Life insurance policy claim denied? Here’s what you can do.

When a loved one dies, their family members are met with the emotional burden and pain of the loss. In addition to the energy that is spent coping with the death, loved ones may also be responsible for covering funeral expenses and other financial hardships that can be overwhelming to manage. To help ease the financial strain that a death can cause, people will buy life insurance policies which can provide beneficiaries with the financial support that they need during a difficult time.


What does a life insurance policy cover?

Life insurance policies provide beneficiaries with a lump sum payment in the event that a policy holder dies. The amount that is paid out, called the death benefit, is dependent upon the amount specified in the policy. When a policy holder dies, their beneficiary will need to file a claim with the insurance company to begin the process of filing to receive the death benefit. As challenging as the task may be to file the claim, it’s important that beneficiaries submit the request as soon as possible. By filing the claim quickly, beneficiaries are closer to getting the financial security that the policy holder intended them to receive in their death.


Why are claims denied?

When you purchase a life insurance, you don’t envision a reality where your beneficiaries struggle in the future to collect payment. Unfortunately, there are some instances where your insurance company may deny your claim. When reviewing the terms of a policy, it’s important to carefully read through the details to confirm what causes of death are covered and what causes of death are excluded. If your loved one’s death falls under a category that is not covered, then your claim will be denied, and you will not receive any payment. If the cause of death falls into a covered category, the insurance company may still initially deny the claim. Common reasons for denial besides an excluded cause of death include:

  • Outstanding insurance premiums: The insurance company may allege that you haven’t paid all of your premiums. Because you have an outstanding balance, they may use that as cause not to pay the claim.
  • Alleged fraud: The insurance company may allege that have committed fraud by not disclosing information about an underlying health condition when purchasing the policy. This type of denial often will arise if the death occurs within the first 2 years of the policy.


My claim was denied. What should I do now?

If your life insurance claim was denied, the next steps will include entering into the appeals process with the insurance company. The appeals process can be confusing to navigate if you do not have the experience. Insurance companies will have attorneys and experts reviewing your case to determine whether they can deny your claim and enforce that decision. Hiring an attorney with expertise in insurance litigation can help put together a compelling case on your behalf to fight to overturn your denial.


If you are a beneficiary of a life insurance policy for someone who has died and have had the claim denied, contact Altman & Altman for a free consultation to discuss the details of your claim. Their compassionate and experienced team will support you through the appeals process so that you have the best chance at winning and receiving the financial support that your loved one intended. You can reach us 24 hours a day, 7 days a week at 617.492.3000 or toll free at 800.481.6199.

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