Life insurance is a critical financial tool for families. When someone takes out a life insurance policy through their employment, it is done to ensure that their loved ones are protected in the event of an unexpected death. However, there are times when life insurance claims are denied. These denials can leave families facing financial uncertainty during an already difficult time. In New Jersey, many families have faced this issue when dealing with employment-based life insurance claims that have been rejected. Understanding the legal strategies that can be employed to reverse these denials is essential for anyone facing this situation. Trief & Olk provides dedicated legal support to help you navigate the complexities of denied employment-based life insurance claims and fight for the benefits you deserve.
Understanding Employment-Based Life Insurance in New Jersey
Employment-based life insurance is a type of policy that is provided as a benefit by many employers. The employer typically pays a portion or the entirety of the premium, offering the employee peace of mind that their family will be cared for financially if they pass away. While these policies can be incredibly helpful, the process for making a claim and ensuring it is paid can sometimes become complicated.
In New Jersey, life insurance claims may be denied for various reasons. Some of the most common reasons include discrepancies in the application, a missed deadline for filing a claim, or alleged misrepresentations about the policyholder’s health when the policy was first issued. When a claim is denied, it can feel like a daunting process to figure out how to challenge that decision. However, it is important to know that there are legal avenues available to reverse a denial and get the claim approved.
Why Life Insurance Claims Are Denied
Understanding the reasons why employment-based life insurance claims are denied can be helpful for families seeking to appeal a decision. One of the most common reasons for denial is an alleged misrepresentation by the policyholder when they first applied for the insurance. This could be related to their health status, their occupation, or other factors that the insurance company deemed significant when determining their risk.
Another reason for denial could be a failure to pay the premiums. In some cases, an employee may not realize that their premium payments have lapsed due to changes in their employment status, such as switching from full-time to part-time. This can lead to an unintentional lapse in coverage, which the insurance company may use as a reason to deny the claim.
Additionally, claims can be denied if there is a dispute about the cause of death. For example, if the policy excludes coverage for deaths resulting from certain causes, such as suicide, the insurance company may deny the claim if they believe that the policyholder’s death falls under one of these exclusions.
Steps to Take After a Denied Life Insurance Claim
If an employment-based life insurance claim is denied in New Jersey, it is important to act quickly. The first step is to gather all the documentation related to the policy and the claim. This includes the original policy documents, any communication with the insurance company, and the denial letter explaining the reasons for the decision. Carefully reviewing this information can provide insight into the specific reasons for the denial and help determine the best course of action.
Once you have reviewed the documents, it is important to contact the insurance company to ask for further clarification if necessary. Sometimes, a denial is the result of a misunderstanding or missing information, and it may be possible to resolve the issue without needing to take further legal action. However, if the denial seems unjust or if the insurance company is not willing to work with you, it may be time to consider legal options.
We contacted Trief & Olk to help us with a life insurance issue and Shelly Friedland was the attorney assigned to our case. Before Shelly took our case she explained to us that the likelihood of our success without going to court was possible but not likely. Unfortunately we did not get the outcome we had hoped for but it was our decision to not move forward and have our case litigated. Shelly is very knowledgeable and was very straight-forward in her assessment of our case as we moved forward. She was very patient and thorough in answering our questions. She always responded in a timely manner and listened to our concerns. We would certainly recommend Shelly and would use her firm again in the future.” - John Ramig If there is any possibility of winning your life insurance case – this is the place to do it for you. They are efficient, honest and will achieve the best possible outcome. Shelly Friedland worked on my case where a life insurance policy had lapsed and was even a few days beyond the grace period. Farmers had rejected my claim twice and was unwilling to take a second look. Shelly was able to get them to pay the entire claim without going to court, and the full amount was deposited in my account within a couple months. Highest recommendation.” - Kathleen Brown Trief & Olk is a superior law firm. Their attorneys and other legal professionals have a brilliant understanding of the law and the litigation process. They diligently perform their work in an efficient, strategic and cost-effective manner to ensure the best possible outcomes for their clients. - Christopher Hughes
Challenging the Denial of an Employment-Based Life Insurance Claim
Challenging a denied life insurance claim requires a solid understanding of both the policy itself and the legal rights of beneficiaries in New Jersey. Beneficiaries may choose to file an appeal directly with the insurance company, but in many cases, hiring an attorney is necessary to ensure that the claim is handled properly. An experienced attorney can review the policy and the details of the denial to identify any potential legal issues or violations that the insurance company may have committed.
