Life insurance offers peace of mind. It’s meant to protect your loved ones and provide financial stability during one of life’s most difficult times. Most policyholders trust that once they pass away, their beneficiaries will receive the benefits they paid for. Unfortunately, that doesn’t always happen. Every year, countless families are devastated not only by loss but by an unexpected and often unfair denied life insurance claim.
If you’ve recently had a claim denied, know that you are not alone—and you may have legal options to fight the decision. Life insurance companies often deny claims for questionable reasons, and many denials can be reversed. Here’s a breakdown of the most common reasons life insurance claims are denied and what steps beneficiaries can take in response.
Claim Denied Due to Contestability Period
One of the most frequent reasons for denial arises when a claim is made during what's known as the contestability period, typically the first two years after the policy is issued. During this window, the insurance company has the legal right to investigate and potentially deny a claim if they believe any information in the original application was false or incomplete.
Even if the insured passed away from a completely unrelated cause, the insurer may dig through medical records, tax documents, and even social media posts to find inconsistencies. This is especially common in policies that were sold with "no medical exam" or "no medical questions" promises. If the insurer uncovers even a minor omission—whether intentional or not—they may declare the contract void and refuse to pay.
Claim Denied Based on the Cause of Death
Many people assume life insurance will pay out no matter how the insured dies. But life insurance policies often include exclusions for specific types of death, particularly if they occur under certain circumstances. One of the most common exclusions is suicide, usually excluded if it occurs within the first two years of the policy.
Other causes of death that may lead to denial include:
Death while committing a felony
Death caused by participation in high-risk activities (e.g., skydiving or scuba diving)
Death due to drug or alcohol intoxication (depending on state law and policy terms)
Death in a foreign country (in rare cases where travel exclusions apply)
If the insurer believes the cause of death falls under an exclusion clause—even if the evidence is weak—they may deny the claim. But this doesn’t mean their decision is final. In many cases, exclusions are applied improperly, and beneficiaries successfully challenge these denials with legal help.
Claim Denied Due to Misrepresentation or Inaccurate Application
When applying for life insurance, the insured is expected to provide honest and complete answers to a series of health, lifestyle, and background questions. If, after the insured’s death, the company finds a discrepancy between the application and reality, they may claim material misrepresentation and deny the claim.
Common examples include:
Failing to disclose a prior medical condition or prescription
Omitting a history of mental health treatment or substance use
Misreporting tobacco or alcohol consumption
Providing incorrect height or weight
Failing to mention a prior criminal conviction or hazardous occupation
It’s important to know that not every mistake justifies a denial. Insurers must prove that the misstatement was material—that is, that they would not have issued the policy or would have offered it under different terms had they known the truth.
Claim Denied Due to Nonpayment or Lapsed Policy
Another devastating reason a claim may be denied is nonpayment of premiums. If a policyholder falls behind on payments—even by one billing cycle—and doesn’t take action during the grace period, the insurer may cancel the policy. Then, when a claim is submitted, the company simply states that the policy was no longer in force.
What many people don’t know is that these lapses aren’t always final. In some cases, insurers fail to send required lapse notices or don't follow proper procedures. Additionally, if the policyholder was incapacitated or died shortly after the lapse, the company may still be responsible for payment. A lawyer can review the details to determine if the lapse was valid or legally challengeable.
What You Should Do if Your Life Insurance Claim Was Denied
A denial letter from the insurance company is not the end of the road. Here’s what to do:
Request a detailed explanation for the denial in writing.
Gather all documents related to the policy, including the original application, policy contract, and all correspondence.
Do not accept the denial as final. Many denials are based on misinterpretations or errors.
Speak with a life insurance attorney. These claims are often complex, and insurers count on beneficiaries walking away without a fight.
We understand how overwhelming this process can feel—especially while dealing with the loss of a loved one. Our attorneys have an extensive track record of getting denied life insurance claims overturned, often without needing to file a lawsuit.
Why Legal Help Makes the Difference
Insurance companies have entire departments dedicated to defending claim denials. Without legal representation, it’s easy to get lost in their bureaucracy. Our attorneys level the playing field. We know the legal standards insurance companies must meet and hold them accountable when they fall short.
Whether your denial was based on contestability, misrepresentation, nonpayment, or an exclusion, we can help. We’ll investigate the facts, identify violations of your rights, and fight to get the full amount your loved one intended for you to receive.
Don’t Face a Denied Claim Alone
If your life insurance claim has been denied and you’re unsure of the next steps, contact us today for a free consultation. Our team is here to support you, and you won’t owe us anything unless we recover the benefits you’re entitled to. If you need a beneficiary dispute attorney in California we are here for you.