Life insurance and declining medical treatment Suppose Bob gets a typical term life insurance policy and pays the premiums through the contestability period. Bob is then diagnosed with a terminal illness. There are treatments for this illness which have a probability p of keeping Bob alive for the rest of the policy's term. If Bob elects not to receive any such treatments and, as a result, dies of this illness in the policy's term, does the insurer have grounds to deny or reduce the claim? Do those grounds depend on p? Do they depend on whether Bob is unable rather than simply unwilling to undergo treatment? Assume that there are no misrepresentations by Bob and the policy does not specifically cover this situation.
Suppose Bob gets a typical term life insurance policy and pays the premiums through the contestability period. . . . If Bob elects not to receive any such treatments and, as a result, dies of this illness in the policy's term, does the insurer have grounds to deny or reduce the claim? No. This is not one of the reasons that an insurance company is allowed to refuse to pay a death benefit when an insurance policy has become incontestable. Once premiums have been paid through the contestability period, the only grounds upon which the insurer may deny or reduce the claim are: Bob isn't actually dead. A life insurance company almost never disputes this issue if it is presented with an apparently authentic death certificate, and it routinely requires claimants to provide it with a death certificate if it doesn't already have one in its file. But, if Bob walked into the insurance company's office alive and well, with his own death certificate, and handed it to the claims adjuster for the insurance company, the insurance company wouldn't write him a check. After the contestability period expired, Bob stopped paying the premium, was given a warning that the policy would terminate or have a reduced premium if he didn't pay the premium by the end of the grace period for doing so, and he didn't pay the premium. In the case of a term life policy this failure to pay would result in the insurance company having no obligation to pay the benefit. In the case of a whole life policy that has not already had all premiums contemplated by the policy paid in full, failure to pay the premium will usually only reduce the amount of the benefit that is payable by the insurance company upon death relative to what it would have been if the premium had been paid in full. Bob has transferred the policy to someone else who will be entitled to the benefit instead (e.g. in a viatical settlement or a transfer of the policy to an ex-spouse or trust). Bob died after the life insurance policy expires for reasons other than non-payment of a premium (usually because the death happens at an age older than the age covered by the policy). For example, my life insurance policy has a provision that states that no life insurance benefit is payable and the policy terminates upon my 75th birthday. This reduces the premium I pay and isn't a concern to me because after I'm that old I won't need to make up for any lost income in order to provide for my children. Another kind of life insurance policy that doesn't always pay a benefit when the insured dies is a "second to die" policy that pays a premium only when both of the insureds (typically a husband and wife who anticipate a large estate tax liability at a second death) have died. Bob had an accidental death policy rather than a plain vanilla life insurance policy. In this case, Bob's death from a terminal illness would not be considered accidental unless, for example, he actually died because a tornado hit the hospital he was in before he died from his terminal illness. What constitutes an accidental death is sometimes the subject of litigation. The whole point of an incontestability clause (which typically makes the policy not subject to contest after one to two years) is to prevent life insurance companies from refusing to pay a death benefit in situations including those like the one described in the question. Generally speaking, state law requires that life insurance policies to be incontestable after one to two years. An incontestable policy can also generally not be contested on the grounds that misrepresentations were made in the application for the life insurance policy, and preventing refusals to pay benefits in these situations is the other main reason that life insurance policies become incontestable. Note that even in the case of an accidental death policy, after the incontestability period expires, the life insurance company may not refuse to pay a benefit on the basis of fraud in the life insurance application. Once an accidental death policy is incontestable, the only reason the insurance company may refuse to pay a premium other than the reasons that apply to any other life insurance policy (as described above) is that the death was not accidental. Because it doesn't cover all possible deaths of the insured, accidental death policies are generally very inexpensive relative to the size of the benefit, compared to term life policies covering the same period of time for the same insured. Also, even if the insurance policy was still contestable, the insurance company could not refuse to pay the death benefit if Bob had been truthful in his insurance application at the time that it was made and Bob had kept his premiums current through the date of his death. For example, if Bob applied for his life insurance policy in January and answered every question on his application truthfully thinking that he was healthy, his application was approved in February, he was diagnosed with a terminal illness in March, and refused treatment and then died in April, the insurance company would not have a right to