Top

How to Appeal a denied life insurance claim

Losing a loved one is an emotional ordeal in itself. But when a life insurance claim—meant to provide financial relief—is denied or delayed, the emotional toll can quickly turn into financial crisis. Many families depend on life insurance benefits to pay for funeral costs, ongoing bills, mortgage payments, and day-to-day living expenses. If the policyholder was the primary source of income, a denial can feel devastating.

Unfortunately, insurance companies frequently deny or delay claims, citing everything from policy lapses to beneficiary disputes. The good news? Many of these denials are reversible. Here's exactly what to do—and what to avoid—if your life insurance claim was recently denied or is stuck in limbo.

Find Out the Specific Reason for the Denial

The first and most important step is to determine why your claim was denied. Insurance companies are legally required to provide a written explanation. If the denial letter is unclear or missing key details, you have the right to request a full written explanation from the insurer.

Understanding the basis of the denial will help you figure out whether it was valid—or simply a tactic to avoid paying. Some common denial reasons include alleged misrepresentation on the application, missed premium payments, policy exclusions, or an active contestability review.

Don’t Accept the Denial Without Challenging It

Many beneficiaries mistakenly believe that once a claim is denied, there’s nothing they can do. That’s not true. Most life insurance denials can be appealed—and many are successfully overturned when challenged with legal support.

For example, a family in Ohio was told their accidental death claim was being denied because the insurer suspected suicide. With legal assistance, the cause of death was proven to be accidental, and the family ultimately recovered the full $301,850 payout from Transamerica.

Insurers often count on grieving families giving up. Filing a timely appeal—especially if the policy is governed by ERISA—can protect your right to challenge the decision. But be aware: ERISA plans typically allow only one appeal, so it must be done right the first time.

Work with an Experienced Life Insurance Attorney

The claims and appeals process is complex, especially when delays or denials are involved. Insurance companies have internal legal teams, and beneficiaries who try to handle appeals on their own are at a serious disadvantage.

Hiring a life insurance attorney dramatically increases your chances of recovering benefits. An experienced lawyer can:

  • Analyze the insurer’s reason for denial

  • Obtain and review the full claim file

  • Draft a detailed legal appeal backed by case law and policy analysis

  • Handle litigation if necessary, including beneficiary disputes and interpleaders

At our firm, we routinely submit legal briefs between 100 and 200 pages to insurance companies, outlining exactly why a denial is improper. These submissions often result in the full claim being paid without the need for court intervention.

Don’t Confuse a Claim Delay With a Denial

It’s important to know the difference between a delayed claim and a denied one. If the insurance company is taking longer than usual, that doesn’t necessarily mean your claim won’t be paid—but it could still be a red flag.

Delays are common during the contestability period, which typically lasts for two years from the date the policy was issued. During this time, insurers have the right to investigate the original application for errors or misstatements. But if the delay stretches beyond 60 days without good reason, it may indicate that the insurer is stalling or hoping you’ll stop pursuing the claim.

Engaging a life insurance lawyer during the delay can help move the process along and hold the insurer accountable to state or federal processing deadlines.

Review the Life Insurance Policy in Detail

Before responding to a denial or pushing back on a delay, locate the full copy of the life insurance policy. You’ll want to review:

  • Coverage limits and exclusions

  • Contestability clauses

  • Premium payment obligations

  • Beneficiary designations

Confirm that the listed beneficiaries are accurate and that the policy was active at the time of death. Any inconsistencies or unclear terms could become part of the insurer’s justification for denial—and must be addressed directly in the appeal.

Examples of Denied Life Insurance Claims We’ve Helped Resolve

Below are some real-world examples of life insurance denials that were reversed after legal action:

  • Unum: Accidental death initially denied; $532,000 paid after appeal

  • Transamerica: Suicide exclusion challenged; $301,850 recovered

  • Stonebridge Life: Spousal beneficiary dispute resolved; $210,000 paid

  • Reliance Standard: Autoerotic asphyxiation exclusion overturned; $315,000 paid

  • Primerica: AD&D claim denial reversed; $178,000 awarded

  • MetLife: Suicide misclassification challenged; $205,000 secured

  • Liberty Mutual: AD&D delay resolved through legal brief; $330,000 paid

  • Colonial Life: Ex-spouse beneficiary conflict resolved in court; $450,000 recovered

  • AIG Life: Prescription drug-related denial overturned; $100,000 paid

  • Sun National Life: Alcohol exclusion rebutted; $219,000 released

These cases highlight the importance of not giving up and seeking experienced legal counsel. With the right legal strategy, even complex denials can be successfully challenged.

Conclusion: Don’t Let a Denied or Delayed Life Insurance Claim Go Uncontested

Life insurance is a contract—and when your loved one paid premiums in good faith, the insurer is obligated to honor that agreement. If your claim has been denied or delayed, you don’t have to fight alone. Most beneficiaries who take legal action significantly improve their chances of receiving the full payout.

Our law firm focuses exclusively on denied and delayed life insurance claims. We know the strategies insurers use to avoid paying and how to beat them. If you're facing a denial or delay, contact us today for a free consultation. There’s no fee unless we recover benefits for you. Let us help you get the compensation your loved one intended for you to have. If you need a Texas life insurance lawyer call us today.

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.

  • By submitting, you agree to receive text messages from at the number provided, including those related to your inquiry, follow-ups, and review requests, via automated technology. Consent is not a condition of purchase. Msg & data rates may apply. Msg frequency may vary. Reply STOP to cancel or HELP for assistance. Acceptable Use Policy