Attempting to claim life insurance benefits can be a challenging process, as many stipulations and potential issues may arise. Even minor mistakes—such as improperly filled-out forms or the policyholder passing away too soon after the policy was implemented—can lead to a denial. On top of that, insurers may dispute the cause of death, which can add unnecessary stress to a grieving family. If this happens, it’s essential to know how to effectively challenge the claim denial and seek the benefits that the insured intended for you to receive.
Why Cause of Death Matters
Insurance companies are concerned with the cause of death because they need to ensure that the claim meets the policy's terms and isn’t based on fraud or misrepresentation. As uncomfortable as it may be, verifying the cause of death is necessary for the insurer to cover themselves legally and financially.
Certain causes of death can automatically trigger a claim denial. For example, suicide is often excluded from coverage, as it’s considered a self-inflicted injury, not an accident. Medical conditions that were not disclosed in the policy application can also be a problem. If the insured failed to disclose a pre-existing condition, the insurance company may claim fraud or misrepresentation, leading to a denial. While these reasons can be unsettling, they are standard procedures to protect against exploitation of the system.
How to Fight a Denial Based on Cause of Death
It can feel disheartening if the insurance company denies your claim based on the cause of death, but remember that not all is lost. Even though an insurer may initially claim that the cause of death doesn’t meet their policy requirements, the situation is often open to interpretation. Just because the insurer believes a death may not be covered doesn’t mean that you can’t fight for the payout that the insured intended to leave behind.
Here are some steps you can take to challenge the denial:
Consult an Experienced Life Insurance Attorney
The first step is to contact a skilled life insurance lawyer. An attorney who specializes in life insurance claims will help you navigate the complicated legal landscape, saving you time and reducing stress. They’ll also help ensure you have a solid case before taking action.Thoroughly Review the Cause of Death
With the assistance of your attorney, review the details surrounding the cause of death. If there’s room to dispute the insurer’s interpretation—whether it’s about a potential exclusion like suicide or the accuracy of medical condition disclosure—your lawyer will ensure these points are properly addressed.Ensure the Policy Was Properly Administered
It’s also crucial to make sure that the life insurance policy was administered correctly and that all terms were met. If there were any errors in the initial policy process or if the insurer’s reasoning for the denial is vague or misleading, your attorney will be able to identify and challenge these discrepancies.Gather Evidence
Collect any evidence that supports your case, including medical records, autopsy reports, and witness statements. This evidence can help clarify any ambiguities about the cause of death and show that the death should be covered under the policy.Don’t Accept Vague Denials
An experienced insurance lawyer will not let the insurance company give vague, unfounded reasons for the denial. They will ensure that the insurer provides clear, concrete explanations, and if discrepancies are found on their side, your attorney will hold them accountable.
Get the Benefits You Deserve
While challenging a claim denial can be overwhelming, it is possible to win the benefits you deserve. The insured person took out the life insurance policy to help their beneficiaries after their death, and you have a right to those benefits.
If your life insurance claim has been delayed or denied, contact our team of experienced life insurance lawyers to get the full amount of the policy. We are here to help you navigate the process and fight for the benefits that are rightfully yours.
Call us for a free consultation.