Our attorneys just resolved a large MetLife denied life insurance claim. Life insurance claim denials have always been very rare. As low as 0.02 percent of claims were denied or delayed in 2019, but since the Covid-19 pandemic broke out, the number of denied life insurance claims has increased significantly. According to Fortune, 2021 saw the highest increase of 15.4 percent in over 100 years.
Insurance companies don't pay the life insurance claim on their own. It has to be claimed after the death of the policyholder by a rightful beneficiary. As long as the insurance is in good standing, there is no reason for a delay or denial, and the beneficiary holds the right to expect a full payout. However, if your life insurance claim is denied, it can be due to one of the following reasons:
- Documentation failure
- Unpaid premiums
- Suicide within the contestable period
- Material misrepresentation
- No proof of death
- Claim filed after the deadline
- Failure to designate a beneficiary on the policy
- Billing non-covered services
- Lack of medical necessity
- Listing down the life insurance in will
If your life insurance claim has been denied, the insurer sends you a written notice outlining the reasons for the denial. If you think your claim was unjustly rejected or you haven't received a valid justification for it, make sure you do present an appeal to contest the denial. You can appeal it on your own or get help from a life insurance lawyer.
Here's what you need to do to start the process:
Contact The Insurer Company
The first step is to get in touch with the insurance company. Ask for a written denial if your life insurance claim was rejected over the phone. As the beneficiary of a life insurance policy, you are entitled to a written explanation of why your claim was refused. The reason the claim was denied should be detailed in the letter.
You can get your answers directly from the insurance provider about your claim and more information about the appeal process. In most circumstances, you'll need to provide proof to support your appeals, such as proof of premium payments, medical documents, or an autopsy report.
Hire a Life Insurance Attorney
If you feel your life insurance claim was denied or delayed unjustly, discuss your situation with an experienced life insurance claim lawyer. Disputing a denied life insurance claim can involve investigations regarding denial, legal research, understanding the legal rules, and filing an appeal.
The lawyer will look into your case and assess the denial letter, the policy, and other documents to figure out how you should move forward. With the lawyer's help, you can design a successful appeal strategy and evaluate the possible outcomes for the case. However, if you don't want to involve a lawyer, make sure you understand the laws, such as ERISA, which states that claims require at least a single administrative appeal before a designated beneficiary, meaning you, can file a lawsuit.
The Bottom Line
Life insurance claims can be wrongfully refused or postponed by an insurance company working in bad faith or just seeking to avoid paying an ERISA life insurance claim.
Don't hesitate to contact a qualified and experienced life insurance claims attorney. The right lawyer can help you get the life insurance benefits you deserve.