Reserve National Insurance Company

Initial Business Response / [redacted] (1000, 5, 2015/05/20) */ On August 25, 1990, the Company issued a Life Insurance Policy to the InsuredSince that time, the Insured elected to change the beneficiary on the policy on multiple occasions, but through most of the life of the policy the beneficiary was the Insured's only childIn August of 2014, a Change of Beneficiary form listing Mr [redacted] as the beneficiary was submitted to the Company and stated that Mr [redacted] was the Insured's grandsonBased on the information provided on the Change of Beneficiary form, the Company changed the beneficiary from the Insured's daughter to Mr [redacted] The Insured passed away on March 12, In an effort to comply with state laws across the country, the Company requires that all beneficiaries have an appropriate insurable interest in the life of the insuredAn appropriate insurable interest includes the following: blood relatives, creditors, employers, and charitable organizationsThe Company's does not permit those without such insurable interests to be beneficiaries of a life insurance policy issued by the Company After the death of the Insured, the Company discovered that Mr [redacted] was not the Insured's grandson as was stated on the Change of Beneficiary form submitted to the CompanyRather, Mr [redacted] was not a blood relative of the Insured and therefore did not have the appropriate insurable interest in the life of the InsuredHad the true nature of Mr [redacted] 's relationship to the Insured been disclosed on the Change of Beneficiary form submitted to the Company in August of 2014, the request would have been rejected by the CompanyAdditionally, a claim has been submitted by both Mr [redacted] and the Insured's daughter under the policy and the Insured's daughter has contested Mr [redacted] as the beneficiary to her father's policyThe Insured's daughter has reiterated on numerous occasions that Mr [redacted] is not a blood relative of the Insured and that she believes Mr [redacted] 's was taking advantage of her fatherThere are also some questions regarding the signature on the Change of Beneficiary form submitted to the Company in August of Based on the information currently in the Company's possession, it appears that the benefits available under the policy should be issued to the Insured's estateAlthough Mr [redacted] has presented the Company with an unprobated will indicating that he was the executor of the Insured's estate, it does not appear that Mr [redacted] has been given the power of executor by any court of relevant jurisdiction, and as such, the unprobated will cannot be accepted by the CompanyThe Company will continue to work with Mr [redacted] and the Insured's daughter to pay the proceeds of the policy to the appropriate party

Initial Business Response / [redacted] (1000, 5, 2015/04/06) */ On July 8, 2014, MrStriker submitted an application for a Dental/Vision policy with the CompanyOn the application Mr [redacted] indicated that he currently had four (4) dental crowns, but answered "No" to the question regarding whether or not he had been advised to have any dental work that had not been completedMr [redacted] did not disclose either his cavity or his need for a replacement crown on the application The policy Mr [redacted] purchased includes a twelve (12) month waiting period for pre-existing conditions for applicants under the age of As Mr [redacted] was over age at the time the application was completed, this waiting period was waivedHowever, separate from, and not associated with the waiting period for pre-existing conditions, the policy does not cover replacement or repair of existing fillings, crowns, bridges or dentures until the policy has been in force for twelve (12) monthsBoth the waiting period for pre-existing conditions and for replacement of existing crowns are noted on an Outline of Coverage completed by Mr [redacted] at the time of application and are set forth in the policy contract delivered to Mr [redacted] on August 22, It is the Company's goal to ensure that all applicants understand the coverage available under their policiesIn addition to requiring that the selling agent review the policy and Outline of Coverage with the applicant, the Company sends a photocopy of the application and the Outline of Coverage to the applicant, along with its letter requesting that he/she review the application and the Outline of Coverage and providing him/her with the Company's toll free telephone number to contact the Company with any questionsA copy of the applicant and Outline of Coverage were sent to MrStriker on July 17, 2014; the Company does not have any record of Mr [redacted] contacting the Company to provide any additional information regarding his application or with questions regarding the coverage available under the policyThe policy was issued as applied for effective July 8, In November of 2014, Mr [redacted] had a crown replacedThis claim was denied as the policy does not provide coverage for replacement crowns for the first twelve months the policy is in forceWe have discussed this matter with the selling agent and he indicates that although he and MrStriker did discuss the waiver of the waiting period for pre-existing conditions, he does not recall Mr [redacted] inquiring about the waiting period on replacement of crowns Based on the foregoing, it appears that Mr [redacted] claim was processed in accordance with the terms and conditions of his policy and that no further action is warranted at this time

Initial Business Response /* (1000, 5, 2015/05/20) */
On August 25, 1990, the Company issued a Life Insurance Policy to the Insured. Since that time, the Insured elected to change the beneficiary on the policy on multiple occasions, but through most of the life of the policy the beneficiary was...

