Two Faces – Two Files – One Person’s Gain is Another Person’s Loss

WHY HAVE INSURANCE COMPANIES REFUSED TO PAY AFTER DEATH OF CIVILIAN CONTRACTOR?

by Sharon Rondeau

(Jul. 10, 2016) — On June 17, 2016, Pauline Boyle, widow of former civilian contractor Thomas J. Boyle, Jr., whose story we have covered over the last several months, once again requested the “complete file” relating to her late husband’s life insurance policies from seven companies which provided them.

Mrs. Boyle asked for a one-week turnaround of the documentation she said she knows exists as a result of file documentation she has acquired independently but which the insurance companies have not released to her.  Some of the revelations of which she learned recently are listed here.

Mr. Boyle was killed on June 19, 2012, in what Pauline believes was a “friendly-fire” accident but which has not been admitted to by the U.S. Army.  While stationed in Kandahar Province, Mr. Boyle’s former employer, L-3 Communications/Engility Corp., supported the 303rd Military Intelligence Battalion in training Afghani police officers.

Mrs. Boyle has reported receiving a payout based on the cause of “accidental death” from Aetna but that none of the six other companies involved have paid nor provided complete copies of the insurance file.

Curiously, Metlife cited “accidental death” as the cause of Mr. Boyle’s death in one of its emails and has refused to comment further on this issue. Metlife denies there exists an accidental death policy.  The remaining companies have not explained why they did not reach the same conclusion as Aetna and Metlife and have consistently denied Mrs. Boyle’s claims as her husband’s beneficiary.  Mrs. Boyle states that the companies continue to deny her copies of the complete files.

Those involved are Wells Fargo, AIG, Chartis, Marsh & McLennan (Marsh), Arthur Gallagher, Metlife, and Mercer, whose representatives have communicated among one other and with Mr. Boyle’s former employer, Engility, contributing to Mrs. Boyle’s belief that a “coalition of corruption” has conspired to keep her husband’s cause of death secret, beginning with the U.S. military.

The five companies which have not paid out have denied the claims by asserting that Mr. Boyle died in a “war zone,” which they say was excluded from coverage.  Mrs. Boyle has stated that it was known that her husband was being deployed to a “war zone” in Afghanistan in May 2012 and that he would never have purchased the policies had he suspected that they would not pay out as expected in the event that the worst came to pass.

“Marsh issued those four checks; what do they represent?  ‘Death Surrender,'” Mrs. Boyle recounted of checks issued to her by Marsh & McLennan without an explanation between November 2012 and December 2013 which remain uncashed.

In an interview on Monday, Mrs. Boyle revealed that she has discovered that a full disclaimer containing the policy exclusions did not appear on Marsh‘s website, where her husband subscribed; rather, the exclusions applying to that specific policy appeared on Engility’s website on the SPD (Summary Plan Description).  “They admitted that it wasn’t on that site, that it was on the personal page of L-3/Engility, so no one would know to go back and forth between the two sites to look for exclusions when signing up for insurance,” Mrs. Boyle told The Post & Email.  “You would think that what they offered to you is reliable, but in one email I discovered, they stated that because of this issue, we have now put the exclusion certificate ‘on the site’ – referring to the Marsh website where L-3 employees selected supplemental insurance coverage.”

“They admit in emails that Tom could not have seen the war risk exclusion, that ‘there is a listing of countries not covered in the war risk exclusion in the certificate but not countries that are covered,’ yet they processed a claim and denied payout on this ‘war risk’ exclusion,” Mrs. Boyle explained.  “If you just do a rudimentary search of ‘insurance policies’ or ‘insurance fraud,’ they always state that if there is any ambiguity, the determination is made in favor of the client.”

“AIG saw the problem, they recognized the problem, they admitted amongst themselves there was a problem; they fixed the problem; however, they still denied benefits to me, and that is where the fraud and collusion are documented.  Engility was copied on the emails along with all of the insurance companies; they are all communicating about this issue with each other,” Mrs. Boyle said.

“We have the U.S. Department of Labor involved also,” she said, referring to the initial Engility report made to the DOL of her husband’s death on June 19, 2012 before she herself was notified later that day.

In past articles, Mrs. Boyle has delineated what she sees as a deliberate cover-up of the facts surrounding her husband’s death among the U.S. military, L-3/Engility, and the insurers so as to prevent the truth of the alleged “fratricide”  incident from emerging.

