Massachusetts Beneficiaries: A Step-by-Step Guide to Handling Denied Life Insurance Claims

If you’re reading this, it’s likely because you’ve recently encountered a situation where a life insurance claim has been denied, and you’re feeling a mix of confusion, frustration, and perhaps even anger. It’s a stressful experience, especially when you’re grieving the loss of a loved one and dealing with the financial implications. Understandably, the last thing you want to think about is dealing with insurance companies and the complex processes that come with a denied claim. But we want you to know that you are not alone, and there is help available. We understand the emotional toll this situation can have, and our goal is to guide you through the next steps.

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.

Ted Treif (Partner)

Life insurance attorney since 1976

Barbara Olk (Retired)

Life insurance attorney since 1976

Eyal Dror (Associate)

Life Insurance Attorney since 2007

In some cases, the insurance company may simply need clarification or more information. However, in other situations, a more aggressive approach may be necessary. This is where having a lawyer who understands the legal nuances of life insurance claims becomes incredibly valuable. An attorney can review the denial letter, gather all the relevant evidence, and work to demonstrate that the claim should not have been denied.

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.

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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

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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 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.

Why You Need a Lawyer for Denied Life Insurance Claims

Handling a denied life insurance claim on your own can be overwhelming. Life insurance companies have teams of lawyers who are dedicated to finding reasons to deny claims, and they may even use aggressive tactics to minimize the amount of money they payout. Without legal representation, you might find yourself up against a tough opponent who is more concerned with protecting their profits than ensuring that you receive the coverage your loved one paid for.

A skilled attorney who understands the law surrounding life insurance claims can help level the playing field. They will fight to ensure that your rights are protected and that you receive the benefits you’re entitled to. Whether it’s negotiating with the insurance company, submitting an appeal, or taking the case to court, an attorney can help guide you through every step of the process.

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

At the end of the day, we understand that you’re going through an emotionally difficult time. The last thing you need is to feel further stress from a denied life insurance claim. With the right legal support, however, you can ensure that your case is handled properly and that you get the best possible outcome.

If you are facing a denied life insurance claim, don’t hesitate to reach out for help. At Trief & Olk, we are here to support you during this challenging time. Our team is committed to helping Massachusetts beneficiaries who have had their life insurance claims denied. We will work tirelessly to ensure that you receive the benefits you deserve. Contact us today to discuss your case and begin the process of challenging your claim denial. You don’t have to face this battle alone.

To learn more about this subject click here: Legal Guidance for Denied Massachusetts FEGLI Claims Beneficiaries