Denied Life Insurance Claim for Misrepresentation? Here's How We Recovered $1,000,000.00 from MetLife
If your loved one’s life insurance claim has been denied due to misrepresentation on the application, you're likely feeling frustrated, confused, and powerless. But you should know that not all denials are final. Our life insurance attorneys recently secured a $1,000,000.00 payout from MetLife, which had originally denied the claim based on alleged misrepresentation. This case proves that beneficiaries can fight back—and win—when insurance companies wrongly deny a claim.
Why Life Insurance Companies Deny Claims—and When They’re Wrong
Life insurance companies like MetLife, Prudential, and New York Life often deny claims based on technicalities. These denials are typically framed as final decisions, but they can often be overturned with the help of experienced life insurance attorneys. Here are some of the most common reasons given for a denial:
Misrepresentation on the Application: The insurer claims the deceased provided false or incomplete information—often regarding medical history, lifestyle, or prescription drug use.
Contestability Period Denials: Insurers may tell you that claims within the first two years can be denied outright. That’s not true. The contestability period only allows the insurer to investigate and validate the application—not deny the claim arbitrarily.
Policy Lapse Due to Non-Payment: If a premium payment was missed or delayed, insurers may assert that the policy lapsed. However, we often find errors in lapse notices, grace period notifications, or address records.
Exclusions (Drug/Alcohol Use, Risky Activities): Certain causes of death, such as overdose or extreme sports, may fall under exclusions—but insurers often stretch these clauses too far.
Fraud Allegations: Some insurers use vague fraud claims to stall or avoid payment, even when there's no evidence supporting the accusation.
The Truth About Misrepresentation and the Contestability Period
When a policyholder dies within the first two years of coverage, the insurer can contest the claim—but only by reviewing the application for material misrepresentations. That means they must prove that inaccurate information was provided and that it was significant enough that the insurer wouldn’t have issued the policy had they known the truth.
In our recent MetLife case, the insurer alleged that the policyholder had failed to disclose a pre-existing medical condition. However, our legal team obtained medical records, reviewed application language, and demonstrated that the question was ambiguous—and that the information allegedly omitted was not material. The denial was overturned, and $1,000,000.00 was paid out to the rightful beneficiary.
What Should You Do If a Life Insurance Claim Is Denied?
Do not take the insurance company's denial at face value. Many claims are wrongfully denied, especially within the contestability period. Insurance providers rely on the assumption that most beneficiaries won’t challenge their decision. But you have legal rights—and a strong legal team can turn things around.
To protect your right to the life insurance benefit, consider the following steps:
Request a written explanation for the denial
Gather and preserve all policy documents, applications, and communications
Do not submit additional information or sign statements without legal advice
Consult with a life insurance attorney experienced in denied claims
Our law firm specializes in overturning denials for misrepresentation, policy lapse, exclusions, and interpleader disputes. We’ve recovered millions of dollars in benefits for beneficiaries across the country.
Frequently Asked Questions
What counts as a material misrepresentation on a life insurance application? A material misrepresentation is any incorrect or omitted information that would have influenced the insurer’s decision to issue or rate the policy. This could involve health conditions, smoking status, alcohol use, or prescribed medications.
Is a denial within the contestability period automatically valid? No. The contestability period allows insurers to investigate a claim, but they must still prove that a material misrepresentation occurred. Many denials during this period can be successfully challenged.
How can I tell if my loved one's policy lapsed due to nonpayment? Review the policy's payment history, grace period terms, and any notices sent by the insurer. If the insurer failed to provide adequate notice or sent mail to an old address, the lapse may be invalid.
Can exclusions for drug or alcohol use be contested? Yes. Insurers often apply exclusions too broadly or without sufficient evidence. If there’s no clear connection between drug/alcohol use and the cause of death, the exclusion may not apply.
What happens if I win an appeal or lawsuit? If you successfully challenge a denied life insurance claim, the insurer is typically required to pay the full death benefit—often with interest. In some cases, they may also be responsible for attorney’s fees.