Her June 17 email to approximately a dozen insurance-company representatives reads as follows:

I am writing with regards to all insurance policies that exist or existed in the name of my deceased husband Thomas J Boyle Jr., kia June 19, 2012.  Throughout the past 4 years after Tom’s death I have been deceived on many many levels, the discussion of which is the purpose of this email.

The lengthy email list is copied directly from correspondence I have obtained in contrast to your impediments initiated by Ms. Wasson of Marsh and includes representatives of Metlife, AIG, Marsh, Arthur Gallagher, Wells Fargo and employees of L-3/EngilityCorp.  I include all to establish past communication between the company (L-3/EngilityCorp) and the above mentioned insurance companies.  In other words, the list is taken from your emails – emails I have repeatedly requested in my extensive inquiries for a copy of the complete administrative file with regards to all policies involving my husband.  Requests that even to this day are denied with the ridiculous comments such as I have already been provided same.  Well I have them now.

I have attached several letters for your review wherein I am once again given the ‘run around’ regarding direct information and copies of the administrative file which should include claim notes and the complete claim file as well as all communications.  I provide this so that you have documentation of the relationship of Metlife, AIG, Mercer, Marsh, and so on.  Not only do I ask for a complete copy of the administrative file but as you can see I am asking specifically for clarification of a notation in the Metlife claim notes on 7/9/2012 stating 6/19/12 was accidental homicide in Afghanistan on 6/19/12 was accident.  A copy of this is attached in the first file below.

I am going to refer to some claim notes of AIG (of course copies denied me by all of the above) as a means of confirming to you that I hold such documents.  And since Marsh is the administrator for both Metlife and AIG, it is apparent that all entities (Marsh, Metlife, AIG/Chartis) are aware of all the documentation and correspondence that exists regarding this issue as they were provided same by Marsh.  Firstly, let us discuss the issue of the SPD (I have never received a copy of the one in effect on the date of death by the way) and the availability to read the SPD when purchasing supplemental insurance.  Important because it would include the exclusions and disclaimers. But you already knew that – and I will use your verbage – ‘due to this claim they have put the certificate on their website’ – meaning it wasn’t there when my husband purchased the policy.  This oversight is admitted to in your emails.  Then we have the issue of designated war risk territories and how that was never fully available when signing up for supplemental insurance and that the certificates are mailed to the home address after enrollment.  Certificates my husband never read since he was deployed overseas.  There is also reference to companion claim 061-060161 – as you all are aware I have four uncashed checks in my possession with certificate numbers and vague notations as to what they represent.  All printed by Marsh.  It has never been fully explained what they represent and what policies the certificate numbers correspond.  Recently I am told to contact Mercer.- a subsidiary of Marsh about these checks – more run around.  Your notes go on to talk about the conflict between the insurance company and the plan administrator. I’ll talk about ambiguity later.

I am also providing a copy of the Aetna claim notes in which the cause of death is listed as ‘death due to accidental bodily injury’ and also there is mention that the act of war limitation does not apply due to the accidental bodily injury.  It would have been your duty to review other policy processing and the requirement that you follow the same processing avenues and documentation.  Simply put you were required to follow the same processing format and use the same information.  But this you already knew

So I am not writing for a review of an appeal for denial of policies but rather I wish to focus on your own notes – wherein counsel states – ‘let’s not mention fraud’.  Well, I am going to mention fraud.  I will shout it from the rooftops if necessary.  Therefore, I am demanding you review evidence you had all along and deceptively decided to keep from me.  Your intent was fraudulent and included repetitive false statements and deceptive acts made with the intent to deceive me and improperly deny numerous claims without just cause or action.  The most grievous of which is the true nature of my husbands death.  Within the context of your own notes you state and acknowledge that YOU do not know the actual circumstances involved in my husband’s death, yet you processed claims.  You intentionally misrepresented yourself and breached your duty of good faith and fair dealing.  You were additionally required to provide the burden of proof regarding exclusion or limitation – of which you have not met.  And as you know any ambiguity should have been interpreted in my favor.  Your conduct was oppressive, fraudulent, and malicious.  The emotional pain you put myself and my son through is inexcusable.  My husband was a good man and a patriot who provided for his family in case of the worst scenario.  Your decision to not honor his actions is unconscionable and un-American.

