Denials can occur in many different areas. The reasons for denial can be even more convoluted than the application process it took to get the insurance policy in the first place. From time of injury/death, to the incident itself, all of these can come under fire when the insurance company seemingly wants to find any sort of reason to not have to payout to the beneficiaries at every single turn along the way.
This is even more true when attempting to deal with a supplemental life insurance denial. This is due to how many parties are generally involved, and how many supplemental coverages were applied to the policyholder’s group insurance. Depending on what transpired between the employee and the employer, the coverages can be denied, or the company can be faced with a liability.
What are Supplemental Life Insurance Coverages?
When talking about supplemental life insurance coverages, these are extra benefits and coverages that can be applied to a company’s basic group life insurance policy. This will usually have to be applied at the start of the policy, such as when the employee is first hired.
The way this is done is through a series of examinations, as well as a series of questions and tests done by the employer. This can be anything from mental health questions to basic physical health as well. All of these are taken into account before the employee is allowed to possibly apply for the extra supplemental life insurance coverages.
What causes a denial of Supplemental Coverages?
The reasons for denials can stem from a few different areas: The insurance company, the employer, and the employee/policyholder.
With the employee/policyholder, a denial can come from incorrect paperwork being filed, lying about certain information, or not holding up their end of the contract. This usually can be seen when an employee may attempt to say that they are more fit than they actually are during the application process, and then having an issue early on down the road.
For Insurance Companies, the problem could stem from their end through faulty paperwork. If the information has not been properly categorized, an innocent mistake in the filing could lead to a massive backhaul on the policyholder’s contract. But, this is quite rare.
A large chunk of the denial will usually rest on the employer. This can be due to many reasons, such as:
- Misrepresentation of supplemental coverages definitions
- Misrepresentation of employee coverages active on the policy
- Vague questioning and inquiries made during vetting process
Although these are just a few of the possible errors made by the employer, it is important to always understand and have a clear answer as to why the denial was raised. This can be gotten from the insurance company themselves, or from the employer to have on record. This is because the full reason of denial will help to exonerate you if the insurance company or employer attempt to accuse you of being in the wrong with the policy.
Our life insurance law firm will get you the full amount of the policy.