Coping with the loss of a loved one is tough enough – but what happens if your expected life insurance claim is denied? Life insurance companies can and do deny countless claims, so learning more about the reasons for a denial can help you protect your family. Dealing with VGLI, SGLI, TSGLI and Prudential claims without a life insurance attorney with at least 20 years of experience is a recipe for disaster.
A denial, when it arrives, shows up at the worst possible time; the family is already coping with not only the loss, but with the financial issues associated with it. For many beneficiaries, a denial is more than inconvenience, it is a huge burden during an already difficult time. What should you do if you have received a denial from your insurance company? While every claim is unique, these steps should help you get started.
What to do if your Life Insurance Claim is Denied
Document Everything: Save every letter, form and piece of paper you receive from the insurance company. This should be scanned and saved, ready to email to your life insurance lawyer. Keep a record of each conversation you have with the representatives of the insurance company.
Locate the original policy: Find the original policy documents and any change notices. If you have proof of payment of your premiums, compile this evidence as well.
Determine the reason for denial: Your insurer should have provided a reason they refuse to pay the claim; they can't simply refuse to pay you without explanation. The most common reasons for denial are:
- Failure to pay the premium (the insurer claims that the deceased did not pay for the insurance in a timely manner)
- Misrepresentation or incorrect information on the application (the deceased misrepresented his age, weight or health at the time of the application)
- Exclusions, death happens under circumstances which would render the insurance invalid (anything from suicide to extreme sports could be considered an exclusion, depending on your contract)
- Incorrect paperwork or paperwork error (On the part of the employer for group insurance or even when the beneficiary files the claim)
- Beneficiary designation issues (no beneficiary given, or the beneficiary stated conflicts with a court order or specific laws).
Terms you will hear frequently relating to these claims are: service member; active duty; servicemembers group life insurance sgli; death benefits; pay the premiums; veterans group life insurance vgli; and vgli coverage.
Speak to a Life Insurance Lawyer Who Has at Least 20 Years of Experience
You can actually permanently ruin your case if you attempt to handle a denied life insurance claim on your own. A group life policy for example, is governed under ERISA, and you only have one appeal, and if it is blown, you are out of luck. The fastest and easiest way to get a resolution is to seek out assistance from a highly experienced life insurance attorney. An experienced life insurance lawyer from our firm will submit a 100-200-page legal brief, which usually results in a check being sent without having to go to court.
If you have received a claim denial or have experienced delays in the processing of your claim, we will fight and win. Contact us to discuss your specific details, and to learn more about your options; we're here to help you get through this troubling time with the best possible outcome, namely, getting you your full policy amount plus interest.