When someone takes out a life insurance policy, they do so with the hope that their loved ones will be financially protected after they pass away. Life insurance is meant to provide comfort and security during a difficult time. Unfortunately, life insurance claims are sometimes denied, leaving beneficiaries feeling confused, frustrated, and unsure of what to do next. If you’re a beneficiary in New Jersey and your claim has been denied, you may be able to appeal the decision. Understanding the process of appealing a life insurance claim denial is important so you can protect your rights and receive the benefits you deserve. Trief & Olk provides dedicated support in navigating the complexities of life insurance claim denials, helping clients secure the benefits they deserve.
Reasons Life Insurance Claims Get Denied
Life insurance claim denials happen for various reasons, and it is important to understand why your claim was rejected. In some cases, the denial could be due to a misunderstanding or a mistake, and in others, it may be based on a legal issue. Some common reasons life insurance claims are denied include:
Missing payments on the policy. If the policyholder missed payments on their life insurance, the policy could lapse. This means the insurance company may no longer be responsible for paying out benefits. However, there are sometimes grace periods and other rules that may apply to missed payments, so it’s important to review the terms of the policy.
Misrepresentation on the insurance application. Insurance companies rely on the information provided by the policyholder when they apply for life insurance. If the policyholder gave inaccurate or incomplete information, the insurer may deny the claim. For example, if someone fails to disclose a medical condition, the insurance company may argue that the policy was based on false information and deny the claim.
Contestability period. Most life insurance policies have a contestability period, which is usually the first two years after the policy is purchased. During this time, the insurance company has the right to review the information provided on the application and can deny a claim if they find something wrong. If the policyholder dies within the contestability period, the insurer may investigate the claim closely to see if there was any misrepresentation.
Failure to provide required documentation. Sometimes, claims are denied because the beneficiary did not provide all the necessary paperwork or documentation. This could include proof of the policyholder’s death, medical records, or other important documents. It’s important to submit all the required information when making a claim.
The policy does not cover the cause of death. Some life insurance policies have exclusions that prevent the insurer from paying benefits in certain situations. For example, policies may not cover deaths caused by suicide, criminal activity, or other specific circumstances.
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
Steps to Appeal a Life Insurance Claim Denial in New Jersey
If your life insurance claim has been denied, you have the right to appeal the decision. While it may seem overwhelming, the process can be broken down into a few key steps. Taking the time to understand these steps and working carefully through each one can increase your chances of success.
First, review the denial letter. The insurance company is required to send a letter explaining why your claim was denied. This letter is an important document because it outlines the reason for the denial and may provide you with important details about the appeal process. Read the denial letter carefully and make sure you understand the reasons for the denial. If anything is unclear, you can contact the insurance company for more information.
Next, gather all relevant documents. To appeal a life insurance claim denial, you will need to collect all the paperwork related to the claim. This includes the original life insurance policy, the denial letter, any medical records, and any other communication you have had with the insurance company. Having a complete set of documents will help you build a strong case when filing your appeal.
After gathering the documents, you will want to write an appeal letter. This letter is your opportunity to explain why you believe the denial was incorrect. In your letter, you should address the reasons for the denial and provide any additional information that supports your claim. For example, if the denial was based on a misunderstanding, you can clarify the situation and offer evidence to back up your explanation. Be sure to include copies of any important documents that support your appeal.
Submitting your appeal is the next step. Most insurance companies have a formal process for appealing denied claims, and it’s important to follow their procedures carefully. Be sure to submit your appeal within any deadlines provided by the insurer. You may need to mail your appeal letter and documents or submit them online, depending on the insurance company’s policies. It’s a good idea to keep copies of everything you send and to get confirmation that your appeal has been received.
While waiting for the insurance company to review your appeal, it may be helpful to stay in touch with them and follow up if necessary. Insurance companies are required to respond to appeals, but the process can sometimes take time. Staying in communication can help ensure that your appeal is moving forward.
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
Legal Help for Appealing a Denial
Appealing a life insurance claim denial can be a complex and frustrating process, especially if you’re dealing with a lot of emotional stress following the death of a loved one. In many cases, it may be helpful to get legal advice from a professional who is experienced in handling life insurance disputes in New Jersey. While it is possible to appeal a denial on your own, working with someone who understands the laws and insurance industry may increase your chances of success.
A legal guide can help you understand your rights as a beneficiary and can help you build a strong case for your appeal. They can also handle communication with the insurance company on your behalf, which may make the process easier for you. In some cases, the denial may be based on a legal issue that requires more in-depth knowledge to resolve. Having a knowledgeable professional on your side can give you peace of mind and help you navigate the appeal process.
If your appeal is denied, you may still have options. For example, you could file a complaint with the New Jersey Department of Banking and Insurance, which oversees insurance companies in the state. In some cases, it may be necessary to take legal action against the insurance company to recover the benefits owed to you. Having legal representation during this time can be crucial to ensure that your rights are protected and that you are taking the appropriate steps to resolve the dispute.
Settlements & Verdicts
When to Seek Help from a Legal Guide
If you are unsure about the appeal process or if you are facing a particularly complicated denial, it is a good idea to seek help sooner rather than later. A legal guide can provide advice and support at any stage of the process, whether you are just beginning to appeal or if you have already received a denial of your appeal.
If your life insurance claim has been denied because of a policy lapse, misrepresentation, or a contestability issue, you may need help understanding the legal grounds for your appeal. Similarly, if the denial involves complicated medical records or exclusions in the policy, a legal guide can help clarify these issues and provide the right strategy for your appeal.
It’s important to remember that the insurance company may have their own legal team working on your case, so having professional guidance can help balance the playing field. If you have been denied life insurance benefits in New Jersey and are considering an appeal, don’t hesitate to reach out for legal advice.
Dealing with a life insurance claim denial can be stressful and overwhelming, especially during a difficult time. At Trief & Olk, we understand how important life insurance benefits are to the financial security of your family. If your claim has been denied, our team is here to help. We have experience handling life insurance claim denials in New Jersey, and we are committed to helping beneficiaries receive the benefits they deserve. Whether you’re filing an appeal or considering legal action, we can guide you through the process and provide the support you need. Contact us today at Trief & Olk to learn how we can help you fight your life insurance claim denial and protect your rights.