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Insurance companies know one simple truth: delay works in their favor. When a claimant stops receiving responses, explanations, or decisions, the insurer is often not confused or overwhelmed—it is buying time, wearing the claimant down, and quietly protecting its bottom line. Silence, in the insurance world, is rarely accidental. Silence Is a Strategy, Not a Mistake Claimants frequently contact us after months of unanswered emails, vague status updates, or repeated requests for “additional time” to review a claim. This conduct is not neutral. It has real consequences: Medical bills go unpaid Mortgage and rent payments fall behind Treatment is delayed [...]

What Happened: Terri Yates filed a claim for accidental death benefits under her employer’s group life insurance policy after her husband, Johnny Yates, died from a heroin overdose. His death occurred unexpectedly. Symetra’s Reason for Denial: Symetra, the insurance company, denied the claim by arguing that Johnny’s death wasn’t an “accident” because he voluntarily used heroin. They also believed his actions were intentional enough to trigger a policy exclusion for “intentionally self-inflicted injuries.” The Court’s Key Questions: Was the Death Accidental? The court looked at whether Johnny’s overdose was truly unexpected. It used a test (known as the Wickman test) [...]