refuse to pay his death benefit, although in that situation, the insurance company would probably conduct an in depth investigation before agreeing to pay the death benefit. One of the reasons that the law doesn't allow insurance companies to refuse to pay in these situations is that (1) everyone dies eventually, so dying sooner only modestly adjusts the timing of when the benefit gets paid, and (2) the vast majority of people try to stay alive, even when there will be a death benefit payable when they die, if there is any realistic chance of doing so. Therefore, the economic cost to the insurance company of allowing some people to decline medical treatment when faced with a potentially deadly illness is very modest. The contestability period only exists at all to prevent people from applying for life insurance policies and lying about their lack of a known terminal illness when they apply for life insurance, which would allow people to avoid paying a life time of premiums and still receiving a life insurance benefit. But, since a terminal illness is pretty much defined as something that is expected to cause you death in six months or less, a year or two of contestability is usually sufficient to prevent this potential loophole from being exploited by unscrupulous terminally ill people.
The solicitor is allowed not to accept a case. If your ex-wife asked him to prepare papers, and he feels that she is getting ripped off, it is absolutely understandable that he won't prepare these papers for her, because he doesn't want to be sued or badmouthed when the deal goes wrong. "We would also reserve the right to take our own professional advice as to our efforts on your behalf." means simply he is not specialised in some subject, and will prefer to ask someone who is. Like a medical doctor asking for a second opinion before going ahead and cutting your leg off. Now I would have preferred if the solicitor had said concretely what exactly is wrong with the contract. Also, it would be obvious that you would be very comfortable with anything that he would advice her against. If he thinks that it is a good deal for you but not for her, he should advice against it. (Your comment to another question seems to indicate that she should be paid a lot more than you offered, so her solicitor seems to have been perfectly right).
You have to look at the contract, which is that thing they made you sign before the treatment. The primary rule is that the written contract rules (look for a clause saying that &quot;this is the whole agreement&quot; – there is a legal principle, the 4 corners rule, that precludes verbal statements from determining what the agreement is), and the contract probably has a specific statement about your financial responsibility. They may be contractually limited to certain amounts if you are an &quot;in network&quot; patient (because of their contract with the insurance company), but there is always language saying that if the insurance company doesn't pay (not in-network, or some deductible or other coverage-related issue), their friendly cost estimates are not price commitments. You can refuse to pay and they can take you to court; you can make your argument that they promised to do the work for $120. They will counter-argue that they gave you an estimate of the actual cost based on information that they had available, but you agreed to pay the full amount, insurance-based estimates notwithstanding. You can argue that at no time did they ever tell you what the worst-case scenario price would be, and they can argue that a reasonable person would know that $120 is not the full price for a crown and filling. They can argue on grounds of unjust enrichment that you owe them more money. It is not uncommon for people to misinterpret dental estimates as concrete prices.
How does GDPR work with insurers in relation to refusing information about pre-existing medical conditions? Due to it being special category data. As in, which of the "conditions for processing special category data" would apply? As far as I see, Article 9 (a) ("explicit consent") would apply. So the insurer would have to ask the customer for consent. My first thought was it would be consent-based (condition a), but under consent, it is noted that you should avoid making consent a precondition of service. Yes, that is often noted, but that is only partially true. The GDPR actually says (Article 7, emphasis mine): When assessing whether consent is freely given, utmost account shall be taken of whether, inter alia, the performance of a contract, including the provision of a service, is conditional on consent to the processing of personal data that is not necessary for the performance of that contract. So making consent a precondition of service can be ok, provided that the data is "necessary for the performance of that contract". Whether knowing about preexisting conditions is "necessary" for an insurance provider is something a court would have to decide, but on the face it does not seem unreasonable. Source: General Data Protection Regulation
What &quot;reasonable accommodation&quot; were you requesting? That they lower the bar of determining your ability to pay your bills on time? I don't think that will qualify. A business setting a minimum bar for financial viability isn't a burden tied to a handicap. It's one thing to request a ramp, contracts in braille, etc., but it's another thing to request that they accept a highly-probable financial risk. What would you expect of them the next time &quot;life&quot; got in the way and you couldn't pay your rent? Another accommodation? I think what they were saying is that since you didn't pass the financial background check, and as such were not accepted as a resident, you aren't in a position to make an accommodation request.