the Insured's only child. In August of 2014, a Change of Beneficiary form listing Mr. [redacted] as the beneficiary was submitted to the Company and stated that Mr. [redacted] was the Insured's grandson. Based on the information provided on the Change of Beneficiary form, the Company changed the beneficiary from the Insured's daughter to Mr. [redacted]. The Insured passed away on March 12, 2015.
In an effort to comply with state laws across the country, the Company requires that all beneficiaries have an appropriate insurable interest in the life of the insured. An appropriate insurable interest includes the following: blood relatives, creditors, employers, and charitable organizations. The Company's does not permit those without such insurable interests to be beneficiaries of a life insurance policy issued by the Company.
After the death of the Insured, the Company discovered that Mr. [redacted] was not the Insured's grandson as was stated on the Change of Beneficiary form submitted to the Company. Rather, Mr. [redacted] was not a blood relative of the Insured and therefore did not have the appropriate insurable interest in the life of the Insured. Had the true nature of Mr. [redacted]'s relationship to the Insured been disclosed on the Change of Beneficiary form submitted to the Company in August of 2014, the request would have been rejected by the Company. Additionally, a claim has been submitted by both Mr. [redacted] and the Insured's daughter under the policy and the Insured's daughter has contested Mr. [redacted] as the beneficiary to her father's policy. The Insured's daughter has reiterated on numerous occasions that Mr. [redacted] is not a blood relative of the Insured and that she believes Mr. [redacted]'s was taking advantage of her father. There are also some questions regarding the signature on the Change of Beneficiary form submitted to the Company in August of 2014.
Based on the information currently in the Company's possession, it appears that the benefits available under the policy should be issued to the Insured's estate. Although Mr. [redacted] has presented the Company with an unprobated will indicating that he was the executor of the Insured's estate, it does not appear that Mr. [redacted] has been given the power of executor by any court of relevant jurisdiction, and as such, the unprobated will cannot be accepted by the Company. The Company will continue to work with Mr. [redacted] and the Insured's daughter to pay the proceeds of the policy to the appropriate party.

Initial Business Response /* (1000, 5, 2015/04/06) */
On July 8, 2014, Mr. Striker submitted an application for a Dental/Vision policy with the Company. On the application Mr. [redacted] indicated that he currently had four (4) dental crowns, but answered "No" to the question regarding whether or not...

he had been advised to have any dental work that had not been completed. Mr. [redacted] did not disclose either his cavity or his need for a replacement crown on the application.
The policy Mr. [redacted] purchased includes a twelve (12) month waiting period for pre-existing conditions for applicants under the age of 65. As Mr. [redacted] was over age 65 at the time the application was completed, this waiting period was waived. However, separate from, and not associated with the waiting period for pre-existing conditions, the policy does not cover replacement or repair of existing fillings, crowns, bridges or dentures until the policy has been in force for twelve (12) months. Both the waiting period for pre-existing conditions and for replacement of existing crowns are noted on an Outline of Coverage completed by Mr. [redacted] at the time of application and are set forth in the policy contract delivered to Mr. [redacted] on August 22, 2014.
It is the Company's goal to ensure that all applicants understand the coverage available under their policies. In addition to requiring that the selling agent review the policy and Outline of Coverage with the applicant, the Company sends a photocopy of the application and the Outline of Coverage to the applicant, along with its letter requesting that he/she review the application and the Outline of Coverage and providing him/her with the Company's toll free telephone number to contact the Company with any questions. A copy of the applicant and Outline of Coverage were sent to Mr. Striker on July 17, 2014; the Company does not have any record of Mr. [redacted] contacting the Company to provide any additional information regarding his application or with questions regarding the coverage available under the policy. The policy was issued as applied for effective July 8, 2014.
In November of 2014, Mr. [redacted] had a crown replaced. This claim was denied as the policy does not provide coverage for replacement crowns for the first twelve months the policy is in force. We have discussed this matter with the selling agent and he indicates that although he and Mr. Striker did discuss the waiver of the waiting period for pre-existing conditions, he does not recall Mr. [redacted] inquiring about the waiting period on replacement of crowns.

Based on the foregoing, it appears that Mr. [redacted] claim was processed in accordance with the terms and conditions of his policy and that no further action is warranted at this time.

Initial Business Response /* (1000, 5, 2016/02/01) */
On October 17, 2013, Mr. [redacted] submitted an application for a Modified Whole Life policy with the Company. The policy was issued as applied for effective October 25, 2013. The Company was notified of Mr. [redacted] passing on November 30,...

2015 by the listed beneficiary on the policy. The Company mailed the claim packet to the beneficiary on this same date to the confirmed address. On December 7, 2015, the beneficiary contacted the Company to confirm that the packet was mailed. The Company confirmed this information. The Company was contacted again on December 14, 2015 by the beneficiary requesting the packet be sent via email. The requested email was sent on that same date. The Company received the claim information on December 22, 2015, and confirmed such with the beneficiary during her call on December 28, 2015. The claim has since been processed and released for payment as of January 27, 2016.
Based on the foregoing, it appears that the life claim for Mr. Sander's policy was processed in accordance with the terms and conditions of his policy and that no further action is warranted at this time.
Initial Consumer Rebuttal /* (3000, 7, 2016/02/03) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I do not accept this response because the claim has not been paid (2/2/2016). Life insurance is purchase for the benefit of the family to help with burying their love ones once death has occurred. This company is causing more pain and grief! They need to be put out of business for the way they operate their company.
Final Business Response /* (4000, 9, 2016/02/12) */
In follow-up to the Company's previous response stating claim had been released for payment on January 27, 2016, please be advised that the claim payment, plus interest, was issued and mailed on 2/2/16, same date rebuttal was submitted. Thank you.
Final Consumer Response /* (2000, 11, 2016/02/16) */
(The consumer indicated he/she ACCEPTED the response from the business.)
Finally received paid claim on 2/5/2016. My brother [redacted] died 11/26/2015!