Life Insurance Expert Witness Testimony Allowed In Part

Plaintiffs filed suit against the defendant related to a denial of a life insurance claim.  Plaintiffs hired a Life Insurance Expert Witness to provide testimony.  Defendant filed a motion to exclude this expert from testifying.  The court denied the motion in part and granted it in part.

Facts:  This case (Hoffman et al v. Kansas City Life Insurance Company – United States District Court – District of South Carolina – May 30th, 2019) involves a denial of a claim for life insurance.  The plaintiffs allege that the defendants wrongfully denied them benefits under a life insurance policy.  The defendants claim that they denied the claim for benefits under the policy because the decedent failed to disclose that he suffered from COPD on his application for the policy.  The plaintiffs hired Life Insurance Expert Witness Maurice Kraut to provide testimony.  The defendant has filed a motion to exclude this expert from testifying.

Discussion:  The plaintiffs have hired Kraut to testify about industry standards for handling claims and provide an opinion on whether the defendant failed to properly process the life insurance claim that the plaintiffs submitted under the policy.  The defendant seeks to include any testimony about life insurance claims practices or life insurance policies because Kraut does not have specialized knowledge in life insurance.

The plaintiffs argue that Kraut is qualified to offer an expert opinion on all insurance claims processes because he has been working in the insurance industry for thirty years.  During his tenure, he has focused on the claims process by supervising claims examiners, reviewing and analyzing pending claims, and managing claims that were in litigation.  In addition, the plaintiffs note that although Kraut has never testified in court in a life insurance case and has never been qualified as an expert in a life insurance case, he has testified in court as a claims expert.

The court opines that the defendant’s concerns about Kraut’s lack of experience in insurance claims processes are misplaced.  The court first notes that Kraut states that he has exposure to insurance claims and that the theories and practices that underlie all insurance claims processing can be applied to life insurance claims.  The court opines that the defendant’s concerns go to the weight of the evidence, not the admissibility.

The court also opines that Kraut will not be allowed to testify about whether the decedent was properly diagnosed with COPD.  In addition, Kraut will not be allowed to testify about the decedent’s intent.  Last, the court opines that Kraut may not testify about whether the defendant’s underwriting policy was appropriate or whether the application for the insurance policy violates the standards of care in the life insurance industry.

Conclusion:  The motion to exclude the expert witness testimony of Maurice Kraut is granted in part and denied in part.