What to Do When Your Life Insurance Claim Has Been Denied

Posted August 16, 2017

It is hard enough to lose a loved one as it is, but when your life insurance company denies your claim for death benefits, it can feel as if they are adding insult to injury. You counted on the deceased’s benefits to help you through this tough time to pay for things such medical expenses, funeral costs, and burial fees. In addition to the astronomical costs of death, you need to figure out how you are going to support yourself and your family without a second income. Unlike auto claims or health insurance claims, life insurance claims are rarely denied, as it is difficult to fake an insured’s death. However, denials do happen, and when they do, families and heirs are rarely prepared to challenge a claim denial. If your life insurance claim was denied, and if you are ill-prepared to deal with such a decision, reach out to The Bennett Law Firm to discuss your legal options today.

Reasons Your Claim Was Denied

Before you contact a lawyer regarding the denial of your life insurance claim, consider these four reasons that your claim may have been denied:

1. The Insured Misrepresented Him or Herself on the Application: As people age, or if they are diagnosed with a certain health condition, it can be difficult to obtain a life insurance policy. For this reason, some individuals will “fudge the facts” a bit on their application, and say that they are five years younger than they actually are, or that they are in perfect health when in actuality, they’re not. If the insurance company finds out that the insured misrepresented themselves, they may not cancel the policy, but they may subtract the additional premium due from the total benefit amount.
2. The Insured Failed to Pay the Premiums On Time: If the insured missed one or more premium payments, their policy could have lapsed, which means that the coverage may not have been in force at the time of death or at the time the claim was filed.
3. The Circumstances of the Insured’s Death Fell Out of the Scope of Coverage: While many life insurance policies don’t carry very many exclusions anymore, many still exclude coverage for suicides that occur within two years of being covered, and certain accidental deaths. If the deceased’s policy was older, it may exclude deaths during military service, acts of war, aviation, dangerous hobbies, and certain health perils such as HIV.
4. You Failed to Provide the Necessary Documentation: There may have been nothing wrong with the policy, but simply with a way that you filed your claim. Unfortunately, a death certificate is not enough paperwork to get the process in motion. Talk to the insurance provider about what documentation is necessary to process your claim.

An Oklahoma City Attorney Can Help Fight the Denial

If your life insurance claim was denied or delayed, don’t count on the insurance company to help you figure out why. A knowledgeable Oklahoma City attorney can help resolve your case simply by putting together the right records, the right arguments, and the right case law. They can contact the insurance company on your behalf via a letter explaining your position, at which point the insurance company is likely to re-review your case and grant you a more favorable outcome.

If you did not receive the outcome you thought you would after filing your life insurance claim, reach out to the attorneys at The Bennett Law Firm today. According to 12 O.S. § 95, you have five years to appeal the insurer’s decision, but the best thing you can do for your case is to get the ball rolling now. Don’t delay, and reach out to our experienced insurance bad faith attorneys today.