Receiving a life insurance claim denial after losing a loved one can feel like a final blow—emotionally and financially. In that moment, many beneficiaries simply accept the insurer’s decision without question. Some are too overwhelmed by grief to fight back, while others assume the insurance company must be right. Unfortunately, that assumption often leads families to walk away from benefits they’re legally entitled to receive.
Here’s the truth: a denial from a life insurance company is not the final word. With the help of an experienced life insurance attorney, many denials can be challenged—and reversed.
Life Insurance Companies Get It Wrong More Often Than You Think
Just because an insurer denies a claim doesn’t mean they’re correct. Life insurance companies have a financial incentive to limit payouts. They rely on complex policy language, vague exclusions, and technical interpretations to reject claims—even those that should be paid under the policy’s terms.
Some companies even issue blanket denials knowing that a percentage of beneficiaries will never challenge the decision. In many of these cases, the denial is not supported by the law or the contract—it’s simply a delay tactic or an unfair interpretation of the policy.
Example: A woman in Texas received a denial letter stating her husband’s death was due to a policy exclusion for “self-inflicted injuries.” After legal review, we proved the death was accidental and unrelated to any exclusion. The insurer reversed its decision and paid the full benefit.
Common Excuses Insurance Companies Use to Deny Claims
Material Misrepresentation
Insurers often claim that the policyholder gave false or incomplete information on the application—whether about health history, smoking habits, or past medical treatment. Even minor omissions are used to justify denials.
Exclusion Clauses
If the death involves alcohol, drug use, extreme sports, or alleged criminal activity, insurers may point to policy exclusions—even when those exclusions are applied unfairly or don’t match the facts.
Lapsed Policy or Coverage Not in Force
Companies frequently deny claims by arguing that the policy lapsed due to non-payment—even if the policyholder was never properly notified or was still within a grace period.
Suicide Determinations
Some insurers classify a death as suicide based on circumstantial evidence, even when the official cause of death is unknown or disputed. This can trigger a denial under a suicide exclusion clause.
The key thing to remember is this: insurers don’t have the final say. Their interpretation of policy language and facts is just that—an interpretation, not the law.
How to Fight Back After a Life Insurance Claim Denial
You don’t have to accept the denial. You have the right to:
Request the insurer’s full claim file
Review the policy’s terms, exclusions, and application materials
Consult a lawyer who focuses specifically on denied life insurance claims
File an internal appeal or a lawsuit to challenge the denial
If you’re the beneficiary, estate executor, or trustee connected to the life insurance policy, you may also have a legal responsibility to act on behalf of other beneficiaries—especially if minor children or dependents are involved.
Why You Need an Attorney Who Handles Life Insurance Denials
Successfully appealing a denied life insurance claim takes more than a phone call or letter. It often requires an attorney who knows how to:
Identify flaws in the insurer’s reasoning
Interpret complex policy language
Gather medical and legal evidence
File lawsuits if negotiations fail
Our legal team prepares 100- to 200-page appeals that cite case law, examine exclusions, analyze medical records, and break down the insurer’s denial in detail. We handle both ERISA (employer-provided) and private life insurance claims, and we’ve overturned denials from nearly every major carrier—including MetLife, Prudential, Lincoln Financial, AIG, Colonial Penn, and many others.
Don’t Let the Insurance Company Keep What’s Rightfully Yours
You’re not powerless. If your life insurance claim has been denied, there’s a high likelihood it can be reversed—especially if the insurer relied on a vague exclusion, alleged misstatement, or questionable judgment call.
Schedule a free consultation today. We don’t charge any fees unless we recover money for you. Let us handle the fight so you and your family can focus on healing—not battling an insurance company. If you need legal help for life insurance disputes in Oregon call our firm.