How Non-Disclosure of Pre-Existing Conditions Triggers Claim Denials
When applying for life insurance, applicants are required to provide detailed information about their health history. This includes diagnoses such as diabetes, hypertension, asthma, heart disease, mental illness, or any past medical treatments that may signal elevated risk. Insurers use this information to determine whether to issue a policy, and if so, at what rate. But if the insurer later learns that a medical condition was not disclosed—or was misrepresented—they may use that omission to rescind the policy or deny a claim outright.
The troubling part? This denial often comes after the policyholder has passed away. Beneficiaries—who likely had no role in the application process—are left blindsided, learning only during the claim process that the policy has been voided due to a supposed misstatement.
Intentional vs. Unintentional Omission: Why It Often Doesn’t Matter
Many people assume that only deliberate lies on a life insurance application can void a policy. But that’s not the case. Insurers can—and often do—deny claims based on unintentional omissions. A person may have genuinely forgotten a diagnosis from several years ago, failed to mention an anxiety prescription, or misunderstood the questions about treatment history. In some cases, applicants assume that the insurer will access their full medical records during underwriting, so they believe there's no need to list every detail. However, most life insurance contracts include language that shifts the burden of full and accurate disclosure onto the applicant.
Insurers are especially aggressive during the contestability period, which typically lasts two years from the policy’s start date. If the policyholder dies during this window, the insurer has the right to closely scrutinize the application and investigate for errors or omissions. Even if the undisclosed condition had nothing to do with the cause of death, insurers may argue that they would have never issued the policy—or would have issued it at a higher premium—if they had known the full truth.
Real-Life Impact on Grieving Families
For beneficiaries, these denials are heartbreaking. They come during a time of emotional turmoil and often result in serious financial strain. The sudden voiding of a policy can mean lost income, unpaid debts, and the inability to cover funeral expenses. Worse, these families often have no idea that a condition was left off the application or that the insurer would use it as an excuse to deny benefits. We've represented numerous families in situations where the insured failed to mention a minor, long-past condition—only to have the policy canceled and the claim denied.
When Legal Action Can Reverse the Denial
Our law firm fights back against these denials. Just because an insurer claims there was a misrepresentation does not mean they are legally justified in voiding the policy. In many states, the insurer must prove that the omission was material to the underwriting decision and that it was made with the intent to deceive. We examine whether the policyholder answered questions to the best of their knowledge, whether the omission truly impacted the risk, and whether the insurer followed the law when rescinding the policy. If the insurer relied on vague or confusing questions, failed to conduct a proper investigation during underwriting, or is using the omission as a post-claim excuse to avoid payment, we fight to enforce the policy.
We Win Life Insurance Claim Disputes Involving Alleged Non-Disclosure
Whether the claim was denied by Prudential, MetLife, Lincoln Financial, Transamerica, or any other major insurer, our legal team is ready to take action. We specialize in overturning claim denials related to pre-existing conditions, alleged fraud, and contestability issues. We've helped families recover full policy benefits—even after the insurer rescinded the contract. If you’ve received a denial letter citing non-disclosure, don’t accept it at face value. You may still have a strong case. If you need life insurance claim help in Wyoming we are here for you.
FAQ: Life Insurance Denials and Pre-Existing Conditions
Can a life insurance policy be voided for failing to disclose a medical condition? Yes, especially within the first two years of the policy. However, denials can often be challenged if the omission was not material or not intentional.
What if the undisclosed condition had nothing to do with the cause of death? Insurers may still deny the claim, but courts often consider whether the omission actually impacted the risk or was relevant to the death. This is where legal advocacy is critical.
Is it common for applicants to forget to disclose something? Absolutely. Many applicants unintentionally omit conditions they consider minor or resolved. These honest mistakes can unfortunately be used against them after death.
Can beneficiaries fight a denied claim even if there was an omission? Yes. Legal arguments can focus on intent, materiality, and whether the insurer followed proper procedures before denying or rescinding the policy.
What should I do if my life insurance claim was denied due to non-disclosure? Contact a life insurance attorney immediately. We can review the policy, the denial letter, and the application to determine if you have grounds to challenge the decision.