Has your life insurance claim been denied? It’s understandable if you feel overwhelmed or defeated, but you don’t have to face this challenge alone. Our experienced life insurance claim denial lawyers just successfully settled a $500,000 Stonebridge life insurance claim that had initially been denied. In many cases, life insurance companies deny claims due to incomplete or incorrect documentation. However, with the right guidance and support from a qualified attorney, you can secure the life insurance benefits you are rightfully entitled to.
What You Can Do When Your Life Insurance Claim Is Denied
In many instances, life insurance companies reject claims because they lack the necessary paperwork to properly process the claim. If you’ve had your claim denied, it may be due to missing or incomplete documentation. Providing the insurance company with the proper paperwork is often the key to ensuring a successful claim.
The standard documentation required includes a completed claim form and an official copy of the deceased’s death certificate. It's important to note that a funeral director’s copy of the death certificate is typically not sufficient for the insurance company’s needs. Additionally, if the insured person passed away within two years of the policy’s issuance, the insurer may need to investigate the cause of death further, specifically ruling out suicide. Many policies contain a suicide clause that excludes benefits if the death was self-inflicted, although in some cases, the beneficiary may be eligible for a refund of premiums paid up until the date of death.
Common Reasons Life Insurance Claims Are Denied
Life insurance claims are closely scrutinized, and not all claims are approved. Understanding the reasons for claim denials is crucial. Some of the most common reasons for denial include:
Fraudulent Activity – Fraud by the insured party or the beneficiary can lead to a claim being denied. If either party provides false information or engages in deceptive behavior, the insurance company may choose to reject the claim.
Material Misrepresentation – This is one of the most frequent reasons for denial, and it can occur when the insured individual provides incorrect, incomplete, or misleading information on the insurance application. This can include misrepresenting their health, lifestyle habits, or even other insurance policies.
How Smoking and Drinking Can Lead to Denial
Two common lifestyle factors that frequently result in life insurance claim denials are smoking and drinking. Insurers consider both smoking and excessive alcohol use as high-risk behaviors that can significantly impact an individual’s health, and therefore, their life expectancy. Here’s how these factors may contribute to a denial:
Smoking: Many life insurance policies ask applicants if they smoke, as smokers are at higher risk for a range of health issues, including lung cancer, heart disease, and stroke. If you fail to disclose smoking habits or underreport the frequency, it can be considered a material misrepresentation. This is particularly true if the individual dies from a condition related to smoking, such as lung cancer. In such cases, the insurance company may use the misrepresentation as a basis to deny the claim.
Drinking: Similarly, life insurance companies are concerned about alcohol consumption, especially excessive drinking. Alcohol abuse is linked to liver disease, heart conditions, and other serious health problems. Failing to accurately disclose alcohol-related health issues or misrepresenting the extent of alcohol consumption on the application form can also result in a denied claim.
What Constitutes Material Misrepresentation?
Material misrepresentation can be defined as providing false, incomplete, or misleading information on an insurance application, which would have impacted the insurer’s decision to approve the policy. The key to determining whether a misrepresentation is material lies in the clarity of the application questions and whether the information was knowingly withheld or distorted.
Some areas where misrepresentations are most commonly seen include:
Smoking habits
Drinking or alcohol consumption levels
Age or date of birth
Medical history
Employment status or history
Income and financial stability
Other insurance policies held
The insurance company may choose to rescind a policy based on material misrepresentation if the question was clear and the failure to disclose or misrepresentation influenced the insurer’s decision to accept the application. Whether the misrepresentation is deemed "material" is usually a factual determination, and it often comes down to whether the insurer would have accepted the policy application had they known the full truth.
What You Can Do If Your Life Insurance Claim Is Denied
If your life insurance claim has been denied due to smoking, drinking, or any other reason, it’s crucial to consult with a skilled life insurance attorney. At our law firm, we are dedicated to helping families fight for their rightful life insurance benefits. We have experience handling complex life insurance disputes and are ready to take legal action on your behalf to recover the proceeds you're entitled to.
Contact Us Today for Help With Your Life Insurance Claim
Life insurance denials are often based on complex legal and procedural issues. If you believe your claim was unfairly denied, don’t give up. Contact our experienced life insurance attorneys today for a free consultation. We are here to help you navigate the legal challenges and ensure that you receive the life insurance benefits that you deserve under the law.
By addressing the issues of smoking, drinking, and other common misrepresentations in your application, we can work together to maximize your chances of a successful claim outcome. Don’t wait—take the first step toward resolving your claim denial today.