Dealing with the death of a loved one is hard enough. But finding out that a life insurance claim has been denied can make things even worse. Many families depend on the death benefit to cover funeral costs, pay off the mortgage, or support dependents after a tragedy. If you've received a claim denial letter from the insurance company, don't panic—and definitely don’t assume their decision is final. You may have the right to appeal and win. When you need legal help for life insurance disputes in West Virginia call us.
Most Common Reasons Life Insurance Claims Are Denied After Death
What happens if premiums weren’t paid on time before the policyholder died?
One of the most common reasons a claim gets denied is for non-payment of premiums. If the insured missed payments and didn’t catch up during the grace period (usually 30–31 days), the policy may lapse. Once it lapses, coverage ends—and if death occurs after that, insurers are likely to deny the claim.
Example: A man in Georgia lost his job and missed two payments. He passed away in a car crash three weeks later. The insurance company denied the claim, arguing the policy had lapsed due to nonpayment.
Can inaccurate answers on the application cause a life insurance claim to be denied?
Yes. If the insurer discovers that the policyholder made a misrepresentation—such as lying about smoking, omitting a medical condition, or failing to mention recent doctor visits—they may use that as grounds to deny the claim. This is especially common during the contestability period (typically the first two years).
Example: A woman in Texas marked “no” to diabetes on her application but had received a prediabetes diagnosis a year earlier. After she died from unrelated causes, the insurer denied the claim due to “material misrepresentation.”
Will life insurance pay out if the death falls under an excluded cause in the policy?
No. Most policies have exclusions—events or conditions that void the coverage. These can include suicide within the first two years, death during the commission of a felony, certain high-risk hobbies, or participation in war or terrorism.
Example: A man in California died while skydiving, which his policy excluded. His family’s claim was denied because extreme sports were listed as an exclusion.
Can drug or alcohol use at the time of death result in denial of benefits?
Yes. If the policy includes a drug or alcohol clause and the deceased had substances in their system, even if unrelated to the death, the insurer may argue the exclusion applies.
Example: A young man in New York died in a boating accident. Although his cause of death was drowning, a toxicology report found cocaine in his system. The claim was denied due to the drug use clause.
Does life insurance cover suicide?
Life insurance generally doesn’t cover suicide if it occurs within the first two years of the policy. After that period, it usually does. But every policy is different, so it’s critical to check the language.
Example: A man in Ohio took his own life 15 months after his policy began. Because it fell within the suicide exclusion period, the insurer refunded premiums but denied the benefit.
Can a life insurance claim be denied if the policyholder dies while overseas?
Yes. Some policies contain foreign death exclusions or restrictions related to travel in specific countries. If the insured dies in a restricted country or under suspicious circumstances abroad, the insurer may delay or deny the claim.
Example: A Florida resident died while vacationing in a country on the State Department's "Do Not Travel" list. The insurer argued that the travel voided coverage and initially denied the claim.
How to Know If Your Life Insurance Denial Is Legitimate
Just because an insurer says the claim is denied doesn’t mean it’s legally valid. Insurance companies count on beneficiaries being confused, overwhelmed, or unwilling to fight back. In many cases, the denial is based on a flawed investigation, misinterpretation of the policy, or an error in the insured’s records.
Ask yourself these questions:
Was the reason for denial clearly stated in writing?
Did the insurer complete a thorough investigation?
Is the denial based on something unrelated to the cause of death?
Does the explanation match the language in the policy?
If anything feels off—or if you’re unsure—your next step should be to consult an attorney who specializes in life insurance denials.
Why You Should Hire a Life Insurance Lawyer After a Claim Denial
Trying to appeal a denied life insurance claim on your own is incredibly difficult. Insurance companies have entire legal departments working to protect their bottom line. A small mistake in your appeal could permanently ruin your chances. This is especially true for group life insurance policies governed by ERISA, where you only get one opportunity to appeal.
An experienced life insurance attorney can:
Analyze your denial letter and policy in detail
Identify violations of insurance law or bad faith tactics
Collect missing records or documentation
Draft and submit a persuasive legal appeal on your behalf
Our law firm submits 100–200-page briefs packed with legal arguments and medical evidence. We’ve overturned thousands of denials from top insurers like AIG, MetLife, Transamerica, Prudential, New York Life, Colonial Penn, and more. In fact, our appeal success rate is nearly perfect.
What to Do If Your Life Insurance Claim Was Denied by the Insurance Company
Don’t wait. If your claim was denied, take these steps immediately:
Review the denial letter carefully to understand the reason.
Request a copy of the full policy, including exclusions and endorsements.
Gather all medical records and documents related to the insured’s health, lifestyle, and cause of death.
Consult a life insurance attorney before submitting any appeal or responding to the insurer.
We handle appeals involving missed premium payments, contestability investigations, ERISA denials, accidental death disputes, foreign death claims, and more. Whether the issue is a technicality or a bad faith denial, we know how to fight it.
Get Legal Help for a Denied Life Insurance Claim Today
Don’t let an insurance company take away the benefits your loved one meant for you to have. If your life insurance claim was denied, delayed, or under review, contact our team immediately. Our lawyers handle denied life insurance claims nationwide and we don’t get paid unless you win. Let us help you turn a denial into a payout—and take the burden off your shoulders during a difficult time.