Named Beneficiary Must be Paid Death Benefit
Barry Zalma
Dec 22, 2023
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Della Lopez, Fred Lopez, Shella Gill, and Paul Imrie (collectively “Plaintiffs”) appealed from the trial court’s Order, arguing the trial court erred by granting summary judgment in favor of The Prudential Insurance Company of America (“Prudential”) and abused its discretion by denying Plaintiffs’ Motion to Compel.
In Della Lopez, Fred Lopez, Shella Gill and Paul Imrie v. The Prudential Insurance Company Of America, No. COA23-427, Court of Appeals of North Carolina (December 19, 2023) the Court of Appeals resolved the dispute of relatives of a decedent’s fight over life insurance benefits.
FACTUAL BACKGROUND
Following her husband’s death, Sherry elected to purchase a Policy from Prudential and continued to make the premium payments. To effectuate purchase of the Policy, Sherry completed and signed an Optional Group Universal Life Enrollment Form (the “Beneficiary Designation”) on 25 April 2007, naming her half-sister, Diana Imrie (“Diana”), as her sole beneficiary and Diana’s children as contingent beneficiaries.
After her husband’s death in 2007, Sherry moved in with Diana and her then-husband Paul Imrie (“Paul”) in North Carolina. Diana and Paul divorced in December 2014, and Sherry continued to live with Diana in North Carolina until March 2016.
Sherry believed Diana took the money because Diana was a joint signatory on the account and had access to the funds. Following this discovery, Sherry wanted to cancel the Policy with Prudential because she could no longer make the monthly payments, and “Diana was the sole beneficiary.”
The Prudential representative advised Della she would send a “Cancel Coverage Form” via email. Della did not complete and return this form. Without the return of this form, the cancellation of the Policy did not go into effect.
In 2016, Sherry attempted to commit suicide by overdosing on her heart medication. On 22 March 2016, Sherry died due to complications from her suicide attempt.
On 10 May 2016, Diana emailed Prudential with a copy of the Beneficiary Designation form Sherry had signed in April 2007. After Prudential received the Beneficiary Designation from Diana Prudential was asked to verify whether the Beneficiary Designation should be accepted by Prudential. Prudential paid Diana $54,000, the full amount of the Policy.
On 5 May 2017, after Paul and Della emailed Prudential alleging Diana was aware the Policy had been canceled and therefore fraudulently claimed she was the beneficiary of the purportedly canceled Policy. As a result of Paul and Della’s multiple emails and the transcription of the cancelation call, the matter was referred to Prudential’s Corporate Investigations Division (“CID”).
CID Investigator Peter Friscia (“Friscia”) was assigned to investigate any alleged fraud regarding the payment of the Policy to Diana and the cancelation call made by Della. Following interviews with Della, Paul, and Diana, Friscia concluded there was no evidence to substantiate any fraud by Diana, but Della’s impersonation of Sherry did constitute fraud.
Based on Friscia’s report, Prudential referred the case to the Georgia Department of Insurance (the “GDOI”) for further investigation. Prudential’s referral stated that Della was suspected of committing insurance fraud due to her impersonation of Sherry on the cancellation call. The referral further stated Paul “aided and abetted” Della in her attempt to cancel the Policy.
Plaintiffs filed a Complaint in Gaston County District Court requesting a declaratory judgment as to their rights under the Policy. In the Complaint, the Sibling-Plaintiffs alleged Prudential was required to pay out the Policy to the surviving siblings in equal shares, and the payout to Diana was wrongful because she was not the beneficiary on file.
On 21 December 2022, Judge Bell granted both of Prudential’s partial motions for summary judgment.
ANALYSIS
First, the Sibling-Plaintiffs argued that the trial court erred but there was no uncertainty as to the respective legal rights of the parties in the Policy. The evidence in the Record showed Diana submitted a Beneficiary Designation, signed by Sherry, noting Diana as the sole beneficiary of the Policy. Prudential confirmed the information in the Beneficiary Designation and concluded the claim by Diana was valid.
Moreover, the Sibling-Plaintiffs’ own evidence shows they likewise believed Diana was the beneficiary of the Policy.
The Sibling-Plaintiffs have failed because the evidence shows Diana was the beneficiary of the Policy and the judgment was affirmed.
ZALMA OPINION
Because the decedent had fallen out with her sister and wanted to cancel the policy to keep her from benefiting from the decedent’s death, she asked her other sister to cancel the policy. The sister failed to do so and the person the decedent did not want to receive the benefits of the policy got the money. The rest of the family tried to make the decedent’s wishes be honored but could not do so because of the incompetence of the attempt to cancel the policy. Relatives should never get involved in the life insurance held by others.
(c) 2023 Barry Zalma & ClaimSchool, Inc.
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Greater St. Stephen Ministries, Inc., a church located in Louisiana, owned property that suffered damage from Hurricane Ida on August 29, 2021. The property was insured under a policy with Mt. Hawley Insurance Company, which required the insured to provide “prompt notice” of any loss or damage, ...
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Read the full article at https://lnkd.in/gBXRbKXD, see the video at https://lnkd.in/g4DKfUDz and at https://lnkd.in/g65V_RQ7 and at https://zalma.com/blog plus more than 5250 posts.
Once The Insured Knows There is Damage It is Obligated to Report the Loss to the Insurer
In Greater St. Stephen Ministries, Inc. v. Mt. Hawley Insurance Company, No. 24-cv-3130 (AS), United States District Court, S.D. New York (January 2, 2026) resolved a case brought by a church against an insurance company for denying coverage after Hurricane Ida. After discovery, the insurance company moved for summary judgment because it claimed the insured breached a material condition of the policy.
BACKGROUND
Greater St. Stephen Ministries, Inc., a church located in Louisiana, owned property that suffered damage from Hurricane Ida on August 29, 2021. The property was insured under a policy with Mt. Hawley Insurance Company, which required the insured to provide “prompt notice” of any loss or damage, ...
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He Who Represents Himself in a Lawsuit has a Fool for a Client
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FACTUAL BACKGROUND
Parties & Claims:
The plaintiff, Pankaj Merchia, is a physician, scientist, engineer, and entrepreneur, proceeding pro se. Merchia sued United Healthcare Services, Inc., a Minnesota-based medical insurance company, for defamation and related claims. The core allegation is that United Healthcare falsely accused Merchia of healthcare fraud, which led to his indictment and arrest in Massachusetts, causing reputational and business harm in the District of Columbia and nationwide.
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ZIFL Volume 29, Issue 24
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Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/
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