Will UKVI allow a concession for this specific situation? Only your wife's UKVI caseworker can definitely answer this with any certainty, but as you say CR2.3 (b) does seem quite compelling but (c) less so - unless the medical records support her condition was &quot;life-threatening&quot; ...any period spent outside the UK will not count towards the 180-day limit if the absence was for any of the following reasons: [...] (b) travel disruption due to natural disaster, military conflict or pandemic; or (c) compelling and compassionate personal circumstances, such as the life-threatening illness of the applicant, or life-threatening illness or death of a close family member; [...]
There is no such legal requirement coming from federal or NY state law. Doctors can refuse treatment when the patient is abusive or the matter is outside the scope of their practice, and that can include a test which requires skills, equipment or a contractual relationship that they don't have. Also if a procedure conflicts with their professional duties (that is a large loophole), they do not have to perform a requested service: an example is prescribing antibiotics for a viral infection. There is also a federal regulation known as the conscience rule which is conceivably applicable. If the test is medically unnecessary (e.g. a covid antibody test &quot;just for the heck of it&quot;) it would be illegal for the physician to perform the test and bill the insurance, though not illegal to do the test and have the patient pay, unless their agreement with the insurance company precludes any and all unnecessary treatments (regardless of whether the patient pays). That is, you cannot compel the doctor to breach his contract with the insurance company. If they do perform the test, then according to HIPAA, they have to tell you the results.
Conditions pertaining to cancellation of a contract are contained in the contract, that is there is no general "right to cancel a contract", apart from certain 3-day window rights in some jurisdictions. For example, Washington state has some specific cancellation laws, summarized here. If the contract does not allow for cancellation, then you can't cancel the contract. I assume that your contract does have a cancellation clause: then you could have to see what that clause actually states. As it turns out, Florida has a law (Fla Stat. 501.017) which regulates health studio (gym) contracts, requiring certain clauses above the signature box. One required clause per (1)(b)2 is that notice of intent to cancel by the buyer shall be given in writing to the health studio. However, If the health studio wishes to enforce the contract after receipt of the notice, it may request the department to determine the sufficiency of the notice. This means that if they want to enforce the contract after a cancellation, they may request "the department" (Department of Agriculture and Consumer Services) to rule whether the notice was according to the contract (as mandated by law). It will also contain under (1)(d) A provision for the cancellation of the contract if the buyer dies or becomes physically unable to avail himself or herself of a substantial portion of those services which he or she used from the commencement of the contract until the time of disability, with refund of funds paid or accepted in payment of the contract in an amount computed by dividing the contract price by the number of weeks in the contract term and multiplying the result by the number of weeks remaining in the contract term. The contract may require a buyer or the buyer’s estate seeking relief under this paragraph to provide proof of disability or death. A physical disability sufficient to warrant cancellation of the contract by the buyer is established if the buyer furnishes to the health studio a certification of such disability by a physician licensed under chapter 458, chapter 459, chapter 460, or chapter 461 to the extent the diagnosis or treatment of the disability is within the physician’s scope of practice. A refund shall be issued within 30 days after receipt of the notice of cancellation made pursuant to this paragraph. It appears, then, that you simply need to give notice in the correct form (written, with a doctor's notice). In case the club does not have the required provisions in the contract, the contract violates state law and is unenforceable.