Understanding Denied Life Insurance Claims: Common Reasons and How to Fight Back
Denied life insurance claims are more common than most people realize—and they often strike families at their most vulnerable moment. Life insurance is supposed to offer peace of mind, yet when a claim is denied, that promise is broken. Whether it’s due to technical policy language, oversight, or insurer tactics, claim denials can be financially and emotionally devastating. At LifeInsuranceAttorney.com, our top-rated life insurance lawyers fight and win these cases nationwide.
We’ve taken on major insurers like Assurity Life, Great-West Life, Gerber Life, Brighthouse Financial, AIG, Primerica, Penn Mutual, Sammons, Bestow, Ethos, Ladder Life, and more. We know how to challenge wrongful denials and recover benefits for our clients.
1. Material Misrepresentation and Non-Disclosure During Application
One of the leading causes of claim denials is material misrepresentation—when the policyholder provides false or incomplete information on their application. This can include:
Omitting a diagnosis of a serious condition like heart disease or diabetes
Failing to report risky hobbies such as scuba diving or skydiving
Misstating age, occupation, income, or medical treatment history
Even honest mistakes can lead to denials, especially during the contestability period, the first two years of the policy, when insurers are allowed to investigate claims more aggressively. If the insurer finds any discrepancy, they may void the policy and deny payment.
2. Pre-Existing Conditions and Policy Exclusions
Policies often include exclusions for deaths linked to pre-existing conditions that were not disclosed at the time of application. If the insurer discovers that the policyholder was aware of a medical condition and failed to report it, the claim may be denied on the basis of fraudulent non-disclosure. Additionally, policies may exclude coverage for deaths resulting from:
Suicide within the suicide clause period (typically two years)
Illegal activity at the time of death
Extreme sports or hazardous occupations unless specifically covered
Even a death caused by a known occupational risk—such as a firefighter succumbing to smoke inhalation—may be denied if the insurer argues that the risk wasn’t disclosed or the coverage excluded it.
3. Lapsed Policies Due to Missed Payments
A policy lapse is one of the most frustrating reasons for a denied life insurance claim. Life insurance requires ongoing premium payments. If a payment is missed—even due to confusion, bank issues, or temporary financial hardship—the policy may be canceled. Insurers are not obligated to honor a policy that was not in force at the time of death, even if the lapse was unintentional. Many of our clients had no idea their loved one’s policy had lapsed until after the claim was filed.
4. Incomplete or Inaccurate Claim Documentation
Filing a claim requires a series of specific documents, including the original policy, death certificate, medical records, proof of identity, and sometimes additional forms. If paperwork is missing, inconsistent, or submitted with errors, insurers may use this as grounds to delay or deny the claim. These technicalities can feel like a trap—especially when grieving families are under stress and unaware of the requirements.
5. Beneficiary Disputes and Interpleader Lawsuits
Disputes between potential beneficiaries are another common cause of claim delays or denials. These occur when:
Multiple people claim to be the rightful beneficiary
The policy conflicts with a will or trust
A new beneficiary is added shortly before death, raising concerns of undue influence
The named beneficiary is deceased, unavailable, or ineligible
In many cases, insurers respond by filing an interpleader lawsuit—depositing the benefit with the court and leaving it to a judge to determine who should receive the payout. Our attorneys represent clients in these high-stakes disputes and have successfully resolved numerous interpleader cases.
6. Foreign Deaths and International Claims
When a policyholder dies abroad, claims become significantly more complex. Insurers may demand official death certificates from foreign governments, autopsy reports, and confirmation from U.S. consulates. If the documentation is delayed, incomplete, or doesn't meet the insurer’s standards, the claim may be denied outright. We’ve handled many cases where the insurer used international red tape as a basis for delay or denial.
7. Deaths Involving Prescription Medications or Substance Use
If a policyholder had a history of substance use or addiction, and their death involved prescription medications, insurers will closely examine the circumstances. Even when prescriptions were taken properly, insurers may claim overdose, misuse, or concealment of addiction history as a reason for denial. These cases often hinge on toxicology reports, past medical records, and how the death is classified by authorities.
8. Fraud and Intentional Deception
Intentional fraud—such as falsifying documents, staging a death, or misreporting key facts—can result in both claim denial and potential legal consequences. But insurers sometimes stretch this concept too far, treating minor application errors as fraud to justify non-payment. Our attorneys push back on these overreaches and prove when insurers are misusing fraud accusations.
9. Misunderstanding of Policy Terms
Many policyholders and beneficiaries don’t fully understand the scope or limitations of the coverage. Misinterpretations about the contestability clause, suicide exclusion, coverage start date, or eligibility criteria can lead to denied claims. Our firm helps families sort through complex policy language to determine whether a denial was justified or challengeable.
We Fight and Win Denied Life Insurance Claims Nationwide
Life insurance is supposed to protect your loved ones. When insurers deny valid claims, they’re breaking that promise—and violating consumer trust. Our experienced life insurance lawyers have handled denied claims involving every major cause and countless insurers. We provide legal representation for denied and delayed claims, beneficiary disputes, interpleader actions, and more.
If your claim has been denied by Assurity Life, Gerber Life, Great-West, Brighthouse, Penn Mutual, AIG, Primerica, Ethos, or any other insurer, contact us today. We’ll investigate your claim, fight the denial, and pursue the full benefits your family deserves. If you have a Pennsylvania life insurance policy dispute call us.
FAQ About Denied Life Insurance Claims
Why was my life insurance claim denied?
Common reasons include misrepresentation on the application, undisclosed pre-existing conditions, missed premium payments, incomplete documentation, or policy exclusions related to the cause of death.
What is the contestability period?
It’s a 2-year window after a policy is issued during which the insurer can review the application for errors. If the insured dies during this period, any discrepancies may be used to deny the claim.
Can a claim be denied after the contestability period ends?
Yes, but only in cases of proven fraud. After the contestability period, the policy becomes "incontestable" for most reasons—except fraud.
What should I do if my claim was denied?
Contact a life insurance attorney immediately. Don’t rely on the insurer’s explanation alone. Legal professionals can evaluate your case and determine whether the denial was valid.
What if the policy lapsed without our knowledge?
Even in lapse cases, there may be grounds for reinstatement or contesting the lapse—especially if the insurer failed to send proper notices or the policyholder was incapacitated.
Can beneficiaries fight over the payout?
Yes. If there’s more than one potential beneficiary or a conflict between the policy and a will, the claim may go to court through an interpleader. We handle these disputes regularly.
How long does it take to resolve a denied claim?
Timelines vary. Some appeals are resolved in weeks, while litigation can take months. The sooner you involve an attorney, the faster we can begin to challenge the denial.
Does it matter which insurance company denied the claim?
We fight denials from all major insurers, including AIG, Brighthouse, Primerica, Penn Mutual, Gerber, Bestow, Ethos, Ladder, and many others.
Is it expensive to hire a life insurance lawyer?
We work on a contingency basis for most clients. That means you don’t pay unless we win your case.
Can a claim be denied due to a death that occurred overseas?
Yes, but we’ve helped many families overcome foreign death denials. Insurers often demand excessive documentation, and we know how to obtain and validate those records.