Filing a life insurance claim after losing a loved one is never easy. But when the claim is unexpectedly denied—especially due to disputes over the cause of death—it adds an extra layer of stress to an already painful time. Unfortunately, this scenario is more common than most people realize. Minor application errors, timing issues, or medical disputes can derail a claim that should be paid. The good news is that cause-of-death denials can often be challenged—and overturned—if you understand your rights and take the right steps. If you need Massachusetts interpleader lawsuit guidance call us.
Why Insurance Companies Scrutinize Cause of Death
Insurers are careful about approving payouts because life insurance is based on risk. If the cause of death falls under an exclusion or reveals an undisclosed condition, the insurer may use that as justification to deny the claim. These denials are typically based on:
Suicide within the first two years: Most policies include a suicide clause, and insurers will deny benefits if the death occurs within that window.
Undisclosed medical conditions: If the policyholder didn’t list a prior diagnosis, such as cancer or heart disease, the insurer may claim misrepresentation.
Drug or alcohol involvement: Even if accidental, deaths involving substances can trigger exclusions, especially under accidental death policies.
Contestability period scrutiny: If death occurs within two years of policy issuance, insurers often dig deeper for reasons to deny based on omissions or inaccuracies.
These clauses are designed to prevent fraud, but insurers frequently overextend their interpretations in order to avoid paying large claims.
Real-World Example: When Denials Go Too Far
We handled a case involving a woman whose husband died of a heart attack just 14 months after his policy began. The insurer denied the claim, citing an alleged failure to disclose high blood pressure. But the man had never been diagnosed or treated for it—there was no “misrepresentation.” After presenting medical records and expert testimony, we overturned the denial and secured the full benefit for the widow. This is one of many examples where cause-of-death denials don’t hold up under legal review.
How to Challenge a Life Insurance Denial Based on Cause of Death
If your claim has been denied due to the cause of death, don’t give up. Here’s how to respond strategically:
1. Work with a Life Insurance Attorney
These cases often hinge on technical interpretations of policy language, autopsy reports, and underwriting guidelines. An experienced attorney knows how to dissect the insurer’s reasoning and build a compelling counterargument.
2. Re-examine the Official Cause of Death
Was it suicide or an accident? Did the policyholder die of natural causes, or was there substance involvement? The precise wording in medical records and death certificates matters. An attorney can help secure and analyze these documents in detail.
3. Investigate the Application and Policy Terms
Some denials stem from simple application mistakes that insurers treat as “material misstatements.” Your lawyer can determine whether the alleged misrepresentation actually affected the insurer’s decision to issue the policy.
4. Demand Specific Reasons for Denial
Insurers often issue vague denial letters. Don’t accept one that simply says “policy terms not met” or “exclusion applies.” You're entitled to a detailed explanation backed by documentation—and we’ll make sure they provide it.
5. Gather and Present Supporting Evidence
Medical records, toxicology reports, physician statements, and witness testimony can all be used to refute the insurer’s version of events. The more evidence you provide, the harder it becomes for them to stand by a shaky denial.
You Have the Right to the Benefits They Intended for You
The person who took out the policy did so to support their family—not to leave them in limbo after their death. A denial doesn’t mean your case is closed; it means the fight may just be starting. Most denials can be challenged, and many are overturned with the right legal support.
If your life insurance claim has been denied or delayed due to cause of death concerns, don’t wait. Contact our life insurance attorneys for a free consultation. We’ve handled hundreds of cases like yours and know how to force insurers to honor the policies your loved ones paid for. Let us fight for the benefits you were meant to receive.