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Act quickly on a denied life insurance claim

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Many beneficiaries are told their life insurance claim is not denied, just “under review.” Weeks turn into months. Phone calls go unanswered. New document requests keep appearing. The insurer insists the claim is still being investigated, even though nothing seems to be happening.

What most beneficiaries do not realize is that their claim may have been quietly transferred to the insurance company’s Special Investigations Unit, often referred to as SIU. Once that happens, payment is rarely prompt and the delay is rarely accidental.

What Triggers a Special Investigations Unit Review

Insurance companies do not send every claim to SIU. Certain red flags cause claims to be escalated internally, including:

• Death occurring within the first two years of the policy
• Accidental or unexpected causes of death
• Overdose, intoxication, or prescription medication involvement
• Inconsistent medical history disclosures
• Recent policy increases or beneficiary changes
• Employer sponsored or group policy paperwork issues

Once a claim enters SIU, it is no longer handled as a routine payout. The insurer is actively searching for a reason not to pay.

SIU Delays Are Often Strategic, Not Procedural

Insurers frequently justify long delays by claiming they are waiting on records. In reality, SIU investigations are often open ended fishing expeditions. The insurer may already have enough information to make a decision but continues requesting:

• Old medical records unrelated to the cause of death
• Pharmacy histories going back many years
• Employment records
• Financial documents
• Prior insurance applications

These requests are not always legally necessary. They are often designed to exhaust beneficiaries or uncover minor inconsistencies that can later be framed as material misrepresentation.

Why “Still Under Review” Is a Warning Sign

When an insurer repeatedly states that a claim is still under investigation without issuing a formal denial, beneficiaries lose leverage. Appeal deadlines may never start. Interest may not accrue. The insurer maintains control while the family waits.

This tactic is especially common when the insurer believes it may have weak grounds for denial and hopes delay will discourage further action.

At a certain point, delay itself can constitute bad faith.

What Insurance Companies Hope Beneficiaries Will Not Do

Insurers rely on the fact that most beneficiaries do not:

• Know how long an investigation is legally allowed to last
• Demand a written coverage position
• Escalate the claim to legal counsel
• Force the insurer to justify continued delay
• Preserve their rights before limitation periods expire

Unrepresented claims are far more likely to remain stalled indefinitely.

How Legal Pressure Changes SIU Behavior

Once a life insurance attorney becomes involved, SIU investigations tend to move quickly. Formal representation forces the insurer to:

• Commit to a coverage position
• Justify ongoing investigation with specific reasons
• Produce internal claim notes
• Explain why requested records are relevant
• Address whether delay violates state insurance law

In many cases, insurers that delayed for months issue payment within weeks of legal involvement.

When Delay Is More Dangerous Than Denial

A denial can be appealed or litigated. A prolonged investigation quietly erodes your position. Evidence becomes harder to obtain. Witnesses disappear. Medical providers purge records. Deadlines approach unnoticed.

If a claim has been “under review” for more than a reasonable period, the delay itself becomes the legal issue.

Key Takeaway for Beneficiaries

If your life insurance claim has not been approved or denied and the insurer keeps requesting more information without explanation, assume the claim is being investigated for nonpayment. At that point, waiting rarely helps.

SIU delays are not administrative mistakes. They are deliberate claim handling strategies.

When to Involve a Life Insurance Attorney

Legal involvement is especially important when:

• The insurer refuses to give a timeline
• The investigation exceeds standard processing periods
• The death occurred within two years of policy issuance
• Requests feel repetitive or irrelevant
• Communication becomes evasive

An experienced life insurance attorney can force resolution, preserve your rights, and prevent delay from becoming denial.

Do You Need a Life Insurance Lawyer?

Please contact us for a free legal review of your claim. Every submission is confidential and reviewed by an experienced life insurance attorney, not a call center or case manager. There is no fee unless we win.

We handle denied and delayed claims, beneficiary disputes, ERISA denials, interpleader lawsuits, and policy lapse cases.

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