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How to Dispute a Life Insurance Denial

By September 28, 2021 No Comments
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After a loved one passes, it can be an incredibly emotional and stressful time. While dealing with an unimaginable loss, you may also be the named beneficiary of that loved one’s life insurance policy meaning you may receive the benefits listed in that policy. While the process of claiming the benefits should be smooth, some claims for life insurance benefits are delayed or even denied. The faster you seek counsel experienced in life insurance denial, the better. Challenging a life insurance denial can be incredibly complicated and will require legal knowledge and strong representation to fight for your rightful benefits as intended by your loved one under their life insurance policy.

Reasons For Life Insurance Denial

Life insurance policies often come with contingencies that can void coverage to the policyholder. There are many situations in which a life insurance claim can be denied and steps that you can take to dispute the denial and still receive the benefits from the policy. One of the most common reasons a life insurance policy has been denied is policy delinquency. This means the policyholder failed to pay their premiums on time which caused a lapse in coverage. The policyholder may also accidentally let their policy expire. Another reason a life insurance policy claim may be denied is material misrepresentation by the policyholder on the initial life insurance application. If the policyholder failed to report a heart condition, history of diabetes, history of smoking, their total income, or failed to disclose other life insurance policies, the validity of the policy may be jeopardized. If the policyholder died outside of the scope of coverage, meaning they died within a contestable timeframe, the policy benefits may be denied. A contestability period may span the first few years of a policy’s effective date in which insurers can deny a claim under specific circumstances. For example, if the policyholder takes their own life or dies while performing an illegal act, life insurance claims may be denied. The contestability period is mostly imposed for insurers to prevent acts of insurance fraud from occurring.

The life insurance company will follow its own specific claims process to determine if a policy remains valid and in effect and whether its benefits are able to be paid to the named beneficiary and/or the loved one’s heirs. If the family has taken all appropriate steps to claim the life insurance benefits, and the life insurance policy has been denied, they should immediately contact experienced legal counsel. The insurance company should send a denial letter listing all reasons the life insurance policy has been denied. In the event that the denial letter does not include the reasons for denial, your counsel can request more information regarding the specific reasons for rejection. An appeal can be sent to the insurance company that contains the more required information, however, there is usually a time limit to appeal – since appeals are limited, you will want to work with an experienced insurance lawyer to handle this portion of the process. Many insurance companies only give beneficiaries 60 days to appeal their decision.

The best chance for success in appealing a life insurance denial is to hire experienced counsel. Working with an attorney that focuses on this type of law will greatly improve your chances of recovering the life insurance benefits. Disputing the denial may take knowledge of specific insurance laws that only an attorney will understand. Your attorney will help you contest the life insurance denial by presenting evidence gathered from their own investigation to demonstrate the beneficiary’s qualifications and to dispute any allegations of wrongdoing by the policyholder. It may only take your attorney presenting certain records that were not previously included in the insurer’s documentation to prove a claim is valid. These records may include an autopsy report, medical documents, and proof of policyholder insurance premium payments. If the claim denial requires an administrative appeal, as is the case with an ERISA claim denial, your attorney will be able to gather the required documents and submit them within the specified time limits set by the insurer.

If the appeal does not come through, or you feel as though the life insurance claim was denied or delayed unfairly, you may choose to discuss taking legal action against the insurance company with your attorney. This may involve filing a lawsuit to receive the money you are rightfully owed. Just like auto insurance companies, life insurance companies do not want to pay big sums of money to anyone. They will attempt to stall, delay, or even wrongfully deny a valid life insurance claim. An insurance company that denies a claim in bad faith, having no legal reason to refuse to pay benefits to the beneficiary of a policy should be held accountable for their actions.

Houston Life Insurance Denial Attorneys

At Feldman & Feldman, we have extensive experience handling life insurance claims, and the delays and bad faith denials that often come with them. We take great pride in helping victims of greedy insurance companies recover the legacy their loved ones left for them. If you are the beneficiary of a life insurance policy and your claim for benefits has been denied, contact our office today. Time is limited and the sooner you appeal the denial with the help of experienced legal counsel, the better the potential result. We will investigate your unique situation and help you receive the benefits you deserve. Contact Feldman & Feldman today to schedule a consultation to discuss your case.