A denied life insurance claim is more than just frustrating—it can completely derail a family’s financial stability after the death of a loved one. While insurers often point to policy details to justify these decisions, many of those denials are based on vague language, misapplied exclusions, or minor paperwork errors. Understanding how to respond to a denial rooted in "policy issues" is critical to reversing it and securing the benefits you’re entitled to. If you have a Minnesota life insurance policy dispute call us.
How to Tell if It’s a Denial or Just a Delay
Before taking action, determine whether your claim has been truly denied or just delayed. Delays are common during the first two years of a policy (the contestability period), when insurers are allowed to investigate the application for misstatements. For example, a claim might be delayed if the insurer is waiting on a certified death certificate or reviewing medical records. A formal denial, however, is issued in writing and typically cites one of the following reasons:
Policy lapse due to nonpayment
Cause of death falls under a policy exclusion
Misrepresentation during the application process
In one case, a widow’s claim was denied because her husband’s policy was allegedly inactive—but an attorney later proved the final premium was paid within the grace period.
Common Policy-Based Reasons Life Insurance Claims Are Denied
Insurance companies use specific language in policies to limit their liability. These clauses can be confusing and often leave room for misinterpretation. Frequent denial reasons tied to policy terms include:
Material misstatements: The insured may have forgotten to disclose a previous medical condition or prescription, even if it had nothing to do with the cause of death.
Excluded causes of death: Suicide, overdose, or death during criminal activity may be used as grounds for denial.
Coverage limitations: Some policies only cover accidental death or include a narrower definition of "accident" than expected.
Example: A family in Georgia was denied a $250,000 payout when the insurer claimed a fall down the stairs was not “accidental” because the insured had a history of vertigo. An appeal reversed the denial after a medical expert was brought in.
How the Contestability Period Impacts Claims
Most life insurance policies include a contestability period—typically the first two years after the policy is issued—during which the insurer can investigate the application for misrepresentations. Denials during this time often involve:
Minor application errors (e.g., reporting a wrong weight or omitting a past diagnosis)
Medical history the insurer claims would’ve changed the underwriting decision
Deaths unrelated to the alleged misstatement
In one case, a man who died in a car accident had his claim denied after the insurer discovered he hadn’t disclosed a past anxiety diagnosis. A legal review showed the condition was irrelevant to his death, and the payout was eventually issued.
Claims Denied Due to Policy Exclusions
Even outside the contestability period, insurers often deny claims based on exclusions written into the policy. Common exclusions include:
Suicide within the first two years
Drug or alcohol-related deaths
High-risk activities like skydiving or off-road racing
Death while committing a felony
Example: A claim was denied after a policyholder died during a motorcycle race. The insurer cited a “hazardous activity” exclusion, but the attorney argued the race was a charity event, not an inherently dangerous act. The court sided with the beneficiary.
Administrative and Filing Errors Can Trigger Denials
Even simple errors can jeopardize a claim. These include:
Submitting the wrong version of a death certificate
Listing the wrong Social Security number on forms
Failing to notify the insurer of a change in address or beneficiary
In one case, two children were listed as co-beneficiaries, but only one was contacted by the insurer. The other didn’t respond in time, causing the claim to be denied and later disputed in court.
Steps to Take If Your Life Insurance Claim Was Denied
If you’ve received a denial, act quickly. Here’s what you should do:
Request a full written explanation from the insurer
Review the original policy, including all riders and amendments
Gather supporting documents, such as payment records, medical files, and beneficiary updates
Consult an experienced life insurance attorney, especially if ERISA or employer-based policies are involved
Our firm prepares detailed legal briefs—often exceeding 100 pages—to counter policy-based denials. In most cases, this results in a successful reversal without the need for litigation.
Don’t Let a Policy Denial Cost You the Benefits You Deserve
Life insurance companies often rely on complex policy language to avoid paying claims. But with legal support, you can push back against unfair denials and recover the benefits your loved one intended for you. If your claim was denied due to a policy issue, contact us for a free consultation. We’ll review your case, explain your rights, and help you fight for the payout your family needs.