Understand Why Your Claim Was Denied
The first step in handling a denied employment-based life insurance claim is understanding why it was denied. Insurance companies are not always forthcoming about their reasons for denial, but it’s crucial to ask for a clear explanation. Common reasons for denial include errors in the application process, missed payments, issues with the policyholder’s health information, or failure to meet specific policy requirements. If you don’t receive a clear answer from the insurer, you have the right to request more detailed documentation. This information will give you a better idea of whether the denial is justified and whether you have a valid reason to appeal. It’s also important to review your policy closely, paying attention to the terms and conditions that might have led to the denial.
Review the Policy and Gather Documentation
Once you understand the reason behind the denial, the next step is to thoroughly review the details of your employment-based life insurance policy. Look for any exclusions, limitations, or conditions that could have influenced the insurance company’s decision. Pay close attention to terms such as “contestability period” and “pre-existing conditions”—these clauses can have a significant impact on whether or not your claim is valid. At the same time, gather all relevant documentation that can support your case. This might include medical records, proof of employment, payment history, and any communication you’ve had with the insurer. The more documentation you can provide, the stronger your case will be. This process can be time-consuming and sometimes overwhelming, but it’s an essential part of ensuring that all your bases are covered when you proceed with an appeal.File an Appeal
In Massachusetts, as in many states, most insurance companies allow you to appeal a denied life insurance claim. An appeal is a formal request for the insurer to reconsider their decision. However, the appeals process can be complicated, and many people mistakenly believe that their insurance company will automatically change their mind once they submit additional documentation. In reality, appeals can be complex and often require legal knowledge to navigate effectively. During the appeals process, it is important to be patient, organized, and persistent. You will likely need to submit a written appeal, explaining why you believe the denial was unjustified. In your appeal, include all relevant documentation and supporting evidence, such as medical records or witness statements.
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