Recently in Accident and Illness Insurance Category

By Steven Muller LL.B, J.D, LL.M.,

Vice-President, Share Lawyers, Lawyers

 In a new twist to the Michael Jackson death, Jackson's aide allegedly allowed the $20 million life insurance policy to lapse. The family of Mr. Jackson are considering a legal action against the assistant who they reportedly believe kept the cash that had been put aside for insurance. Because the final payments were missed it is reported that Jackson's children, Prince Michael, Paris and Prince Michael II will now receive $2.5 million rather than $22.5 million.

 

Ontario law has grace periods with respect to non payment of premiums for life insurance policies. The policy may provide for a longer grace period. There is no mandatory grace period for a disability policy but non payment could trigger termination of a policy. There are strict requirements for termination that the insurer must comply with. In either case, don't end up like Jackson's family. Seek the advice of a lawyer familiar with this area. Incompetence can lead to disaster.

 

By Janice Grevler  B.A., L.L.B.

Associate Lawyer, Share Lawyers, Lawyers

 

There's no doubt that internet-based social networking has shrunk the world in which we live, and has allowed us to stay connected with others, near and far.  These social utilities provide a plethora of otherwise-unavailable information to keep our "friends" (real or web-based) informed of our whereabouts, our activities and, even, our daily status. 

 

Yet the benefits of staying "connected" can have drawbacks when the information attainable on the world-wide web is used for more than social networking and is, instead, utilized for the purposes of defending a personal injury or insurance lawsuit.

 

Those who have profiles on Facebook, MySpace, Twitter or other social networks, and who are involved in litigation, should be forewarned that insurance companies too have begun to employ the internet for their own benefit.  We have witnessed this phenomenon over the past many months.   On the basis of information obtained on social networking utilities, we have seen defence counsel argue that various Plaintiffs in personal injury or disability actions are not as disabled or injured as they have claimed.  What may seem to be a harmless comment to update one's "status" on Twitter or Facebook, or to communicate with a friend on his or her Facebook wall, may ultimately be used against the author where he or she is involved in litigation.  While investigations of the Plaintiff (including surveillance) have long-since been used by Defence counsel and insurance companies alike, these tactics are now incorporating searches on various social networks to look for clues about the Plaintiff's day-to-day life.  At its worst, any such "clues" may be taken out of context by a Defendant who seeks to portray a seemingly harmless comment or photograph in an unfavourable light to the detriment of the Plaintiff's claim.

 

To eliminate or minimize the risks that a Plaintiff will encounter in the course of litigation, he or she should keep in mind the following tips related to social networking:

 

  1. Consider removing your Profiles from social-utility networks pending the outcome of your litigation.  If you are not prepared to do so, know that information about you on these sites may be used against you;

 

  1. Ensure that you employ the maximum privacy settings possible, including not allowing others to view your friends list on Facebook,  so as to limit the access that outsiders have to information about you;

 

  1. Be aware that, on Facebook, even where your settings are "private", non-friends may still gain access to information about you by reviewing the profiles, photographs and walls of your friends (especially those whose settings are less "private") for information that may pertain to you.  Investigators will endeavour to retrieve information about you by accessing your friends' profiles;

 

  1. Be wary of photographs and videos that you upload to your Facebook or MySpace profile, as well as your friends' photographs on which you are "tagged".  A picture is worth a thousand words and may be used by a Defendant, out of context, to undermine your personal injury or disability case.  Untag yourself on photographs posted by others, or ask your friends to remove photographs of you that could be used against you.  Know that a friend who is "tagged" in your photo album will, in turn, provide his or her friends with access to your album, unless the strictest of privacy settings is selected;

 

  1. Keep in mind that every time you make a comment on Facebook, whether it be on someone's wall or photograph or as part of a group, your note may be easily accessible to investigators.  Keep such postings to a minimum and be cautious about commenting on anything that you would not like raised in the course of your lawsuit;

 

  1. Similarly, investigators can easily ascertain to what "Events" you have accepted invitations over Facebook (whether they be social, recreational or other events), thereby becoming informed of your activities and social calendar.  Keep this in mind;

 

  1. As tempting as it may be to change your Status on Facebook or Twitter regularly to reflect the goings-on in your life, we recommend that you not do so.  Through a personal injury lawsuit, it is optimal for the Plaintiff's lawyer to control, or at least be aware of, information about the Plaintiff's daily life that is provided to the Defendant.  The Plaintiff's lawyer will not be aware of, and won't have control over, information gleaned from Facebook or Twitter Status Updates.  A seemingly benign Status Update, for example, such as "Peter had a great time with his friends at the park today", can be used to undermine a Plaintiff's claim that he has lost enjoyment of life owing to an accident.  The Status Update, of course, does not indicate for how long Peter was out at the Park, how much pain medication he ingested that day, whether he required assistance with transportation to and mobility at the park, whether his outing caused an exacerbation in his symptoms thereafter and whether this is the first time Peter has socialized since the accident.  Taken out of context, therefore, the comment can have consequences for Peter in the course of his lawsuit.

