also is a plaintiff in the case, which names Life Insurance Co. of North America as the defendant.
According to the suit, Henry Sanders purchased a supplemental life insurance from Life Insurance Co. of North America under a policy offered by his employer.
After relatives of Henry Sanders submitted a claim to the insurance company, the insurer denied the claim on the basis that Henry Sanders “falsely” indicated on his insurance application that he was 5 feet, 11 inches tall, according to the suit. The insurer, citing medical records, said Henry Sanders’ actual height was 5 feet, 8 inches to 5 feet, 9 inches tall and that the company’s medical underwriter would not have approved the man’s policy if he stated his correct height on his insurance application, according to the suit.
The plaintiffs provided the company with an autopsy report that showed Henry Sanders had a body height of 5 feet, 10½ inches — a half-inch shorter than the height he reported on his insurance application, the suit alleges.
The plaintiffs, according to court records, also sent the company a statement from a medical doctor indicating that body height varies with the passage of time and can differ by as much as a half-inch during the course of a single day.
The suit alleges Life Insurance Co. of North America refused to pay the claim, based on a
“hyper-technical” excuse.
“It appears that Mr. Sanders stated his height correctly. Defendant nevertheless persists in its denial of benefits in the face of this evidence, a position which bears no rational relation to the known facts. Defendant’s refusal to pay these benefits is an arbitrary and capricious abuse of discretion,” according to the complaint.
The suit alleges the insurance company incorrectly applied the plan’s provisions in two ways: by imposing a height requirement that didn’t exist in its insurance plan and by using an allegedly incorrect medical history to deny payment with no evidence that Henry Sanders intentionally misrepresented his medical history.
“A denial of benefits due to an incorrect medical history must be supported by evidence that the applicant made a material misrepresentation of medical history; otherwise a carrier could seize on the most trivial and innocent mistake as an excuse to deny benefits, which is precisely what the defendant has done in this case,” the complaint alleges.
Jim Angstadt, a spokesman for Life Insurance Co. of North America, said in a statement that the company could not comment on the suit at this time.
“As this involves pending litigation, we cannot discuss the details of this customer’s concerns,” he said. “LINA is committed to ensuring our customers receive all of the benefits to which they are entitled under the terms of the policy. We take our commitment to our customers very seriously and are proud of the great service we deliver each day.”
