At our law firm, we recently resolved a large MetLife denied life insurance claim, and we understand the frustrations that come with such situations. If you've experienced a denied claim, here's what you need to know and the steps you should take to fight for your benefits. If you have a beneficiary dispute attorney in Hawaii call us.
Why Life Insurance Claims Get Denied: Common Reasons
While insurers are legally required to pay out claims as long as the policy is in good standing, there are several reasons why they might deny a life insurance claim. Some of the most common reasons include:
Documentation Failure
If the required documentation—like a death certificate, medical records, or proof of premium payments—is missing, the insurer may deny your claim.Unpaid Premiums
If the premiums weren’t paid on time and the policy lapsed, the insurer may refuse to honor the death benefit claim.Suicide Within the Contestability Period
Many policies have a contestability period (usually 2 years) during which claims may be denied if the insured dies by suicide.Material Misrepresentation
If the insurer finds that you provided false information (such as failing to disclose health conditions) during the application process, they may deny the claim.No Proof of Death
Without a valid death certificate or adequate evidence of the cause of death, your claim might be denied.Claim Filed After the Deadline
Every life insurance policy has a filing deadline for claims. If you file a claim after the set deadline, it may be rejected.Failure to Designate a Beneficiary
If no beneficiary is named on the policy, the death benefit may be directed to the estate, which complicates the claims process.Billing Non-Covered Services
If the death occurred due to an excluded cause, like participating in high-risk activities or illegal behavior, your claim could be denied.Lack of Medical Necessity
If the insured was undergoing treatment that wasn’t medically necessary or died as a result of negligence, the claim might be denied.Listing the Life Insurance in a Will
If a policyholder has listed their life insurance as part of their will instead of specifying a beneficiary on the policy itself, the claim might face challenges.
FAQ: Frequently Asked Questions About Life Insurance Claim Denials
Can a life insurance claim be denied for no reason?
No, insurers must provide a valid reason for denying a claim. They are required by law to explain the reason in writing.
What should I do if my life insurance claim is denied?
First, request a written explanation from the insurer. Then, you can either appeal the decision yourself or consult with a life insurance attorney to help you navigate the process.
Can I sue my life insurance company for denying my claim?
Yes, you can file a lawsuit if your claim is wrongfully denied. A life insurance attorney can help you determine whether this is the best course of action.
What is the contestability period in life insurance?
The contestability period is typically the first two years of a life insurance policy. During this time, the insurer can investigate the policyholder’s application and deny a claim if there were any misrepresentations or omissions.
How long do I have to file a life insurance claim?
Each policy has a filing deadline, which you should be aware of. If you miss this deadline, your claim may be denied. Always check the terms of the policy.