When you purchase a life insurance policy, you expect it to provide financial security for your family. But buried in the fine print is a provision many people overlook—the contestability clause. This clause can be the reason a seemingly valid claim is denied, especially if the insured passes away within a certain timeframe after the policy goes into effect.
Understanding how the contestability period works, and how insurers use it to investigate claims, is crucial to protecting your loved ones from losing the benefits they’re counting on.
What Is a Contestability Clause in Life Insurance?
The contestability clause gives the life insurance company the right to investigate a death claim and potentially deny the payout if they find errors, omissions, or misstatements in the original application.
This period typically lasts two years from the date the policy was issued. If the policyholder dies during this window, the insurer has the legal right to scrutinize the application line by line—and if they uncover anything inaccurate, even something minor, they may use it to void the policy.
Unlike outright fraud, these misstatements don’t have to be intentional. An innocent mistake—like forgetting to mention a prescription or misreporting a past condition—can be enough to trigger a denial.
Common Reasons Claims Are Denied During the Contestability Period
Life insurance companies deny claims during the contestability period more frequently than most people realize. Here are some common scenarios that lead to problems:
Incorrect Smoking Status: If the insured marked “non-smoker” on the application but occasionally smoked socially or had a prior history of smoking, the insurer may argue the misrepresentation was material and deny the claim.
Undisclosed Medical Conditions: Omitting even a minor health issue—like controlled high blood pressure, a past ER visit, or antidepressant use—can lead to denial if the insurer claims it influenced their underwriting decision.
Changed Travel Plans: If the applicant stated they had no plans to travel internationally but later died while abroad, the insurer may point to that inconsistency—even if travel wasn’t related to the death.
Wrongful Age or Weight Reporting: Incorrectly stating age, weight, or height, even by a small margin, may be viewed as a material misstatement, particularly if it affects the risk classification.
Past Criminal or Mental Health History: Some policies ask about legal or psychiatric history. Failing to disclose a past arrest, counseling, or hospitalization—even years prior—can be grounds for denial during this period.
Example: A woman in Florida passed away from a heart attack just 11 months after her policy began. Her insurer denied the $500,000 claim, citing her omission of anxiety medication during the application process—even though the medication had no relation to her cause of death.
The Importance of Accuracy When Applying for Life Insurance
One of the best ways to protect your beneficiaries is to provide complete and honest answers when applying. Never assume a detail is too small to matter. Insurance companies are not obligated to pay claims if they discover application misstatements during the contestability window.
Additionally, if your health or lifestyle changes significantly after your policy is issued, consider notifying the insurer or applying for a policy update—even if it means higher premiums. Ensuring your application and file are up-to-date can eliminate challenges later on.
What to Do If a Life Insurance Claim Is Denied Due to the Contestability Clause
If your loved one’s death occurred within the first two years of their policy and the claim has been denied, you’re not out of options—but time is critical.
Your first step should be to request a detailed explanation of the denial and obtain a copy of the original application and the insurer’s claim file. These documents will help identify whether the denial is based on a genuine misrepresentation or an unfair interpretation.
Then, consult an experienced life insurance attorney who specializes in contestability-related denials. These cases are highly technical, and most beneficiaries are unaware of how to fight back effectively. A skilled lawyer can identify weak spots in the insurer’s argument and build a powerful appeal.
At our firm, we routinely submit 100- to 200-page legal briefs breaking down the insurer’s reasoning, exposing flaws in their investigation, and citing relevant case law. This level of detail is often what it takes to force insurers to reverse a denial and pay what’s owed.
Why You Need a Lawyer with Experience in Contestability Disputes
Not all attorneys understand life insurance litigation—especially when contestability clauses are involved. These cases often depend on subtle wording in the application, medical records, and policy exclusions that general practitioners may overlook.
Our firm has handled hundreds of claims denied during the contestability period. We’ve recovered millions in wrongfully withheld benefits by proving that alleged misrepresentations were:
Unintentional
Irrelevant to the cause of death
Not material to the underwriting decision
Based on information the insurer already had access to
Example: We represented a family in New York whose claim was denied over a missing disclosure of high cholesterol. The death was caused by a car accident. We proved the omission was unrelated and immaterial, and the full $750,000 payout was secured.
Conclusion: Know Your Rights and Take Action
The contestability clause exists to prevent fraud—but insurers often use it to deny legitimate claims. If you’ve been told your loved one’s claim is denied because of a supposed misstatement in the application, don’t assume it’s a lost cause. With the right legal help, you can challenge the denial and fight for the benefits your family is entitled to.
Contact us today for a free consultation. We don’t get paid unless we recover for you. If your claim was denied due to a contestability clause, let us help you overturn it and secure the protection your loved one intended for you. Call us if you need a beneficiary dispute attorney in South Carolina