Denial Of Life Insurance Claim Due To Claimed Material Misrepresentation

How Massachusetts Attorneys Fight Life Insurance Denials for Misrepresentation

Posted on by Trief, Olk & Dror
When someone you love dies, the last thing you want is a letter from an insurance company telling you the life insurance claim has been denied. It feels cold. It feels unfair. And it often comes out of nowhere. If you live in Massachusetts and you’re facing this kind of denial, you’re not alone. Many families find themselves in this painful spot when the insurance company claims the policyholder gave wrong information—something called “misrepresentation.” What happens next can feel like a battle. But you don’t have to fight it by yourself. In fact, you shouldn’t.

Why Insurance Companies Deny Claims Over Misrepresentation

When a person applies for life insurance, they fill out a lot of forms. These forms ask questions about health, family history, habits, and travel. Insurance companies use this information to decide whether to approve the policy and how much to charge. If the person dies within two years of getting the policy, the insurance company often reviews those forms with a fine-tooth comb. This is called the “contestability period.” During this time, the insurer can deny a claim if they think the person gave wrong or incomplete answers. The problem is, not every mistake is a lie. Some mistakes are honest. Others happen because the person didn’t fully understand the question. But insurance companies often treat any wrong answer as a reason to deny the claim.

How Massachusetts Law Treats These Cases

Massachusetts law gives insurance companies the right to look at the answers given in a life insurance application. But the law also protects families. An insurer can’t just point to a mistake and walk away. They have to prove two things. First, that the person gave an answer that was false. And second, that the correct answer would have changed the insurer’s decision. If the person said they didn’t have a certain illness, but they did—and that illness would have made the company say no to the policy—that’s a problem. But if the illness would not have mattered, the denial won’t hold up. That’s where legal help makes a difference.

Ted Trief (Partner)

Life insurance attorney since 1976

Barbara Olk (Retired)

Life insurance attorney since 1976

Eyal Dror (Associate)

Life Insurance Attorney since 2007

What Attorneys in Massachusetts Do to Help

Attorneys who handle life insurance denials for misrepresentation know what to look for. They know the rules. They dig into the policy, the application, the medical records, and the letter of denial. They ask questions the insurance company hopes no one will ask. They look at how the questions were asked on the forms. Were they clear? Were they fair? Did the person answer in a way most people would understand? They check if the insurance company actually would have made a different decision with the right information. And they see if the insurer followed the law during the contestability review. Attorneys also handle communication with the insurance company. That matters more than people think. When a lawyer gets involved, insurers tend to take the claim more seriously. And if the insurance company won’t change its decision, the attorney can take the case to court.

The Kind of Cases That Often Win

Not every denial is overturned. But many are. Here are the kinds of cases that often lead to a win for the family:

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We contacted Trief, Olk & Dror 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

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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

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Trief, Olk & Dror 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

 The person misunderstood a question on the form. Maybe they didn’t list a visit to the doctor because they didn’t think it was important. But the visit was for something minor, and the insurance company tries to use it as a reason to deny the claim. The medical records are wrong. It happens more often than you think. A doctor may have written something down incorrectly, and the insurance company uses that note to say the person lied on their application. The person had no idea they were sick. They answered the health questions truthfully at the time, but later a diagnosis came up. The insurer tries to say the person should have known. The insurer approved the policy even with the information in hand. Sometimes, the insurer had access to the medical records or history before approving the policy. If they missed something, they can’t deny the claim later and act like it’s new.

Why Timing Is So Important

There are strict time limits on these cases. If you wait too long, you may lose the right to challenge the denial. Also, the sooner an attorney gets involved, the better the chances of keeping the claim on track or even turning it around before it ends up in court. Families often wait, hoping the insurance company will change its mind. But most companies don’t back down unless someone pushes back with facts, law, and legal pressure.

Life Insurance Denial Statistics

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.

What You Can Expect From the Process

Once a lawyer steps in, they’ll likely start by asking for the full claim file from the insurance company. This includes the application, any health records they used, the denial letter, and internal notes about why the decision was made. Reviewing these documents is the first step in building a strong case. The lawyer may also speak with your loved one’s doctors. They’ll look for proof that your loved one didn’t knowingly leave out key health information or that the health condition listed had no effect on the approval decision. In many cases, insurers claim something was hidden when in fact it was not—or it simply didn’t matter. Attorneys often bring in medical and insurance professionals to explain things in simple terms. They may write letters or give statements that show why the denial is unfair or unlawful. This step can shift the conversation. Sometimes, it’s enough to get the insurance company to pay the claim without going to court. If the insurer still won’t pay, the next step is to file a lawsuit. In Massachusetts, these cases are heard in civil court. Your lawyer will lay out all the facts, show how the law applies, and ask the judge to rule that the denial was wrong. This may sound intimidating, but your lawyer will walk you through each part. Most of the time, you won’t have to appear in court.

Settlements & Verdicts

$3 Million Policy

William Penn Life Insurance

$1.2 Million Policy

Primerica

$1.5 Million Policy

Metropolitan Life Insurance Company

$1 Million Policy

Protective Life Insurance

$675,000 Settlement

Confidential Settlement

$4.3 Million Policy

State Farm, Primerica, Farmers, BrightHouse

You Don’t Have to Accept the Denial

Getting that denial letter can feel like the end. But in many cases, it’s just the start. The insurance company might count on you giving up. Don’t. There’s a path forward. You just need someone who knows how to walk it with you. If you received a life insurance denial letter in Massachusetts that says the policy was void because of misrepresentation, now is the time to act. You don’t have to fight this alone. The attorneys at Trief, Olk & Dror have years of experience challenging wrongful denials and getting families the money they’re owed. Call today to talk with someone who will listen, take your case seriously, and help you move forward.