Life Insurance Denial Lawyers Helping Claimants Nationwide

A life insurance claim denial requires the help of a lawyer when an insurance company either refuses to pay the death benefit to a beneficiary(s) or refuses to waive the premium when an insured is disabled. Our lawyers have helped hundreds of families / beneficiaries to collect life insurance death benefits as result of the loss of a loved one or life insurance policy holder. Life insurance companies perform extensive investigations prior to paying death benefits as they are looking for a reason not to pay a claim. It is always in your best interest to consult with a life insurance lawyer prior to submitting a claim for life insurance proceeds. Our lawyers always provide a free immediate phone consultation to discuss how we could assist you.

How Could A Life Insurance Claim Be Denied?

Life Insurance Denial Attorneys and Lawyers

Life insurance companies rely on exclusionary clauses in a life insurance policy to deny payment of life insurance proceeds to a beneficiary(s). Understanding the terms and conditions of the life insurance policy is very important, especially when a beneficiary is often seeing a life insurance policy that they are not familiar with. Every life insurance policy has different exclusionary language so the language in the insured’s life insurance policy will govern. The exclusions that insurance companies most commonly rely upon to deny death benefits and the ones we have litigated are as follows:

Misrepresentation The life insurance company claims that the insured either failed to disclose information when applying for benefits or answered an application question in a manner that was false. The insurance company attempts to rescind / cancel the life insurance policy claiming that if they had not been misled then they would not have sold the life insurance policy. Life claims based upon misrepresentation are often litigated as the life insurance company claims the applicant failed to disclose relevant information. Most misrepresentation claims deal with an insured failing to disclose a prior medical issue at the time they apply to obtain the life policy. A typical misrepresentation life insurance denial occurs when the life insurance company investigates the medical history of the insured post death and learns about a pre-existing condition which would have prevented them from selling the life insurance policy. As long as the death of the insured is more than two years after it was issued, then a life insurance company cannot deny for misrepresentation unless they can prove that the insured intentionally or fraudulently misrepresented. There is a significant difference between a negligent misrepresentation and an intentional misrepresentation which is what become the focus of life insurance claim based upon misrepresentation. 

Suicide The life insurance company claims that that insured took his or her own life and as a result death benefits are not payable. There is a lot of litigation in this area as to whether the death was intentional or accidental. For example, insurance companies have denied life insurance claims arguing that a drug overdose resulting in death was a suicide. In most life insurance policies, if a suicide takes place 2 years after the policy is issued, then a death by suicide is not excluded.

Illegal Activity Most life insurance policies state that if an insured dies as the result of engaging in an illegal activity, then death benefits are not payable. Our lawyers have litigated many life insurance denials where the insured died in a car accident in which he or she was allegedly driving under the influence of drugs or alcohol. These life insurance denials are highly litigated as the insurance company must prove that the insured was intoxicated in accordance with the laws of the state in which the accident took place. Drug overdose death claims are also commonly considered an illegal activity resulting in claim denial.

Substance Abuse The life insurance company claims that death was due to the abuse of drugs or alcohol. This provision is commonly litigated as an insured’s alleged abuse of a substance is subject to interpretation and the alleged abuse may not have been the cause of death. An alcoholic can die as a result of numerous other causes and the fact the person was an alcoholic should not preclude him or her from eligibility for death benefits. There have also been cases where a claimant dies of a heart attack and the life insurance company denies life insurance benefits claiming the death was due to an abuse of prescription drugs.

Dangerous Activity The life insurance company claims that the insured engaged in an activity such as sky diving, race car driving, cliff diving, mountain climbing, back country skiing, etc. and the policy excludes coverage for any death caused while performing activities considered extreme. The policy may state the dangerous activities which are not covered which exclude payment of death benefits.  

Life Insurance Waiver of Premium Claims

Our law firm regularly handles waiver of premium claims for life insurance policies. A waiver of life insurance premium provision states that if a policy holder is “disabled” then the premium for life insurance is no owed.  The definition of “disability” in a waiver of premium provision in a life insurance policy is usually similar to the definition of “disability” in a long-term disability policy. In most claims we handle the long-term disability benefit and waiver of premium claims simultaneously for our clients. It is common for the life insurance waiver of premium definition of disability to change from “own occupation” to “any occupation” after 12-24 months from the date of disability. Unfortunately, a life insurance company will first deny the waiver of life insurance premium claim and then try to use the same information to deny the long-term disability claim. As a result of this, claimants need to be proactive in fighting the waiver of life insurance premium denial. While challenging a life insurance waiver of premium denial it is very important to pay any premiums owed so that you can maintain the life insurance policy in case you lose your challenge to the denial. Any of our lawyers are available for a free phone consultation to discuss your waiver of life insurance premium claim denial.