Reference no: EM132839779

Mr. and Mrs. Lodge applied for life insurance and were approved. When her husband died several months later, Mrs. Lodge claimed the benefits under the policy. The insurance company denied the claim for failing to disclose information about Mr. Lodge's health.

Mrs. Lodge brought her final position letter to the insurance company. She explained to the manager that a nurse had come to their home on behalf of the insurance company to collect blood and urine samples and fill out a questionnaire. During their conversation, Mr. Lodge told her about his high iron levels and his visits to a hematologist. The nurse noted "blood work normal" in her report despite his disclosure. Mrs. Lodge and her husband gathered that high iron was not important since the nurse did not take it into account, nor did the insurance company analyze his blood for this.

After his review of the information from Mrs. Lodge and the insurance company, the manager recommended a further investigation.

The investigator discovered that the company had not contacted the nurse to find out more about her visit with Mr. and Mrs. Lodge. He recommended Mrs. Lodge contact this nurse, to see if she could validate their conversation. The nurse was unable to recall the specifics of their meeting.

While Mr. Lodge's medical records showed he had been diagnosed with a blood condition, it was not disclosed in his insurance application. However, Mr. Lodge had signed this application, along with the report that the nurse prepared, confirming that all information provided was accurate. For this reason, the investigator recommended that there was no reason to further pursue this complaint.

What do you think Mrs. Lodge would have done or could further do to gain her claim?