Losing a loved one is a painful experience, and while dealing with that loss, the last thing you want to face is a denial of a life insurance claim. Life insurance is meant to provide financial relief to beneficiaries during a difficult time. However, insurance companies sometimes deny these claims, leaving beneficiaries without the support they were promised. If you’re in New Jersey and find yourself in this situation, it’s important to understand your rights and know how to protect them. Here, we will guide you through the steps you can take after a life insurance denial and what options you have as a beneficiary. At, Trief & Olk, we are here to guide you through the legal process and help you navigate the complexities of your case.
Understand the Reasons for Denial
When a life insurance claim is denied, the insurance company usually provides a reason for the denial. Understanding why your claim was denied is the first step in protecting your rights as a beneficiary. Common reasons for denial include incomplete or inaccurate information in the application, policy lapses, misrepresentation, or exclusions that are outlined in the policy. For instance, if the policyholder provided incorrect health information when they applied for life insurance, the insurer may deny the claim based on misrepresentation. Additionally, if the policyholder missed premium payments, the policy might have lapsed, leading to a denial.
It’s important to carefully review the denial letter from the insurance company and go through the terms of the policy. Insurance companies are required to explain their reasons for denial, but these explanations can sometimes be confusing. This is where seeking help from someone with experience in handling insurance disputes can be useful. If the explanation doesn’t seem right or fair, you have the right to contest it.
Gather Important Documents and Evidence
Once you have understood the reason for the denial, the next step is to gather all the necessary documents and evidence to support your claim. This includes the insurance policy itself, the application for the policy, any communication between the policyholder and the insurance company, medical records, and proof of premium payments. If the denial was due to alleged misrepresentation, obtaining the relevant medical or financial records can help you show that the information provided by the policyholder was accurate or that any mistake was minor and should not lead to a denial.
Keeping a record of all communication with the insurance company after the denial is also important. This can include letters, emails, and even notes from phone calls. Being organized with your documents will help you build a strong case when you challenge the denial.
Communicate with the Insurance Company
After gathering all the necessary documents, it’s time to communicate with the insurance company. In some cases, denials can be overturned simply by providing additional information or correcting a misunderstanding. You can write a letter to the insurance company, explaining why you believe the denial was incorrect and providing any supporting documentation. Be sure to stay calm and professional in all your communication. Avoiding emotional language and sticking to the facts will help make your case stronger.
If you are not comfortable communicating with the insurance company on your own, you can have someone assist you with this process. It can be helpful to have someone review your correspondence to ensure it is clear and that it addresses all the issues raised in the denial letter.
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
File an Appeal
If the insurance company maintains its denial after your initial communication, you have the right to file a formal appeal. Insurance companies are required by law to have an appeal process in place, and as a beneficiary, you have the right to challenge their decision through this process. When you file an appeal, you will need to submit all the evidence and documentation you have gathered, along with a written explanation of why you believe the denial was incorrect.
The appeal process can vary depending on the insurance company and the specific policy, but it generally involves submitting a formal letter and supporting documents. It’s important to be aware of any deadlines for filing an appeal, as missing these deadlines can limit your options. Once the appeal is submitted, the insurance company will review it and either uphold the denial or reverse their decision.
Consider Legal Action
If the insurance company denies your appeal, you still have options. In New Jersey, beneficiaries have the right to take legal action if they believe their claim was wrongfully denied. This can involve filing a lawsuit against the insurance company to recover the benefits that are owed to you. Before taking this step, it’s important to make sure you have explored all other options, such as appeals and mediation. Legal action can be a lengthy and complex process, but it may be necessary to protect your rights as a beneficiary.
New Jersey has specific laws that govern life insurance claims, and these laws are designed to protect beneficiaries from unfair denials. For example, insurance companies are not allowed to deny claims based on minor misstatements in the application, unless the misstatement was intentional and material to the issuance of the policy. This means that if the policyholder made an innocent mistake on their application, the insurance company may not be able to use that mistake as a reason to deny the claim.
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
Additionally, insurance companies are required to act in good faith when handling claims. This means they must thoroughly investigate claims, respond to claims in a timely manner, and provide a valid reason for any denial. If an insurance company fails to meet these obligations, you may have grounds for a lawsuit.
Seek Assistance from Someone with Experience in Insurance Claims
Handling a life insurance denial on your own can be overwhelming, especially when you are already dealing with the emotional stress of losing a loved one. If you feel unsure about how to proceed, it may be time to seek help from someone familiar with insurance disputes. There are individuals who understand the legal and procedural aspects of insurance claims, and they can guide you through the process of challenging a denial. This can involve helping you gather the necessary documentation, communicating with the insurance company on your behalf, and representing you if you decide to file a lawsuit.
The earlier you seek help, the better your chances of successfully challenging the denial. Insurance companies have teams of professionals working to protect their interests, so having someone on your side who knows how to navigate the system can make a significant difference.
Know Your Rights as a Beneficiary
As a beneficiary in New Jersey, you have specific rights when it comes to life insurance claims. One important right is the right to receive clear and timely communication from the insurance company regarding your claim. Insurance companies are required to respond to claims within a reasonable time and must provide an explanation for any denial. If the insurance company is delaying the processing of your claim or is not providing you with clear information, this could be a violation of your rights.
Another right you have is the right to appeal a denial and, if necessary, take legal action to recover the benefits you are owed. Life insurance policies are legal contracts, and if the insurance company is not fulfilling its obligations under the contract, you have the right to hold them accountable.
Being aware of your rights as a beneficiary can help you protect yourself in the event of a denial. If you believe your rights are being violated, it’s important to take action to ensure you receive the benefits you are entitled to.
Settlements & Verdicts
Stay Calm and Take Action
Facing a life insurance denial can be frustrating, but it’s important to stay calm and take action to protect your rights. By understanding the reasons for the denial, gathering the necessary documentation, and following the proper procedures for appealing the decision, you can improve your chances of success. Remember, you have the right to challenge a denial, and there are steps you can take to protect your interests.
If the denial is not resolved through communication or appeals, it may be necessary to consider taking legal action. This can be a daunting prospect, but it’s important to remember that you have options and that you don’t have to face this process alone.
In conclusion, if you find yourself dealing with a life insurance denial in New Jersey, it’s important to understand your rights and take the appropriate steps to protect them. Whether you choose to communicate with the insurance company on your own, file an appeal, or seek assistance from someone who knows how to handle insurance disputes, the key is to take action and not give up on your claim. Life insurance is meant to provide financial protection during a difficult time, and as a beneficiary, you deserve to receive the benefits you were promised.
If you are in New Jersey and have experienced a life insurance denial, Trief & Olk can assist you in navigating the process and protecting your rights. Their team is ready to help you understand your options and fight for the benefits you are entitled to. Don’t hesitate to reach out for support during this challenging time.