ASHLAND, Mass.(AP)
When Jenny and John Crowley learned they were having a baby,
they did the responsible thing: they bought life insurance.
Barely in their 30s, they passed the insurance company's
physicals, applied for a $500,000 policy for Jenny and a $1 million
policy for John, and thought they wouldn't have to worry about
it for decades.
The Savings Bank Life Insurance Co. of Massachusetts was so
taken with the Crowleys, the company used a photograph of their
newborn daughter swaddled in a yellow blanket on the cover of one
of its brochures.
Just one year later, Jenny was dead of an aggressive form of
breast cancer, and when John tried to start his life anew as a
single father, SBLI rejected his claim for it to pay his wife's
policy. The company claimed that even though doctors said Jenny was
healthy, she must have been sick before they agreed to insure
her.
"I took solace in the fact that I had this life insurance
policy that was designed to protect me financially. Without that,
it put a lot of stress on me," John Crowley said.
"Financially, I was thinking about how am I going to care for
my daughter, how am I going to be a mom and a dad? It's a very
rough and kind of scary situation."
Now Crowley is pushing for a change in Massachusetts law that
would force an insurer to prove a person misrepresented his
well-being or should have known he was not in good health based on
"active symptoms of a serious change in health" in order
to deny a claim. Under current standards, the responsibility rests
with the insured person to prove he didn't know he was ill.
SBLI, which has since settled with Crowley, acknowledges that it
changed its own policy several months ago and is now supporting
Crowley in his fight for the legislation, dubbed "Jenny's
Law."
"Under precedent at the time, it did require that a person
be in good health when the policy was issued, even if they
didn't know about it," said general counsel Terence
O'Malley. "We reviewed all that and agreed that a
different standard should apply."
In most states, "good health" is clearly defined in
insurance laws, but in Massachusetts the courts have relied on
precedent set in cases dating back to 1920 that put the burden on
policyholders to demonstrate that they were in good health when the
policies were issued.
Under the proposed law, which is expected to come up for a vote
this spring, there is a presumption that the policyholder was in
good health _ otherwise, the insurer would not have issued a
policy.
In Jenny Crowley's case, SBLI cited the "good
health" provision, which says the person insured must be in
good health when a policy is issued, and the
"incontestability" provision, which says that for a
certain period after a policy is issued, usually two years, an
insurer can rescind a policy or refuse to pay a claim.
Both are standard in life insurance policies, and insurers
generally closely scrutinize claims made within the two-year
period, said Edward Graves, a professor of insurance at The
American College, a financial services college based in Bryn Mawr,
Pa.
State Sen. Karen Spilka, who introduced the proposed change to
the law, said the provisions are meant to prevent fraud and should
not be invoked in cases like Jenny Crowley's.
"When somebody is going through grieving the loss of a
spouse, particularly someone so young, to have to think that
you've taken all the steps that you're told to be taking,
to then find out that well, because of this possible technicality,
that you may not get what you thought you were getting is just not
fair," she said.
Several state and national insurance associations said it was
difficult to estimate how often a case like the Crowleys' could
occur.
In July 2004, Jenny Crowley passed a medical exam and blood work
done by SBLI.
A month later, her doctor examined her breasts during a
postpartum checkup and no abnormalities were noted. Two months
later, a doctor noted some breast firmness and suggested that Jenny
see a specialist as a precaution. A biopsy showed that she had
stage IV breast cancer.
Jenny and John had known each other since elementary school, and
were high school sweethearts. John proposed at the top of the Arc
de Triomphe in Paris in 1999, and they were married a year
later.
John went to work for an accounting firm, while Jenny was an
account manager at an advertising agency. In 2002, they bought a
house in Ashland, about 25 miles west of Boston. The following
year, they were overjoyed when they learned Jenny was pregnant.
They chose SBLI because their rates were competitive, and Jenny
had managed the company's advertising. After Kaitlyn was born,
SBLI asked if they could use her photo on their marketing
brochure.
"If only every decision were as easy as choosing the right
life insurance," reads the brochure's headline.
Some in the insurance industry were initially concerned that the
proposed legislation would preclude companies from denying claims
when they suspect fraud. But the industry now supports the
measure.
"We believe the bill strikes a reasonable balance, enabling
consumers to challenge claims decisions while preserving
insurers' ability to protect against fraud and
misrepresentation," said Andrew Calamare, president of the
Life Insurance Association of Massachusetts.
John Crowley, now 34, testified before the state legislature
about the proposed law.
"I feel like I have a moral obligation to prevent this from
happening to anyone else," he said.
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