Mass Mutual Life Insurance Claim Denial Successfully Resolved
We are proud to announce the successful resolution of a denied life insurance claim involving Mass Mutual Life Insurance. Our client came to us after the insurer wrongfully denied a claim on the grounds of alleged misrepresentation. After a thorough investigation and strategic legal action, we were able to overturn the denial and secure the full payout. This case joins a long list of recent victories against top insurers, including National Western Life, Physicians Mutual Life, Atlantic Specialty Life, Gerber Life, Protective Life, Sagicor Life, and Colombian Mutual Life.
Why Misrepresentation Leads to Life Insurance Claim Denials
Misrepresentation is one of the most commonly cited reasons for denying a life insurance claim. When someone applies for a life insurance policy, they are legally required to provide truthful and complete information. This includes disclosures about medical history, lifestyle habits, finances, and personal details. If an insurer later discovers that the information was inaccurate, it may argue that the policy was obtained under false pretenses—giving it grounds to void the contract and deny the claim.
Medical Misrepresentation
One of the most serious and frequent issues involves the failure to disclose pre-existing medical conditions. For example, if an applicant had a history of cancer, heart disease, or another life-threatening illness and did not include it on the application, the insurer may view that as a material misrepresentation. If the insured dies from that condition or a related illness, the insurer will likely use the omission to deny the claim—especially if the death occurred during the contestability period, which is typically the first two years after policy issuance.
Lifestyle Misrepresentation
Insurers also ask about lifestyle factors such as smoking, alcohol consumption, drug use, and participation in hazardous activities. If the policyholder fails to report such habits—particularly when they are linked to the cause of death—the insurer may argue that the omission was material. For instance, if an insured person dies while skydiving but never disclosed their participation in extreme sports, the insurer might deny the claim based on inaccurate risk representation.
Financial Misrepresentation
Insurers also assess financial details when underwriting larger policies. Applicants may be asked about their income, debt, and dependents. If a person exaggerates their income or downplays liabilities to qualify for a higher coverage amount, and that misstatement is discovered during the claims process, the insurer may argue fraud or intentional misrepresentation. While this is less common than medical misrepresentation, it becomes more prominent in high-value policy disputes.
Personal Information Misrepresentation
Providing false information about one's age, identity, or occupation can also jeopardize a life insurance policy. For example, misstating age to qualify for lower premiums may void the policy entirely if discovered. Age is a key actuarial factor, and any intentional misstatement undermines the policy's foundation. We’ve also handled cases where insurers wrongfully alleged identity fraud or clerical inconsistencies to delay or deny claims—tactics that we challenge aggressively.
Our Law Firm Fights and Wins These Claims
At our law firm, we’ve resolved life insurance disputes against nearly every major insurer. When clients come to us after a denial, we begin by requesting the full claim file, reviewing the original application, obtaining relevant medical and financial records, and analyzing the insurer’s basis for denial. Our attorneys prepare a comprehensive appeal or, if necessary, file a lawsuit to enforce the policy terms. We’ve overturned denials based on alleged misrepresentation, lapse in coverage, contestability investigations, and more.
We Also Handle:
Beneficiary disputes involving ex-spouses, family conflict, and estate litigation
Life insurance interpleader lawsuits when multiple parties claim the same benefit
Delayed claims where the insurer withholds payment without justification
You Don’t Pay Unless We Win
We work on a contingency fee basis. That means you owe us nothing unless we recover life insurance proceeds on your behalf. With successful outcomes across all 50 states, our team has recovered millions for clients who were wrongfully denied the benefits they were promised.
FAQ: Life Insurance Claim Denials Based on Misrepresentation
What is misrepresentation in a life insurance policy?
Misrepresentation refers to providing false or incomplete information on the insurance application. This can include health, lifestyle, income, or even age. If the insurer discovers it—especially during the contestability period—it may use it to deny the claim.
Is misrepresentation always intentional?
No. Sometimes applicants make honest mistakes or misunderstand the questions. However, insurers often treat even unintentional omissions as material, especially if the omission relates to the cause of death.
What is the contestability period?
It’s a two-year period after policy issuance during which the insurer can investigate the application for errors or omissions. If death occurs during this window, the insurer has greater freedom to review and deny claims.
What happens if the insured dies due to an undisclosed condition?
If the medical condition was material and not disclosed, the insurer may deny the claim. However, we often prove that the omission wasn’t relevant to underwriting or that the insurer should have discovered it during their review.
Can misrepresentation claims be challenged?
Yes. Many denied claims are reversed with proper legal action. Our attorneys analyze the insurer’s reasoning, gather evidence, and build a case to show the policy should remain in force.
What if the insurer accuses fraud?
Fraud is a serious allegation, but insurers often use it loosely. We counter with evidence showing the insured’s intent, health history, and insurer’s underwriting practices.
Do all policies ask for financial information?
No. It’s more common in high-value policies. Still, misstatements about income or debt can become an issue if the insurer tries to argue the applicant wasn’t eligible for the coverage amount.
How long does it take to resolve a misrepresentation denial?
It varies. Some are resolved within weeks; others require litigation and can take several months. We act quickly and efficiently to secure results.
Do I need an attorney for a denied claim?
Absolutely. Insurers have teams of lawyers reviewing claims. You should have someone on your side with equal or greater expertise.
What does it cost to hire your firm?
Nothing upfront. We work on contingency, meaning you pay only if we recover money for you.