Life insurance is purchased with one purpose in mind: to protect family members financially after a death. Yet one of the most common reasons insurers deny claims has nothing to do with how the person died. Instead, the denial is based on something the insurer claims was left out of the original application.
An “omission” denial occurs when the insurance company argues that the insured failed to disclose information when applying for coverage. These denials are extremely common, especially when the death occurs within the first two years of the policy. They are also among the most frequently overturned.
What Insurers Mean by an “Omission”
An omission is not necessarily a lie. It can include:
Forgetting to list a past doctor visit
Failing to mention a medication that was short term
Leaving out a minor diagnosis that resolved years earlier
Not disclosing symptoms that were never formally diagnosed
Answering a vague question based on personal understanding
Insurance companies often use the word “omission” to imply dishonesty, but legally, the issue is much narrower.
The real question is whether the omitted information was material.
Why Materiality Matters More Than Accuracy
Life insurance law does not require perfection. It requires material accuracy.
For an omission to justify denying a claim, the insurer must show that the missing information would have changed one of the following:
Whether the policy would have been issued at all
The amount of the premium charged
The risk classification assigned to the insured
If the insurer cannot prove that the omission affected underwriting, the denial may fail.
Many insurers skip this analysis entirely and deny claims automatically once they find anything missing.
Common Omissions Insurers Rely On
Certain omissions are repeatedly cited in denial letters:
Anxiety or depression treatment
Blood pressure readings that were borderline
Cholesterol or prediabetes notes
Temporary prescriptions
Prior diagnostic testing with normal results
These details are often unrelated to the cause of death, but insurers still rely on them to deny payment.
Courts frequently reject this approach.
Omission Versus Misrepresentation
There is a legal difference between leaving something out and making a false statement.
An omission may occur when:
The application question was vague
The insured misunderstood what was being asked
The condition was not known at the time
The issue resolved and was not considered ongoing
Insurers often blur this distinction, labeling omissions as intentional misrepresentations even when there is no evidence of intent.
Intent matters, especially when the insurer attempts to rescind the policy entirely.
When Omission Denials Are Most Common
Omission based denials appear most often when:
Death occurs within the contestability period
The policy was issued without a medical exam
Medical records are reviewed only after death
The insurer conducts a retroactive underwriting review
In these cases, the insurer is comparing post death medical records to application answers that may have been completed years earlier under very different circumstances.
Why These Denials Are Frequently Overturned
Omission denials fail for several recurring reasons:
The omitted information was unrelated to the cause of death
The insurer already had access to the information
The application questions were ambiguous
The insurer cannot prove underwriting impact
The insurer accepted premiums despite the omission
Courts do not allow insurers to retroactively rewrite underwriting decisions simply because a claim was filed.
What Beneficiaries Should Do After an Omission Denial
If a claim is denied due to an alleged omission:
Request the full application and underwriting file
Identify exactly what information is claimed to be missing
Determine whether the insurer explains why it mattered
Compare the omission to the actual cause of death
Preserve all medical records and correspondence
Many denial letters never explain materiality. That omission alone can be significant.
Why Legal Review Changes the Outcome
Insurers often rely on beneficiaries assuming the denial is correct. Once challenged, many insurers struggle to justify their position.
A focused legal review examines:
The wording of the application questions
The underwriting guidelines in effect at issuance
Whether the insurer would have acted differently
Whether the insurer complied with rescission rules
When forced to prove these elements, insurers frequently reverse course.
Final Takeaway
An omission on a life insurance application does not automatically void coverage. It does not automatically justify denial. And it does not give the insurer unlimited discretion.
Most omission based denials hinge on whether the missing information actually mattered. In many cases, it did not.
If a life insurance claim has been denied due to an alleged omission, that denial deserves careful scrutiny. When handled correctly, these claims are often paid, even after an initial rejection.