$100,000 AARP Life Insurance Claim Successfully Resolved
The top life insurance claim lawyers at our firm are proud to announce the successful recovery of a $100,000 life insurance payout from AARP on behalf of our client. The claim, initially delayed due to confusion over benefit eligibility and rider provisions, was resolved in full after our legal team intervened. Many AARP life insurance policies include optional riders, such as the accelerated death benefit rider, which can provide crucial financial relief for policyholders facing serious medical conditions. Unfortunately, claims under these riders are often misunderstood or denied by insurers based on narrow interpretations or vague policy language. We help families navigate and challenge those denials to secure the funds they are entitled to.
What Is an Accelerated Death Benefit Rider?
An accelerated death benefit rider is a supplemental feature that allows a life insurance policyholder to access a portion of their policy’s death benefit while still alive if they meet certain qualifying conditions. Most commonly, these conditions include being diagnosed with a terminal illness, requiring long-term care, or being unable to perform key activities of daily living. The funds received through an accelerated death benefit are typically deducted from the total death benefit that would otherwise be paid to beneficiaries upon the insured’s passing. This rider is often used to cover medical bills, hospice care, or other end-of-life expenses, helping relieve the financial burden on both the policyholder and their loved ones.
Common Reasons for Denial of Accelerated Death Benefit Claims
Although the purpose of an accelerated death benefit is to provide early financial relief, insurance companies may deny claims under this rider for various technical or administrative reasons. These denials can feel especially devastating, as they often come at a time when the policyholder is seriously ill or facing life-altering medical expenses. Below are common reasons insurers may deny accelerated benefit claims:
Failure to meet eligibility criteria – The policyholder does not qualify under the policy’s definition of terminal illness or long-term care requirements.
Insufficient medical documentation – Medical records do not adequately support the diagnosis or fail to show that the condition meets the policy’s severity thresholds.
Incomplete or inaccurate application – Errors or omissions in the application for the rider, or in the original life insurance application, may be used to contest eligibility.
Condition not listed as qualifying – The specific illness or disability does not fall within the policy’s defined list of covered conditions or circumstances.
Waiting period not satisfied – The rider may include a waiting period, often 90 to 180 days, that must be met before benefits are payable.
Maximum benefit already paid out – The insured may have previously accessed part of the death benefit and reached the policy’s cap on accelerated distributions.
Exclusion applies – The illness is excluded by the rider, such as certain pre-existing conditions or illnesses not recognized as terminal under the policy’s terms.
Noncompliance with treatment – The insurer may argue that the policyholder is not eligible because they have refused care or are not following medical advice.
Age restrictions – Some policies limit the rider to individuals below a certain age or require it to be exercised within a specific timeframe.
Cause of condition tied to exclusionary events – If the illness or decline is related to an excluded cause, such as suicide or a criminal act, the claim may be denied.
When a claim for an accelerated death benefit is denied, it’s often due to strict or unclear policy language. In many cases, policyholders and their families aren’t even aware of the rider’s limitations until a claim is submitted and rejected. If you’ve had an accelerated death benefit denied, you may still have legal options—especially if the denial was based on ambiguous language or a misinterpretation of the policy terms.
Legal Help for Denied Accelerated Death Benefit Claims
In our recent AARP case, the insurer delayed processing the claim due to conflicting interpretations of the policyholder’s diagnosis and the rider’s eligibility requirements. After a thorough review of the medical records and the policy language, we successfully demonstrated that the policyholder met the criteria for the benefit. Our legal advocacy led to a full $100,000 payout to the beneficiary. If you’re facing a denied or delayed claim under an accelerated death benefit rider, contact our law firm for immediate assistance. We work on a contingency basis—no fees unless we recover your benefits.
FAQ: Denied Accelerated Death Benefit Claims
What is an accelerated death benefit rider in life insurance?
It’s a policy add-on that allows the insured to receive part of their death benefit early if diagnosed with a terminal illness or if they meet long-term care requirements.
Who qualifies for accelerated death benefits?
Typically, individuals with a diagnosis of terminal illness (with a life expectancy of 6 to 24 months), or those unable to perform a set number of activities of daily living.
Can my claim be denied if I don’t meet the policy’s definition of terminal illness?
Yes. Insurers will closely examine the diagnosis to determine whether it aligns with their specific eligibility criteria.
What if my condition is serious but not explicitly listed in the policy?
If the condition doesn’t meet the listed definitions, the claim may be denied. However, ambiguous definitions can be legally challenged.
Are there age limits for receiving accelerated benefits?
Some policies restrict the rider to policyholders under a certain age, typically 65 or 70. Exceeding the age limit may disqualify you.
Can pre-existing conditions affect my eligibility?
Yes. If your illness existed before the rider was added and is excluded in the terms, your claim could be denied.
What happens if I’ve already used part of the benefit?
Once the maximum amount under the rider is paid out, additional benefits may be denied. The death benefit will be reduced accordingly.
Is there usually a waiting period for accelerated benefits?
Yes, many policies impose a waiting period—often several months—before the rider can be used. Filing a claim too early may result in denial.
What if the insurer says I didn’t provide enough documentation?
You may be able to appeal the decision. An attorney can help gather the necessary records and ensure they meet the insurer’s standards.
Can I reapply if my claim is denied?
In some cases, yes—especially if your condition worsens or additional documentation becomes available. A lawyer can help you refile or appeal.
What if the insurer claims I’m not following medical advice?
Insurers may argue noncompliance disqualifies you. If this is the basis for denial, it may be challengeable with medical expert input.
Can a beneficiary dispute an accelerated death benefit denial after the policyholder’s death?
Yes. If the claim was wrongly denied or the insurer delayed approval until the insured passed, the beneficiary may pursue legal action.
Are taxes owed on accelerated death benefits?
Generally, no—if the insured is terminally ill as defined by the IRS. However, consult a tax professional for your specific situation.
Do all life insurance policies include this rider automatically?
No. Some require you to opt in or pay extra for the rider. Always confirm that it’s included in your specific policy.
Is AARP known to deny accelerated death benefit claims?
Like other insurers, AARP (underwritten by New York Life) may deny claims for technical reasons. We’ve successfully overturned such denials.
Do I need legal help to appeal an accelerated death benefit denial?
Yes. These cases often hinge on policy interpretation and medical documentation. A lawyer can build a strong case and deal directly with the insurer.