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Life Insurance Denial Appeal Letter – Life insurance protects those who rely on the insured’s continued financial support and will suffer if that support is withdrawn. Ideally, the insurer will pay the full policy amount after the death of the insured. Unfortunately, this is not always the case. Major insurance companies deny life insurance claims for a variety of reasons, leaving life insurance beneficiaries in dire straits.
In this article, our attorneys explain what happens and what you should do when the insurance company denies your life insurance claim. If your claim has been denied, call (888) 510-2212 for a free case evaluation.
Life Insurance Denial Appeal Letter
If a life insurance claim is denied, the insurance company will send a letter to the beneficiary explaining the reasons for the denial. The letter will typically refer to the policy provisions that apply and list the documents the insurer reviewed in making the denial decision.
Life Insurance Claim Denials
Sometimes beneficiary claims are denied over the phone. If this has happened to you, you have the right to request a letter of refusal (in writing). A denial letter will not only outline the important information needed to dispute the denial, but will also show the date the decision was made, which will help identify the deadline for filing a lawsuit. Finally, a denial letter may outline an appeals procedure.
In some cases, insurers refuse to submit a life insurance claim to their beneficiaries. This is usually done over the phone. The reasons could be:
Oftentimes, insurance company representatives who verbally deny the right to file a claim make the mistake of not accepting perfectly valid claims. When a life insurance company representative tells you over the phone that you cannot file a claim, always contact a life insurance attorney.
The reasons for a life insurance claim denial can vary depending on the policy provisions, state and federal laws, and the specific circumstances of an individual whose claim is denied. Below are the most common excuses life insurance companies use to deny claims:
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Our attorneys explain each of these situations in detail in our article on reasons life insurance won’t pay.
Claims are usually denied if the policy is less than two years old and the dispute is investigated. The competitive period is when the insurance company investigates the answers to the application to make sure they are supported by the insured’s medical records and background. Competitively denied life insurance claims can be appealed if the insurance company wrongly denied the claim.
When a life insurance claim is denied, many family members become demotivated and some may refuse to seek further benefits.
However, it is within their rights as a life insurance beneficiary to fight a life insurance claim denial by filing a complaint or appeal if they disagree with the reason for the denial. Even if the insurance company accepts the denial on appeal, you should contact an attorney to properly evaluate your case and your chances of winning.
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If the insurance company decides to deny a claim, the denial letter sent to the person who submitted the claim must be specific and specify the specific reasons for the denial.
Unfortunately, all too often, insurance companies send vague denial letters stating that the claim will not be paid without providing specific reasons for the denial. If so, contact the insurer and ask for specific reasons for the denial.
Be sure to ask about the appeals process as well. They should tell you what the policy supports and what you need to know to file an appeal. You will need to provide additional documentation, such as medical records, an autopsy report, or insurance payment receipts to support your appeal.
In some cases, the denial letter may refer to a particular statute or legal theory that does not pay the claim. If so, a life insurance attorney will assess whether the applicable law is applicable.
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You should work with an attorney who handles life insurance cases to improve your chances of recovering your life insurance death benefit. A life insurance attorney working on your case will know which law controls your claim and how to legally appeal a denial.
Disputing a denied life insurance claim involves investigating the denial of the claim, gathering evidence, conducting legal research, and filing an appeal. This process is controlled by strict regulations.
For example, the denial of an ERISA claim requires that an administrative appeal be filed within a certain period of time after the denial letter. Since the collected documents and the issues raised in the appeal will be analyzed later during the litigation, it is important to do thorough research and legal research before filing the appeal.
Additionally, many life insurance claims may involve the interaction of various state and federal laws, policy provisions, and court documents. In these cases, a life insurance attorney will help design a successful appeal strategy and help resolve the possible outcomes of the case.
Can I Request My Disability Claim File After A Denial?
Many insurance companies allow administrative appeals before the denied claim is filed. In order to file a successful administrative appeal, your life insurance attorney will present a compelling argument based on the facts of the case as permitted by the governing laws. This is a crucial step in paying the denied claim.
If you believe your life insurance claim has been unfairly denied or delayed, talk to an attorney who handles life insurance matters. An experienced attorney can advise you on how to proceed after a denied life insurance claim, which may include filing an appeal, contest, or lawsuit to get the money you deserve.
At our law firm, our attorneys handle claims that have been denied for all of the reasons listed above. They have extensive experience in complex appeals proceedings and litigation and have a high success rate in recovering the life insurance benefits our clients were entitled to.
We offer free consultations and work on a contingency fee basis, so there are no legal fees if you win and don’t receive your life insurance payout. If you or someone you know is having trouble with a denied life insurance claim, call (888) 510-2212 to speak with one of our attorneys. We offer free consultations.
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Attorney Tatiana Kadetskaya has over 10 years of experience in life insurance law representing beneficiaries and policy owners. He is known for successfully collecting denied and delayed claims and resolving complex beneficiary disputes and interpleader litigation.
The information on this website is for general information only. Nothing on this site should be construed as legal advice for any individual case or situation. This information is not intended to be created, and receipt or viewing does not constitute an attorney-client relationship. “Expert-vetted” means that our Financial Review Board has thoroughly evaluated the article for accuracy and clarity. The Review Board is made up of financial experts, and our goal is to always keep our content objective and balanced.
Written by Natalie Todoroff Written by Natalie Todoroff. Arrow right writer, Insurance is insurance writer Natalie Todoroff, who previously wrote for a popular insurance comparison shopping app. B.A. in English, he initially pursued a career in bookmaking. Now, he’s focused on transitioning from professional reader to professional writer. Natalie Todoroff
Edited by Amelia Buckley Amelia BuckleyArrow Right Editor, Insurance Amelia Buckley is an insurance editor covering auto, home and life insurance. Emphasizes creating informative, engaging and nuanced content to help readers make personalized insurance decisions. Connect with Amelia Buckley on LinkedIn Linkedin with Amelia Buckley
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Review by Mark Friedlander Review by Mark Friedlander Arrow Right Director of Corporate Communications, Insurance Information Institute Mark Friedlander is director of corporate communications at III, a nonprofit organization dedicated to helping consumers better understand insurance. Connect with Mark Friedlander on Twitter Twitter Connect with Mark Friedlander on LinkedIn Linkedin About Our Review Board Mark Friedlander
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State Farm Appeal Process
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