Learn About 20 Denied Life Insurance Claim Questions and Answers
Q: What is a denied life insurance claim?
A: A denied life insurance claim occurs when the insurance company refuses to pay the death benefit to the listed beneficiary. This often leads to financial hardship for grieving families who were counting on the payout. Our life insurance attorneys help challenge these denials and recover the funds owed.
Q: Why do life insurance claims get denied?
A: Claims may be denied for many reasons, including alleged misrepresentations during the application process, missed premium payments, policy lapses, or deaths that the insurer argues fall outside the scope of coverage. Each denial should be reviewed carefully with legal guidance.
Q: Can a life insurance claim be denied due to suicide?
A: Yes, many policies include a suicide exclusion clause that allows the insurer to deny a claim if the death occurred within a certain time—often two years—after policy issuance. However, insurers sometimes misuse this clause, and our attorneys regularly dispute these denials successfully.
Q: Can a claim be denied if the policyholder died in a foreign country?
A: It depends on the specific terms of the policy. Some life insurance contracts contain exclusions for certain countries or require additional documentation when a death occurs overseas. These denials can often be overturned with legal help and proof of legitimate death circumstances.
Q: How can I appeal a denied life insurance claim?
A: The best course of action is to contact an experienced life insurance attorney. Our team prepares detailed appeals, negotiates with insurers, and, if necessary, files lawsuits to secure the benefits you deserve.
Q: What should I do if my life insurance claim is denied?
A: Don’t try to handle the appeal alone. Call our firm immediately. We’ll assess the denial letter, investigate the policy, and build a strong legal strategy tailored to your situation.
Q: Can a claim be denied if the policyholder had a pre-existing medical condition?
A: If the condition was not disclosed and deemed a material misrepresentation, the insurer may deny the claim—especially during the contestability period. We fight these denials aggressively and often prove that the omission was not material or that the insurer waived its right to contest.
Q: Are there time limits for filing a life insurance claim?
A: Yes, every policy contains a time window for submitting a claim, which can range from one to several years depending on the policy and state law. However, some delays are legally excusable, and we’ve recovered benefits long after the filing deadline.
Q: Can a life insurance claim be denied if premiums were not paid on time?
A: Yes. If a policy lapses due to non-payment and the grace period has passed, insurers can deny claims. However, we’ve won numerous cases where non-payment was due to address errors, insurer misconduct, or medical incapacity of the insured.
Q: What should I do if the insurer claims there was a misrepresentation on the application?
A: You should retain our firm immediately. We investigate whether the alleged misrepresentation was actually material, whether it was made intentionally, and whether the insurer conducted a proper investigation during underwriting.
Q: Can a claim be delayed or denied if the cause of death is under investigation?
A: Deaths under investigation—such as homicides or accidental deaths—can lead to temporary delays, but not necessarily denials. Insurers may withhold payment pending a final autopsy or police report. We push for timely resolution or file suit if the delay becomes unreasonable.
Q: Can a beneficiary be changed after the policyholder’s death?
A: No. Beneficiary changes must be made by the policyholder during their lifetime. After death, the last valid designation governs. If an ex-spouse, new partner, or relative disputes the listed beneficiary, we handle those legal battles, including interpleader cases.
Q: Can a denied claim be reconsidered if new evidence arises?
A: Absolutely. We've had great success reopening cases and overturning denials by submitting extensive legal briefs—often hundreds of pages long—with newly uncovered facts, policy documents, or medical records.
Q: Is there a specific process to appeal a denied life insurance claim?
A: Yes. Most policies, especially group life insurance governed by ERISA, allow only one appeal. That’s why it's critical to retain a lawyer before submitting anything—your appeal must be thorough and legally precise from the start.
Q: Can a claim be denied if the policyholder died during high-risk activities?
A: Yes, policies often exclude coverage for deaths resulting from extreme sports or hazardous hobbies. However, insurers must prove the activity directly caused the death and that it was clearly excluded in the contract.
Q: Can a new life insurance policy be challenged more easily?
A: Insurers scrutinize claims during the first two years due to the contestability period. But contrary to what some may believe, valid claims should still be honored. Don’t accept the excuse that “it’s too soon” for a payout—we challenge that narrative and win.
Q: Can smoking-related misrepresentations lead to denied claims?
A: Yes. If the insured said they were a non-smoker but medical records show otherwise, the insurer may claim fraud. Still, denials often rely on weak evidence or overlook the insurer’s failure to investigate, which we expose during litigation.
Q: What does a beneficiary have to do during the claims process?
A: Beneficiaries must submit a death certificate, claim forms, and any requested documents. But when problems arise—such as missing forms, contradictory records, or disputes—it’s best to let an attorney handle the communication.
Q: Can a claim be denied if the policyholder died during the contestability period?
A: Claims during this two-year window are scrutinized, and insurers often deny based on misstatements. However, the burden is on them to prove the misrepresentation was material and intentional. We fight these denials and hold insurers accountable.
Q: Can an attorney really help reverse a denied life insurance claim?
A: Absolutely. Our firm has spent over two decades overturning wrongfully denied life insurance claims. We’ve recovered millions for our clients, whether the issue was contestability, lapse, suicide exclusions, or beneficiary disputes.