To be clear – at this time – I am requesting a complete copy of all administrative files, claim notes, claim files, emails, documents, communications, with regards to benefits, determinations, medical records, casualty reports, military records, Dept of Defense records, anything generated in the course of making a determination and relevant to my claim for benefits, copies of all policies including COLI, ‘janitor’, companion, etc.  ALL POLICIES – copy all of them, everything means everything held or once held by Marsh, Metlife, AIG, Chartis, Mercer, National Union Fire, Wells Fargo, Arthur Gallagher, Aetna, and the Dept of Labor and any other insurance company you are keeping from me.  Please include all communications with any attorney as well as all communications with L-3 Communications/EngilityCorp.  No attorney client privilege attaches to these communications as I am the sole beneficiary of my husband policies and estate – please review Wildbur v ARCO, Smith v Jefferson Pilot Financial Ins Co… – you already know the case law involved which diffuses Ms. Millers statement regarding privilege.

To provide to you additional information regarding this issue I am linking a series of articles that you might find informative.  I look forward to your response and the complete files within one week.

Sincerely

Pauline Boyle

http://www.thepostemail.com/2016/06/05/are-major-u-s-insurance-companies-defrauding-pauline-boyle-and-others/

http://www.thepostemail.com/2016/05/16/civilian-contractors-surviving-spouse-says-husbands-death-just-like-benghazi/

http://www.thepostemail.com/2016/04/29/are-civilian-contractors-sacrificed-to-the-big-business-of-war/

http://www.thepostemail.com/2016/04/12/why-have-insurance-companies-denied-accidental-death-claims-for-civilian-contractor-thomas-j-boyle-jr/

http://www.thepostemail.com/2016/03/20/why-is-the-dod-obscuring-the-cause-of-death-of-thomas-j-boyle-jr/

regarding the last article above – why is the dod….please be sure to link to the four articles at the end of the document for further articles on the Uncle Sam’s Misguided Children’s site

“They’re going to dance around to deny giving me the complete files and have continually stated I have the complete file when in fact the insurance companies intentionally omit the emails and notes as well as other documentation to which an attorney would be privy,” she said.  As of this writing, the only insurance company which has responded to her latest request is AIG, in an email dated June 30 acknowledging her email, stating that “We will be in touch with you soon.”  To that, Mrs. Boyle told The Post & Email, “I want the file, not more responses.”

“What do you plan to do from here?” The Post & Email asked Mrs. Boyle, to which she responded:

I think making this known to the public is first – that what is happening to me can happen to you…why even buy insurance?  And the silly distinction AIG places on the difference between the administrative file and the claim file is more smoke and mirrors.  In other words, Ms. Miller of AIG is inferring in her correspondence that the client/beneficiary is entitled to one file and counsel is entitled to another file – one that contains additional documentation and communications.  Why would the client be refused anything in the file?  What is it that insurance companies do not want you to know?  My guess is how they wheel and deal with your policy payouts.  The bottom line for the insurance companies is to persuade your own attorney to convince you to settle for a lesser amount – or in my case, as I was told by another attorney – I have no case at all.  Funny since I now possess the email where AIG admits the wrongdoing and how it was corrected.

Everything is interrelated.  The reason the insurance companies don’t want to release the file is that they have the real documents that state how Tom actually died.  Go back to Metlife and Aetna, where it says the cause was “accidental death.”  They know his death was accidental.  Where did they get that information?  Marsh would have had to have given it to them as the administrator for Metlife and AIG/Chartis, so Marsh knows.  Where did Marsh get that information?  It had to be from the employer, L-3/Engility.  And where did L-3/Engility receive the information – the military/DOD, of course – and so the coalition of corruption continues.

Even Aetna, although they paid an accidental death claim will not provide me the documentation as to how they made that determination as well as the claim file.

I also would like to expose information about “janitor” policies (companion policies, COLI policies) where the corporation/employer takes out insurance on its employees.  I want to know how much money everyone made on the death of my husband, because eventually this will prove that contractor lives are expendable.  It all goes back to Benghazi and all the contractors deployed; they’re worth more to the employers dead than alive.  I even wonder if they’re doing this to military also.

My husband would never have bought an insurance policy if he knew it would never pay out.  Engility offered him a policy through Marsh without providing full disclosure of everything and a copy of the SPD on the same page where you sign up.  At that time, there was no link saying, “Please check for exclusions on this policy with your employer;” that was actually asking too much.  AIG found the mistake and corrected it, and at this point it is fraudulent that AIG kept this information from me.  All of the companies thus far have done absolutely nothing, and that could be their downfall.

Mrs. Boyle has been copying Reps. Jason Chaffetz, Chairman of the Oversight and Government Reform Committee, and Trey Gowdy, Chairman of the Select Committee on Benghazi, on much of her email correspondence in her quest to obtain official documentation from the U.S. military; its civilian contractor, Engility; and the insurance companies to whom Mr. Boyle in good faith paid premiums, of the cause of her husband’s death.

 

 

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