After the death of a loved one it’s normal to feel overwhelmed with grief, sadness, and even anger. Then there’s the stress of arranging a funeral or memorial service, contacting family members and friends to share the heartbreaking news, and handling your loved one’s estate.
The last thing you need during this difficult period is to have a life insurance claim denied. That’s why we’ve provided this step-by-step guide to help you understand what to do next.
Life Insurance Claim Denied? Here’s How to Handle It
Although it may seem an insurmountable hurdle, having a life insurance claim denied isn’t the end of the world. You do have recourse. Let’s take a look.
First, Find Out Why the Claim Was Denied
As heartless as it may sound, insurance companies look for reasons to deny claims — and to maximize their profit. Here are some of the most common reasons or excuses.
Alleged Misrepresentations in the Application
Failure to disclose certain personal information on the initial policy application — such as drunk driving convictions or health issues — can be a valid reason for an insurance company to deny a claim. However, life insurance policy applications can be vague, confusing, or downright misleading, in which case it may be possible to show that the omission was unintentional. And sometimes the omission is completely unrelated to the cause of death. If your claim is denied because the insurance adjuster claims there were omissions or misrepresentations on the initial insurance application, that’s not the final word. You may still be entitled to payment of your claim.
Manner of Death Excluded
Most life insurance policies exclude coverage for deaths that occur under certain circumstances, such as suicide, intentionally ingesting certain drugs or chemicals, or resulting from the insured operating a motor vehicle while intoxicated. Just because your claim is denied for one of these reasons doesn’t mean you are not entitled to payment. The evidence for the denial can be weak or inconclusive (i.e., the blood alcohol level test was done incorrectly, or there is evidence the deceased died by accident, rather than suicide). If this is the case, you should consult an attorney as soon as possible.
Remember: Delays Aren’t Necessarily Denials
Just because you don’t receive a payout immediately doesn’t mean you won’t eventually receive the benefits. Having a life insurance claim denied is different than having it delayed. Insurance companies have the right to investigate claims before paying them. But that doesn’t mean an adjuster can delay paying a claim indefinitely. So long as you have submitted sufficient proof of your claim, insurance companies must adhere to certain deadlines, whether the insurance claim is governed by federal (ERISA) or state law.
If your claim is being unduly delayed you need an experienced attorney on your side.
Seek Legal Representation
Appealing the life insurance claim denial is your best bet for recovering the financial compensation that you are entitled to. This process can complicated and confusing — so you should not attempt it on your own.
Instead, find an attorney who specializes in dealing with insurance companies. He or she will answer any questions you might have during an initial, no-cost and no-obligation consultation.
After you have secured the attorney’s services, he or she will take care of the necessary paperwork, file the appeal, and, if necessary, file suit against the life insurance company. Your chances of success will be vastly improved by working with an attorney.
Questions About a Policy Denial or the Appeals Process?
Don’t make the insurance claim or appeal process any harder than it needs to be. During this difficult time, turn to an attorney you can trust, so that you can receive your payout and move forward with your life. Contact Doskey Law today.