$106,250 Woodmen Life Insurance Claim Successfully Resolved After Misrepresentation Dispute
Yes, a life insurance claim can be denied due to alleged misrepresentation on the application—but that doesn’t mean the insurer’s decision is final. In fact, many of these denials are legally challengeable, as demonstrated by our recent victory where we secured $106,250 for a client after Woodmen Life wrongfully denied their claim on the grounds of misrepresentation.
How We Recovered $106,250 from Woodmen Life After a Misrepresentation Denial
Our client, the named beneficiary of a life insurance policy issued by Woodmen Life, was shocked to receive a denial letter following the policyholder’s death. The insurance company alleged that the policyholder had provided inaccurate information during the application process. Specifically, they claimed omissions related to the policyholder’s health history invalidated the entire contract. We immediately launched a comprehensive review of the application, the medical records, and the insurer’s internal guidelines. After building a strong factual and legal case, we successfully demonstrated that the alleged misstatements were not material to the policy’s issuance and did not justify denial. The insurer ultimately reversed its position and paid the full $106,250 benefit. This case reinforces the fact that beneficiaries should never accept a misrepresentation-based denial without seeking legal counsel.
What Is Misrepresentation—and Why Do Insurers Rely on It to Deny Claims?
Misrepresentation in life insurance occurs when the applicant provides incorrect, incomplete, or misleading information during the application process. The insurer will often claim that if the truth had been known, they would have either denied coverage or offered a policy with different terms or higher premiums. It’s important to understand that misrepresentation does not require fraud. Even honest mistakes—like forgetting to disclose a past diagnosis, misunderstanding a question, or unintentionally omitting a minor health issue—can trigger a denial if the insurer decides the information was “material.” This standard is heavily biased in favor of insurers and frequently misused to void valid claims.
Why the Contestability Period Matters
The first two years after a policy is issued are known as the contestability period. During this time, the insurer has broad power to review the policyholder’s application in the event of death and look for any discrepancies that could void the contract. This often includes pulling full medical records, pharmacy reports, and even financial or lifestyle information. If a death occurs during this window, insurers routinely comb through the application to identify anything that could be used to justify denial. Unfortunately, many grieving families are unaware that even small, seemingly irrelevant inaccuracies can be twisted into grounds for denying a death benefit.
How Misrepresentation Affects Premiums and Risk Pools
Insurance underwriting depends on full disclosure. The insurer sets premiums based on the level of risk the applicant presents. If someone fails to report a chronic illness, for example, they might receive a lower premium than someone who discloses the condition. Insurers argue that misrepresentations harm the fairness of the insurance pool and justify denial to protect overall pricing integrity. However, this logic can be stretched too far when denials are based on immaterial or ambiguous details—especially when there’s no link between the information in question and the cause of death.
Insurers Use Misrepresentation as a Tool—Not Just a Protection
While misrepresentation rules are designed to prevent fraud, insurers frequently weaponize them against honest policyholders and their families. We've seen cases where the insured checked a box incorrectly, misunderstood a question about treatment timelines, or didn’t mention a resolved medical condition from years ago. Even when the insured believed they answered truthfully, the insurer may reinterpret the application retroactively and allege misrepresentation. In these scenarios, insurers often act in bad faith, exploiting technicalities to avoid payment.
How We Challenge Misrepresentation-Based Life Insurance Denials
Successfully reversing a denial based on misrepresentation requires a multi-layered legal strategy. Our team begins by analyzing the claim denial letter and the original application to determine whether the insurer's allegation holds legal weight. We then:
Compare the insurer’s underwriting guidelines to assess whether the application would have been approved regardless
Examine whether the insurer asked follow-up questions when application answers were vague or incomplete
Highlight the insurer’s duty to clarify ambiguous answers before issuing a policy
Demonstrate that the insured answered questions honestly based on their knowledge at the time
Argue that the insurer acted in bad faith by using non-material discrepancies as a pretext for denial
We also investigate whether the misrepresentation would have changed the insurer’s decision to issue the policy at all. In many cases, we’re able to show that the insurer would have still offered coverage—perhaps at a slightly higher rate—which undermines their basis for denying the claim entirely.
We Fight and Win Life Insurance Denials Based on Misrepresentation
Our firm has resolved life insurance disputes involving alleged misrepresentation, omissions, and contestability issues with numerous insurers, including Woodmen Life, Penn Mutual, Primerica, and Sammons. We have the tools, experience, and strategic approach to confront even the most complex denials. If your life insurance claim has been denied because the insurer claims the application was inaccurate or incomplete, don’t give up. Many of these denials can be overturned through legal advocacy.
Contact Us for Help with Your Denied Life Insurance Claim
Insurance companies are counting on you to accept their decision without a fight. But you have legal rights—and we’re here to help you enforce them. If your life insurance claim was denied due to alleged misrepresentation, reach out to our firm today. We’ll evaluate your case, explain your legal options, and work to recover the benefits your loved one intended for you to receive.
FAQ: Misrepresentation in Life Insurance Claims
What counts as misrepresentation in a life insurance application? Any inaccurate or omitted information that the insurer claims would have affected their decision to issue coverage. This includes undisclosed medical conditions, smoking history, or treatment records.
Is intent required for a misrepresentation to result in denial? No. Insurers can deny claims even if the error was unintentional—as long as they consider it material. However, this can often be challenged legally.
Can insurers deny a claim years after the policy was issued? Typically only during the first two years (contestability period). After that, most policies are incontestable except in cases of outright fraud.
How can an attorney help reverse a misrepresentation denial? Attorneys can analyze the application, review underwriting standards, and argue that the alleged misrepresentation was not material or was based on ambiguous questions.
What if the insured answered a question incorrectly but believed it was truthful? Courts often consider whether the insured answered in good faith. If there was no intent to deceive, the denial can often be reversed.