According to the American Council of Life Insurers (ACLI), US citizens are carrying $1.3 trillion in life insurance coverage, and $21 billion was paid out to them in 2016. That paints an appealing picture of financial security for the many people in the US who have chosen to protect their families by purchasing life insurance. Unfortunately, the reality is quite different for some beneficiaries. Read about can life insurance deny a claim
You Can Fight Denial of Life Insurance Benefits
When a life insurance claim is denied, it can be jarring. Spouses, children, and others who have just suffered the loss of a loved one may have been dependent on the life insurance benefits for financial stability. Even where life insurance proceeds aren’t quite so critical, it is unsettling to have expectations upset, and to know that the time, effort, and money the deceased put into protecting the family has come to nothing.
Fortunately, you don’t have to take “no” for an answer.
Life Insurance Claims May be Wrongly Denied
The fact that a life insurance company has sent you a denial notice does not necessarily mean that you aren’t eligible for benefits. When a life insurance claim is denied, your next step should be to talk to an attorney who represents beneficiaries in life insurance denial cases.
Some of the common situations in which a beneficiary can receive life insurance benefits despite an initial denial notice include:
- When the insurance company has denied coverage due to a “material misstatement,” but the error or omission was actually minor and would not have affected the insurance application
- When a premium payment was late or missed and the insurance company is asserting that the policy had lapsed
- When the policy is an accidental death and dismemberment (AD&D) policy and the company determines that the cause of death was not an accident
- When the insurance company concludes that the cause of death is specifically excluded by the policy terms
These statements sound categorical and are probably convincing when they appear in a denial notice from the insurance company. However, there is one important fact you must keep in mind: each of these foundations for denial relies on a conclusion drawn by the insurance company. Fortunately, the insurance company does not have the final say on issues such as interpretation of policy terms, cause of death, or what constitutes a material misstatement.
Life insurance companies frequently classify insignificant flaws in the application as “material misstatements” or determine for themselves that the cause of death was excluded, though there is no official ruling to support their conclusion regarding cause of death.
We have succeeded in securing full benefits for life insurance beneficiaries who were denied under a variety of circumstances, even when the policyholder had missed a payment and the company was asserting that the policy had lapsed.
A Life Insurance Claim Denial Attorney Can Help
If you’ve been wrongly denied life insurance benefits, or if you have received a denial notice and don’t know whether you have a claim, it is in your best interest to get advice from an attorney who is experienced with life insurance denial claims.
The law surrounding life insurance can be complicated, particularly as different laws apply depending on the type of policy. Most individual life insurance policies are governed by life insurance law, and the insurance code imposes significant restrictions and obligations on the insurance industry. However, many life insurance policies offered as an employee benefit fall under the Employment Retirement Income Security Act of 1974 (ERISA). ERISA is a federal law that pre-empts state law, so those policies are governed by an entirely different set of rules.
Not every attorney has the knowledge and experience necessary to effectively fight a life insurance company on your behalf. Our life insurance lawyers have a perfect track record when it comes to fighting unjust denial of life insurance benefits. If you’ve been denied, contact us right now to learn more about how we can help you secure the benefits to which you are entitled.