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Life Insurance Claim Denials

Life Insurance Claim Denials

The benefits from a life insurance policy are often the only thing that keeps a family financially afloat after the death of a loved one. Unfortunately, insurance companies sometimes wrongly deny life insurance claims. Call today to see if we can help: 401-331-6300. The attorneys at Chisholm Chisholm & Kilpatrick LTD have years of experience helping people just like you appeal life insurance claim denials. We often handle cases for clients with no upfront or out-of-pocket cost to them, on a contingency basis. That means that clients pay us only if we recover money for them, and only out of the recovery. Call us now, there is no charge for our consultation to determine if we can assist you.

Why would an insurer deny my life insurance claim?

Here are some common reasons why insurers deny life insurance claims.

Inaccurate information in the policy application.

Under many policies, the insurer has the right to contest coverage if the insured dies within two years of the policy date. The insurer can investigate whether the insured provided inaccurate information in the policy application. If there is a material inaccuracy (generally one that would have impacted the insurer’s risk or the underwriting process) the insurer might deny the claim. Some common issues used to deny benefits include:

  • Pre-existing health conditions
  • Risky hobbies or activities
  • Unhealthy lifestyles or habits
  • Smoking
  • Illegal drug use
  • Hazardous occupation
  • Income
  • Age

The cause of death is covered by a “policy exclusion.”

Sometimes, an insurer will deny your claim based on certain exclusions listed in the policy. A very common policy exclusion is suicide of the insured. Often, no benefits will be paid if the insured dies by suicide.

Other policy exclusions may bar claims when the insured died after consuming drugs or alcohol.  Even death resulting from a car crash could be excluded if the insurance company takes the position that the insured was driving recklessly.

Determining whether a cause of death is a policy exclusion requires careful analysis of the insurance policy and the applicable law.

Your policy lapsed.

If your loved one’s employer allowed the policy to lapse (i.e., stopped paying the monthly premiums), this can complicate matters. We can discuss your case with you and determine whether you might be eligible to file a claim against the employer.

Sometimes benefits should have continued even though premiums were not paid. Many policies contain life insurance waiver of premium benefits that provide continued life insurance, to the maximum coverage period, at no charge so long as the insured meets the policy definition of disability.

You did not follow the correct procedures.

Many life insurance policies have specific claim procedures that you must follow. If you neglected a step, the insurer might deny your claim. However, there may be arguments that errors, which did not prejudice the insurer, should not result in the denial of benefits. Our experienced insurance attorneys can determine whether your claim should be paid.

What can our attorneys do to help?

At Chisholm Chisholm & Kilpatrick LTD, we have years of experience representing grieving families who are being deprived the life insurance benefits owed to them. We understand that dealing with unhelpful insurers is the last thing you need during this difficult time.

We would like to speak with you and review your documents to determine if we can help you. We may ask you for the following:

  • The life insurance policy: We will review the specific terms of the policy to determine the level of coverage available and applicable exclusions.
  • Denial letters and other correspondence from the insurer: When it denies your claim, your insurer should provide you with a letter explaining the denial. This letter may contain important information that helps us determine how to best serve you. We will also look for written evidence that shows the insurer acted in bad faith by unnecessarily delaying or denying your benefits.
  • Don’t delay contacting us because you don’t have your documents. Sometimes we can help you by collecting the documents from the insurance company for you.  Call us now; there is no charge for our consultation to determine if we can assist you.

We take the burden of dealing with the insurance company away from our clients. We perform the investigation and legal research. We use our years of experience to put a plan together for our clients’ cases. We write and file their appeals and, in appropriate cases, are ready to file a lawsuit to fight the insurance company in state or federal court. We often handle cases for clients with no upfront or out-of-pocket cost to them, on a contingency basis. That means that clients pay us only if we recovery money for them, and only out of the recovery.

Schedule your free consultation with Chisholm Chisholm & Kilpatrick LTD.

If you are a beneficiary of a life insurance policy and you have not received the benefits you are owed, contact our attorneys today at 401-331-6300.