Understanding Life Insurance: Common Reasons for Non-Payment and How to Navigate Them

Welcome to the Trief & Olk blog, where we delve into important topics to help you navigate the complexities of life insurance. Life insurance serves as a vital safety net, ensuring financial security for your loved ones in the event of your untimely demise. However, the journey from purchasing a policy to successfully claiming benefits is fraught with potential obstacles. It’s not uncommon for life insurance claims to be denied, leaving beneficiaries without the expected support. In this post, we aim to illuminate the most common reasons life insurance claims are denied and provide guidance on how to avoid these pitfalls.

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

One of the primary reasons for the denial of life insurance claims is policy lapse due to non-payment of premiums. If premiums are not consistently paid, the insurance company may cancel the policy, leaving beneficiaries unprotected. To avoid this, we recommend setting up automatic payments to ensure that premiums are never missed. It is also crucial to stay informed about your payment schedule and policy status. Should you encounter financial difficulties, contact your insurer immediately; they may offer a grace period or payment plan to help you maintain your coverage.

Misrepresentation or non-disclosure on the application form is another common reason for claim denial. Honesty is paramount when applying for life insurance. Providing incomplete or inaccurate information about your health, occupation, or lifestyle can lead to claim denial. To mitigate this risk, it’s essential to provide complete and accurate information on your application, disclose any existing health conditions, smoking habits, or participation in risky activities, and thoroughly review your application before submission.

Most life insurance policies contain exclusions, which are specific circumstances under which the policy will not pay out. Common exclusions include suicide within the policy’s contestability period (usually the first two years), death resulting from dangerous activities like skydiving or car racing, and deaths occurring in certain high-risk geographic locations. Understanding these exclusions is crucial to avoid surprises during the claims process.

The contestability period, typically the first two years after the policy is issued, is a critical time during which the insurer can investigate and deny claims for any misrepresentation or fraud. To navigate this period successfully, ensure all information provided on your application is accurate and truthful. Be aware that even unintentional mistakes can lead to claim denial during this time.

Engaging in illegal activities or undisclosed drug use can also lead to claim denial. If the insured dies while participating in illegal activities or from drug use not disclosed at the time of application, the claim may be denied. To safeguard against this, live within the law and be transparent about any drug use when applying for insurance.

The absence of a named beneficiary can complicate and delay the payout process. To prevent this, name a primary and contingent beneficiary when purchasing the policy and regularly review and update your beneficiaries, especially after major life events like marriage, divorce, or the birth of a child.

Ted Treif (Partner)

Life insurance attorney since 1976

Barbara Olk (Retired)

Life insurance attorney since 1976

Eyal Dror (Associate)

Life Insurance Attorney since 2007

If a life insurance claim is denied, it’s not necessarily the end of the road. Beneficiaries can take steps to contest the decision. Review the denial letter carefully to understand the insurer’s reasoning, gather supporting documents that can challenge the insurer’s decision, and seek legal advice from experienced professionals like Trief & Olk. We are here to explore your options and potentially contest the denial. For more information and assistance, visit our website or contact our office directly. Your peace of mind is our priority, and we’re here to help you secure the financial future of your loved ones.

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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

At Trief & Olk, we understand that life insurance is much more than a mere policy—it’s a pivotal promise of protection for your loved ones. To ensure that this promise holds steadfast, proactive measures are crucial, both at the initial stage of application and throughout the policy’s tenure. Our firm advises on the importance of regular policy reviews, especially in light of life’s significant events such as marriage, divorce, the birth of a child, or acquiring a new mortgage. These changes necessitate a thorough reassessment of your life insurance coverage to ensure it aligns with your current needs and that all information is accurate and up-to-date.

Maintaining open communication with your insurer is also vital. Significant changes in health status, occupation, or lifestyle, such as quitting smoking or engaging in new, potentially risky hobbies, should be promptly reported to your insurance provider. This transparency is key to preventing disputes about the policy’s validity later on. Moreover, a deep understanding of your policy’s terms, including any exclusions, limitations, and the contestability period, is essential. It ensures that policyholders are fully aware of the coverage scope and the implications of any actions or circumstances that might influence the outcome of a claim.

The Role of Trief & Olk in Life Insurance Disputes

At Trief & Olk, our mission is anchored in the realm of life insurance disputes, where we champion the cause of ensuring our clients attain the benefits rightfully due to them. We recognize the profound emotional and financial strain that can besiege families when a claim is denied. This understanding shapes our methodical approach, starting with a comprehensive case evaluation. We delve into the specifics of your case, meticulously analyzing the policy details and the insurer’s rationale for denial, ensuring no stone is left unturned.

Our strategic legal planning is the cornerstone of our practice, where we craft bespoke strategies aimed at effectively challenging the denial of claims. We believe in the power of persistent advocacy; our team is steadfast in representing our clients’ interests, whether it be through negotiations, appeals, or taking the battle to court. The essence of our endeavor is to ensure that life insurance serves its fundamental purpose for you and your loved ones, providing a bulwark of financial security in times of loss.

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.

Engagement with Trief & Olk transcends mere legal representation; it is about forging a pathway to uphold the promises encapsulated in life insurance policies. Facing challenges with a life insurance claim or seeking guidance on policy nuances can be daunting, but we stand ready to guide our clients through every phase, ensuring the fulfillment of the contractual promises.