Employment-based life insurance can provide financial security for families after the death of a loved one. When someone passes away, beneficiaries often rely on life insurance policies to cover expenses and maintain their quality of life. However, there are times when life insurance claims are denied. This can leave beneficiaries in a difficult position, unsure of what to do next. If you are a beneficiary of a denied employment-based life insurance policy in Massachusetts, understanding your legal options is crucial. Knowing how to proceed can help you seek the benefits that were promised to you. At, Trief & Olk, we are here to guide you through the legal process and help you navigate the complexities of your case.
Understanding Employment-Based Life Insurance
Employment-based life insurance is a benefit provided by employers to their employees. This type of insurance is meant to protect the employee’s family or other designated beneficiaries in case of the employee’s death. Typically, the employee pays for a portion of the premium, while the employer covers the rest. Upon the employee’s death, the policy is meant to pay out a lump sum to the beneficiaries listed in the policy. The payout is intended to help with funeral costs, outstanding debts, and other financial needs. When a claim is denied, it can create additional stress for the beneficiaries at an already challenging time.
Common Reasons for Life Insurance Claim Denials
Life insurance companies may deny a claim for several reasons. One common reason is that the policy may have lapsed. If the premiums were not paid, even for a short time, the insurance company might refuse to pay out the benefits. Another reason may be related to inaccuracies or omissions in the policy application. If the employee did not disclose a medical condition or provided incorrect information, the insurance company could use this as a reason to deny the claim. Additionally, if the cause of death is excluded from the policy, such as death from a pre-existing condition or suicide within a certain time frame, the company may refuse to provide the payout. These reasons are often stated in the fine print of the policy, and understanding them can be difficult without legal help.
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
Legal Rights of Beneficiaries in Massachusetts
As a beneficiary, you have certain legal rights when a life insurance claim is denied in Massachusetts. Life insurance policies are contracts, and if the insurance company fails to honor the contract, you may have grounds to challenge their decision. Massachusetts law requires insurance companies to act in good faith when handling claims. This means they must thoroughly investigate the claim and not unfairly deny it. If you believe the denial was unjust, you may be able to take legal action to seek the benefits you are owed.
Massachusetts courts recognize that beneficiaries depend on life insurance payouts to cope with financial burdens after the death of a loved one. The courts may review whether the insurance company followed proper procedures when denying the claim. In some cases, you may be able to file a lawsuit against the insurance company for breach of contract or bad faith practices. A legal professional familiar with life insurance laws in Massachusetts can guide you through this process.
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
Steps to Take After a Claim Denial
If your claim has been denied, there are several steps you can take to protect your rights. The first thing you should do is carefully review the denial letter. Insurance companies are required to provide a reason for the denial, and understanding this reason is critical to figuring out your next steps. The denial letter should explain whether the issue is related to the policy itself, such as a lapse in coverage, or if the denial is based on a specific clause in the contract.
Once you have reviewed the denial, you may want to gather any relevant documents that could help support your case. These documents may include the life insurance policy, proof of premium payments, the death certificate, and any correspondence with the insurance company. Having this information can be helpful if you decide to appeal the denial or seek legal assistance.
Appealing the denial directly with the insurance company is often the next step. Many insurance companies have an internal appeals process, where you can submit additional documentation or clarify any misunderstandings related to the claim. However, this process can be complex, and it may not always result in the reversal of the denial. If your appeal is unsuccessful or if you feel overwhelmed by the process, seeking legal assistance can provide you with the support you need.
Filing a Lawsuit Against the Insurance Company
In some cases, filing a lawsuit may be the best way to challenge a denied claim. A lawsuit can be filed if the insurance company has not acted in good faith or if there has been a breach of contract. When pursuing legal action, you will need to prove that the insurance company wrongfully denied the claim. This may involve gathering evidence to show that the policy was valid, the premiums were paid, and the cause of death was covered by the policy.
Massachusetts law protects beneficiaries by ensuring that insurance companies cannot simply deny claims without proper justification. Courts in Massachusetts take these cases seriously, as life insurance is meant to provide for families during times of loss. A legal representative can present your case to the court and work to secure the payout that you are owed. It is important to act quickly if you are considering this option, as there are time limits on when you can file a lawsuit.
Settlements & Verdicts
How Legal Assistance Can Help You
Facing a denied life insurance claim can be overwhelming, especially when you are dealing with the emotional and financial impact of losing a loved one. Legal assistance can make a significant difference in the outcome of your case. A legal professional who understands the complexities of life insurance laws in Massachusetts can review your case, explain your options, and guide you through the appeals process or litigation.
Massachusetts law provides avenues for beneficiaries to challenge denied claims, but navigating this process on your own can be difficult. Insurance companies often have teams of lawyers and resources to defend their decisions, so having someone on your side can level the playing field. Whether you need help filing an appeal, gathering evidence, or representing you in court, a legal representative can provide valuable support at every stage.
If you are the beneficiary of a denied employment-based life insurance policy in Massachusetts, you have legal options to pursue the benefits that were promised. Understanding why the claim was denied, gathering supporting documentation, and appealing the decision are essential steps. If the insurance company still refuses to pay, filing a lawsuit may be necessary to seek justice. Although this process can be challenging, it is important to remember that you have rights as a beneficiary, and the law is on your side.
Trief & Olk is here to help you navigate these difficult situations. Our team has experience in handling denied life insurance claims, and we are committed to helping beneficiaries fight for the compensation they deserve. If your claim has been denied, we can review your case, explore your legal options, and take action on your behalf. Contact Trief & Olk today to schedule a consultation and get the support you need during this challenging time.