In some cases, an attorney may find that the denial was based on incorrect information or an unfair interpretation of the policy. For example, if the insurance company claims that the policyholder misrepresented their health when applying for the policy, the attorney may be able to present evidence showing that the misrepresentation was unintentional or that it did not impact the insurance company’s decision to issue the policy.
Additionally, an attorney can help ensure that the insurance company follows all state laws and regulations regarding life insurance claims. In New Jersey, insurance companies are required to act in good faith when handling claims, meaning that they must investigate and process claims fairly and without unnecessary delay. If an insurance company is found to have acted in bad faith, the beneficiary may be able to pursue additional legal remedies beyond just having the claim paid.
20% The annual average number of life insurance claims denied. $50 Million The yearly average dollar amount of claims denied by life insurance companies. .2% The number of claims appealed annually by consumers.Life Insurance Denial Statistics
Filing a Lawsuit Against the Insurance Company
In some cases, it may be necessary to file a lawsuit against the insurance company to reverse the denial of a life insurance claim. This can be a complicated and time-consuming process, but it is sometimes the only way to ensure that the insurance company is held accountable for their actions. When filing a lawsuit, the attorney will present evidence showing that the insurance company wrongfully denied the claim and that the beneficiary is entitled to receive the life insurance benefits.
During the lawsuit, the court will consider a variety of factors, including the wording of the policy, the circumstances surrounding the denial, and whether the insurance company acted in bad faith. If the court determines that the insurance company wrongfully denied the claim, they may order the insurance company to pay the full amount of the policy, as well as any additional damages that may be awarded for the insurance company’s misconduct.
It is important to note that lawsuits against insurance companies can take time to resolve, and the outcome is not always guaranteed. However, with the right legal representation, beneficiaries can significantly increase their chances of success in court.
The Importance of Legal Representation in Denied Life Insurance Claims
For anyone facing a denied employment-based life insurance claim in New Jersey, seeking legal representation can be one of the most important steps in reversing the denial. An attorney who is familiar with New Jersey insurance laws and the specific regulations surrounding life insurance claims can provide valuable guidance and support throughout the process.
One of the benefits of having an attorney is that they can handle all communication with the insurance company, ensuring that the claim is properly investigated and that the insurance company is held accountable for their actions. Additionally, an attorney can help gather evidence to support the claim, such as medical records, employment records, and other documentation that may be necessary to prove that the beneficiary is entitled to the life insurance benefits.
By having legal representation, beneficiaries can also avoid common pitfalls that can occur when dealing with insurance companies. Insurance companies often have teams of lawyers working to protect their interests, and without proper legal representation, beneficiaries may find themselves at a disadvantage when trying to appeal a denial. With an attorney by their side, beneficiaries can level the playing field and ensure that their rights are protected.
Facing the denial of an employment-based life insurance claim can be overwhelming, but it is important to know that there are legal strategies available to help reverse the decision. By understanding the reasons for the denial and taking the appropriate steps to challenge it, beneficiaries can significantly increase their chances of success. Whether through filing an appeal, negotiating with the insurance company, or taking legal action in court, there are options available for those who have been wrongfully denied life insurance benefits in New Jersey.
If you or someone you know has had an employment-based life insurance claim denied in New Jersey, the team at Trief & Olk can help. Our dedicated attorneys have the knowledge and experience to fight for your rights and ensure that you receive the benefits you are entitled to. Contact Trief & Olk today to schedule a consultation and learn more about how we can assist you in reversing a denied life insurance claim.