 

So, in short, what can you take from all of this?  Be cognizant of the information you are sharing with anyone on-line, even where it appears that you have control over the reader.  Think before you speak on social networks.  Only say or reveal information that you are amenable to sharing in the course of your lawsuit.  And, definitely, speak to your lawyer if you have any question about how your participation on social networking utilities can impact on your case.

By Steven Muller LL.B, J.D, LL.M.,

Vice-President, Share Lawyers, Lawyers

 

What does Heath Ledger and Britney Spears have in common? Their life and disability insurance companies delayed payment of legitimate claims worth millions of dollars. Competent specialised lawyers were retained to fight their entitlements.

 

ReliaStar Life Insurance Company, owned by ING America, refused to pay Heath Ledger's death benefit of $10 million dollars to his 3 year old daughter, Matilda Rose. The 28 year old star of Brokeback Mountain and The Dark Knight is now the winner of the Golden Globe and Oscar posthumously. Ledger was found dead in his New York apartment in January 2008 some seven months after taking out the policy where his daughter Matilda is the beneficiary. The New York medical examiner ruled an accidental prescription drug overdose of painkillers and other medicine: alprazolam, diazepam, doxylamine, hydocodone, oxycodene and temazepam. Despite the ruling, ReliaStar suggested Ledger committed suicide or lied on his insurance application when he said he never used illegal drugs showing bad faith in applying to the policy. ReliaStar refused to pay claiming the policy was voided.

 

Prior to approving the application, Reliastar didn't ask for Ledger's physicians' records. Post claim the insurance company asked for names of doctors, psychiatrists and all kinds of records. The estate hired a lawyer on behalf of Matilda and sued ReliaStar claiming punitive damages and contending that the insurer acted in bad faith in its refusal to pay the Ledger policy. ReliaStar in January 2009 agreed to a confidential settlement rumoured to be around $10 million. The insurer appears to have attempted to engage in post claims underwriting in order to delay payment to Matilda.  

 

Britney Spears hasn't been as fortunate with her insurance dispute. In 2005, Spears sued eight international insurance companies including Liberty, AXA and QBE to recover $9.8 million in damages for their refusal to pay her for losses she sustained when her European concert tour in 2004 was cancelled because of a knee injury. Spears paid more than $1.3 million in insurance premiums on contingency insurance, a form of accident and illness insurance for celebrities, to cover abandonment, postponement and cancellation of performances for her 2004 Onyx Hotel Tour through the United States, Canada and Europe. 

 

Spears underwent a medical examination for her insurers on February 5, 2004 and Dr. Drazin concluded that she was "in sound health and free from disease" and "in fit condition" for the Tour. Unfortunately for Spears, she failed to note on the questionnaire that five years earlier she had an orthopaedic surgery on her left knee and had fully recovered subsequently performing hundreds of times since the surgery. In March 2004 Spears injured her left knee during a performance and cancelled two shows. Spears was examined the by the insurers doctor and cleared to perform further shows. In April 2004 Spears provided an explanation at the request of the insurers for the omission in the 2004 questionnaire. After April 2004 the insurers extended the policy from August 10, 2004 to August 15, 2004 and accepted premiums despite Spears acknowledging that she made a mistake on the 2004 questionnaire. On June 11, 2004 Spears had surgery for her injury that took place on June 8, 2004 while shooting her music video "Outrageous". Ultimately Spears was diagnosed with a floating cartilage and cancelled her summer tour of 2004. Despite Spears insistence that many of the insurers knew of her pre existing problems because they insured her for the Tour 2000 with disclosure at that time, Spears insurers are dragging their feet in paying this legitimate claim. 

 

Whether you're a celebrity or not, being denied your claim is stressful for you and your family. Insurers delay as a matter of course. Able counsel may reduce the delay and help resolve your life insurance claim and disability insurance claim.

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