Understanding Why Life Insurance Claims Are Denied
Life insurance claims can be denied for many different reasons. Some of these reasons may seem valid, while others can be contested. The insurance company might deny a claim because of technicalities in the policy or because they claim that the deceased person did not meet certain requirements outlined in the policy. One common reason for a denial is if the person who passed away didn’t disclose important health information when they originally applied for the policy. In some cases, the insurer may argue that the cause of death is not covered by the policy, or they may claim that the claim was submitted too late. While some of these reasons may be legitimate, it’s essential to remember that life insurance policies are full of legal language, and sometimes companies deny claims without sufficient reason. This is where the help of a skilled attorney can make a significant difference. If you’ve received a denial letter, it’s important to understand the specifics of the denial, so you can start building your case for a potential appeal.Steps to Take After a Denial of Life Insurance
When you receive a denial letter from the insurance company, it may feel like the end of the road, but it’s not. The first step is to read the denial letter carefully. This letter should explain the specific reason for the denial. It will often reference the terms of the policy that the insurer believes were violated or that led to the denial. Once you have that information, you can start to gather the necessary documentation to support your case. This might include medical records, the life insurance policy, proof of the beneficiary’s relationship to the deceased, or other related documents.
Reviewing the Life Insurance Policy
One of the first things your attorney will do is carefully review the terms of the life insurance policy. Insurance policies can be complicated and full of legal jargon. A lawyer can help break down the policy and explain the terms in a way that is easy to understand. They will also compare the terms of the policy with the reasons provided by the insurer for the denial. If the insurance company failed to adhere to the policy’s guidelines or misinterpreted the terms, this could form the basis of a legal challenge.
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
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 & 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
Appealing the Denial of Life Insurance
If your claim has been denied, you typically have the right to appeal. The insurance company will often outline the process for appealing in the denial letter. However, many insurance companies make the appeals process difficult and time-consuming, hoping that the beneficiary will give up or drop the case. This is when an attorney can be invaluable in ensuring that your appeal is handled properly. An experienced lawyer will know how to properly submit an appeal and what steps to take to ensure that all the right evidence is presented. Your attorney may also negotiate directly with the insurance company to resolve the issue without needing to go to court. The key is to ensure that you have a strong case and to be persistent in pursuing a fair resolution.When to Take Legal Action
While many life insurance claims can be successfully appealed, there are instances where legal action may be necessary. If your claim is denied and the appeal process is unsuccessful, filing a lawsuit against the insurance company could be the next step. Suing an insurance company is not a decision to be taken lightly, but it may be the only way to receive the benefits you’re entitled to. If you’re forced to take legal action, your attorney will guide you through the process, helping you understand your options and what to expect. A lawsuit may involve proving that the insurance company acted in bad faith by denying your claim without just cause or failed to follow the terms of the policy. A judge may rule in your favor if they find that the insurance company was acting unfairly or unlawfully. It’s crucial to have a lawyer who understands the legal intricacies of these cases and can build a compelling argument on your behalf.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.