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Attorneys Raquel Busani + Robert Rosati

Life insurance denied? Challenging a claim rejection

On Behalf of | Oct 21, 2024 | Life Insurance Denial

Life insurance is designed to provide financial security for your loved ones after you’re gone. It’s a promise of support during a difficult time. But what happens when your provider breaks their promise and denies your claim? This can be a devastating experience, leaving families in financial distress while grieving a loss.

If you’re facing a denied life insurance claim, it’s essential to understand that you have rights. Insurance companies may deny claims for various reasons, some legitimate and some not. Knowing the common grounds for denial and the steps you can take to fight back can make a significant difference in securing the benefits your loved ones deserve.

Common reasons for life insurance claim denials

Insurance companies may deny claims for a variety of reasons, including:

  • Material misrepresentation: This occurs when the policyholder provides false information on their application, such as their health history or lifestyle habits. If the insurer can prove that the misrepresentation was intentional and impacted their decision to issue the policy, they may deny the claim.
  • Policy lapse: If the policyholder failed to pay their premiums, the policy may have lapsed, resulting in a denial of the claim.
  • Exclusions: Life insurance policies often contain exclusions for specific causes of death, such as suicide within a particular timeframe or death resulting from dangerous activities like skydiving or car racing.

It’s important to review the policy documents carefully and understand the terms and conditions, including any exclusions or limitations.

Taking action after a life insurance denial

If your life insurance claim has been denied, you don’t have to accept the decision. Here are some steps you can take to challenge the denial:

  • Review the denial letter: The insurance company must provide a written explanation for the denial. Carefully review this letter to understand their reasoning and identify any potential errors or inconsistencies.
  • Gather evidence: Collect all relevant documents, including the policy documents, medical records and any communication with the insurance company. This evidence will be crucial in supporting your appeal.
  • File an appeal: Most insurance companies have an internal appeals process. You can submit a written appeal, providing additional evidence and arguments to challenge the denial.
  • Consider legal action: If the appeal is unsuccessful, you may need to consider legal action. An attorney experienced in insurance law can help you understand your options and fight for the benefits you are entitled to.

Denial of a life insurance claim can be challenging, but it’s not always the end of the road. Understanding your rights and taking the necessary steps can increase the chances of overturning the denial and securing the financial protection your loved ones deserve.

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