My Dad passed away January 30, 2007. In December 2007 he had an accident at home. He fell landing head first onto the concrete driveway and the corner of the house. He was knocked unconscious and the paramedics took him to ER. My Dad suffered a hemorrhage from the fall and his health declined from that day to his death. Dad never returned home and was taken to a nursing home. We filed a claim with Transamerica for his accidental insurance in February. The policy was for $100,000.00 but they only paid us on July 17th $600.00. They claim the fall wasn't considered an accidental & also claimed that because his death wasn't within 120 days, the claim isn't valid. The death certificate shows probable acute myocardial infarction, coronary artery disease, diabetes, COPD, cardiac arrhythmia and cerebrovascular accident. The claim is based on the word "probable". Do we have a chance to fight this with Transamerica? Thank you, XXXXX XXXXX (daughter)
Optional Information: State/Country: California Already Tried: Nothing. We just received this letter yesterday, 7/26/09, at my post office box. We were told of you by a friend.
Claim such as this rely heavily upon the coroner's listing as cause of death and the time from injury to death. It may be possible to seek connection between the injury and death but you will need to obtain a copy of your father's medical file at the time of the fall as well as last treatment records prior to death and present it all to a personal injury attorney to review. Only upon review of the records can an attorney give you a definate answer.
There wasn't a coroner's report. We only have the death certificate. We didn't feel it was necessary, nor did his doctor, to have the coroner do an autopsy. We had him taken to the mortuary and cremated. The doctor who treated him at the nursing home was the one who gave the information on his death certificate. We moved my Dad from southern Oregon back to Orange, CA prior to the accident. He didn't have a doctor long enough here prior to the fall. We would have mostly from the day of the accident to his death.
Thank you for the additional information. It may still be possible but more difficult since there was no corroner's report. It gives more weight to the insurance company's position that the death was not accident related. You have to show that the resulting illnesses that resulting in your father's death were either created or worsened by the fall. You would still need the report from the date of the fall and treatment/injuries immediately thereafter and present it to the attorney for review. It will be very difficult.
Experience: Practing General Attorney, Professor and Lecturer of law for two decades