$104,250 AuguStar Life Insurance Claim Reversal Successfully Achieved
We are proud to announce the successful recovery of a $104,250 life insurance benefit wrongfully denied by AuguStar Life. The insurer originally refused to pay, citing a policy exclusion. After a thorough review and legal challenge by our experienced attorneys, the denial was overturned, and the beneficiary received the full amount. If you’ve had a life insurance claim denied due to an obscure policy clause or misunderstood exclusion, you're not alone—and help is available.
Lesser-Known Life Insurance Exclusions That Lead to Claim Denials
Most people believe that once a life insurance policy is in force and premiums are paid, the death benefit will be paid out without issue. Unfortunately, that's not always the case. Life insurance policies often contain exclusions—some obvious, others buried in fine print—that insurers may use to deny a claim. Understanding these lesser-known exclusions is essential to protecting your loved ones and knowing when to fight back.
1. Undisclosed High-Risk Activities or Hobbies
Many people enjoy hobbies that carry higher risks—skydiving, rock climbing, motorcycle racing, or deep-sea diving, to name a few. These pursuits can significantly impact an insurance company's underwriting decision. If a policyholder fails to disclose participation in such activities when applying for coverage, the insurer may later argue that this omission was material and deny a claim. What’s more, even if the death was unrelated to the risky activity, the failure to disclose it can still serve as the basis for a denial.
We have resolved numerous claims where insurers attempted to deny benefits based on general lifestyle questions that were either misunderstood by the applicant or were too vague to support a solid denial.
2. Suicide During the Policy's Exclusion Period
Most life insurance policies include a suicide clause, which excludes coverage for death by suicide during the first one to two years after the policy takes effect. This clause is intended to prevent policy abuse and fraud. However, its enforcement can sometimes be overly aggressive or applied when the facts surrounding the death are unclear.
Insurers may investigate any questionable death within the exclusion period for signs of suicide, even when the official cause is listed as accidental or undetermined. If your loved one died during this time and the insurer cited suicide as the reason for denial, you may have grounds to dispute their findings—especially if there is conflicting medical, psychological, or forensic evidence.
3. Misrepresentation or Omissions on the Application
Life insurance contracts are built on full disclosure. If a policyholder omits details about their health history, smoking status, or prescription medications, even inadvertently, the insurer may deny a claim after death. This typically arises during the contestability period, the first two years of the policy, when insurers have the right to scrutinize the application and medical records.
What many beneficiaries don’t know is that not all misstatements justify a denial. For a claim to be denied, the misrepresented information must be material—meaning the insurer would have altered the policy terms or denied coverage entirely had the truth been known. Proving materiality is a high legal standard, and denials based on minor or unrelated medical details can often be successfully challenged with the help of a life insurance attorney.
4. Death Involving Criminal Acts or Illegal Behavior
Another lesser-known exclusion applies when the insured dies while committing or participating in a criminal act. If the policyholder was engaged in illegal activity—such as drug trafficking, burglary, or armed robbery—at the time of death, the insurer may deny the claim. However, this exclusion is sometimes broadly interpreted, leading to unjustified denials.
In some cases, insurers have denied claims based on events that were only allegedly criminal or where the insured was present during an unlawful act but not directly involved. Beneficiaries should not accept such denials without first having the claim and circumstances reviewed by legal counsel. Courts often require a direct causal link between the illegal act and the death—not just proximity to criminal behavior.
What to Do If Your Life Insurance Claim Was Denied
If your claim was denied for one of these lesser-known reasons, it’s essential to take the following steps:
Request a written explanation from the insurer detailing the exact basis for the denial.
Review the policy language, including any exclusions and definitions, to understand whether the denial is justified.
Consult a life insurance attorney to evaluate whether the denial can be challenged, either through appeal or litigation.
Act promptly, especially if the denial occurs within the contestability or suicide exclusion period, as evidence and deadlines can affect your ability to recover benefits.
We Handle All Types of Life Insurance Claim Disputes
Our law firm is nationally recognized for overturning denied life insurance claims—including those involving obscure policy exclusions, beneficiary disputes, and interpleader lawsuits. We've successfully resolved claims against Confederation Life, Bankers Life, Erie Life, AAA Life, and many more.
Whether your issue involves undisclosed medical conditions, high-risk hobbies, suicide allegations, or alleged criminal acts, we have the experience and legal strategy to challenge the insurer’s decision and recover the benefits you’re owed.
Get Help From a Top Life Insurance Lawyer Today
If you’re dealing with a denied life insurance claim, don’t let the insurance company dictate the outcome. Contact us today to schedule a free consultation. Our legal team will evaluate your situation, explain your options, and fight for the full death benefit your loved one intended for you to receive.