$50,000 Denied Globe Life Insurance Claim Successfully Resolved
Just this week, our top life insurance attorneys successfully resolved a $50,000 denied claim involving Globe Life. The insurer initially denied the claim based on unwritten and unfair eligibility requirements that were never disclosed in the policy. Our client was blindsided by the denial, believing they had complied with all terms of the policy. Our law firm challenged the denial, exposed the insurer’s improper practices, and obtained the full benefit payout. This case highlights a troubling tactic used by some insurers—imposing requirements not found in the written contract. These tactics are not only unfair but often illegal, and beneficiaries have the right to fight back.
Can Insurance Companies Deny Claims Based on Unfair or Undisclosed Eligibility Requirements?
Yes, insurers may attempt to deny a claim by relying on unwritten or vaguely referenced eligibility requirements—but such practices are often challengeable under contract law. Life insurance is a contract between the insurer and the policyholder, and the terms of that contract must be clear and complete. If an insurer imposes post-issuance requirements that were not outlined in the policy, they may be acting in bad faith. Courts generally hold insurers to the "four corners" of the policy. In other words, if a requirement isn’t in the policy or application documents, it cannot be retroactively enforced. This is especially true in group or simplified issue policies, where medical underwriting is minimal and policy terms are expected to be transparent. Our law firm frequently sees denials based on arbitrary documentation demands, unpublished underwriting rules, or vague "eligibility" disputes—all of which can be overturned with the right legal approach.
Examples of Unfair Eligibility Requirements That Can Trigger Denial
Some of the most common unfair eligibility requirements that may lead to claim denials include:
Retroactively applying new underwriting standards that didn’t exist at the time of policy issuance
Failing to disclose underwriting guidelines that would have affected how the applicant completed the application
Requiring a medical exam or test without proper notice and later using the results to deny a claim
Applying policy exclusions that are not stated in the policy contract
Changing the terms or conditions of coverage without notifying the policyholder
Requiring excessive documentation far beyond what the policy requires to process a claim
Imposing unreasonable waiting periods that are not clearly outlined in the policy language
Delaying payment based on internal procedures not found in the policy, such as unverifiable internal audits
Relying on agent representations rather than written terms, then denying based on conflicts between what the agent said and what the policy states
Enforcing vague or subjective eligibility criteria, such as "must be in good health" without defining what that entails
In all of these situations, insurers rely on the policyholder’s lack of legal knowledge to enforce unwritten rules. But the law is clear: insurance companies must honor the written terms of the policy. If they do not, they may be liable not only for the death benefit but also for interest, attorney’s fees, and in some cases, punitive damages for acting in bad faith.
The Legal Remedy for Unfair Denials
In the recent Globe Life case, our client was denied benefits due to a supposed eligibility issue never mentioned in the policy. The insurer claimed the policy should not have been issued based on information available at the time—but that information was never part of the application process, nor was it required by the written underwriting guidelines. We argued that Globe Life waived its right to enforce unwritten conditions by issuing the policy without clarifying those requirements. The insurer ultimately agreed to pay the full $50,000 benefit. If your life insurance claim was denied due to arbitrary or hidden requirements, contact our legal team. We handle all denied claims on a contingency basis—you pay nothing unless we win.
FAQ: Denied Life Insurance Claims Due to Unfair Eligibility Requirements
Can an insurer deny a claim based on rules that aren’t in the policy?
No. Insurers must abide by the written terms of the contract. If the requirement is not clearly stated in the policy or application, it should not be used to deny a claim.
Is it legal for a life insurance company to change underwriting guidelines after the policy is issued?
No. Retroactively applying new standards is generally considered unfair and can be challenged. The insurer must assess the application based on the rules in effect at the time of underwriting.
What if the insurer says I didn’t qualify but never explained why?
Insurers must provide a specific and valid reason for denial. If the reason involves undisclosed eligibility terms, you may have grounds to contest the decision.
Can a claim be denied if a medical exam was never requested but later deemed necessary?
Not usually. If no medical exam was required when the policy was issued, the insurer cannot later claim the absence of an exam is grounds for denial.
What happens if the insurer applies an exclusion that’s not in the policy?
That’s improper and potentially unlawful. Any exclusions must be clearly listed in the policy. Applying hidden exclusions may justify legal action.
Can an insurer deny a claim for not meeting undocumented internal requirements?
Insurers may try, but these denials are highly contestable. The policyholder is only bound by the written terms of the contract.
Are excessive documentation requests a valid reason to delay or deny a claim?
No. Insurers must process claims based on the documentation outlined in the policy. Requiring unreasonable paperwork may be viewed as a delay tactic or bad faith.
What is a waiting period, and can it be added after the policy is issued?
A waiting period is the time between policy issuance and eligibility for coverage. It must be clearly stated in the contract. Insurers cannot impose new waiting periods after the fact.
What if the policy terms changed and I wasn’t notified?
Policy changes must be communicated in writing and agreed to by the policyholder. Unilateral changes without notice may be unenforceable.
Can an insurer enforce eligibility based on what the agent said instead of the written policy?
No. Courts usually favor the written policy over oral statements. If there is a conflict, the written contract prevails.
How can I prove the requirement wasn’t in the policy?
By reviewing the policy, application, and any supplemental documents. An attorney can help you build a case based on what's legally enforceable.
Is it common for insurers to deny claims based on internal guidelines?
Yes. Some insurers reference internal procedures not shared with the applicant. These are often not enforceable and can be challenged.
What is a bad faith denial?
Bad faith occurs when an insurer unreasonably refuses to pay a claim. Denying benefits based on unwritten or unfair requirements can be considered bad faith.
Can I sue the insurance company for an unfair denial?
Yes. If a claim was denied without a valid reason outlined in the policy, you may be able to sue for breach of contract and bad faith.
What if I didn’t know I was violating a guideline?
If the guideline wasn’t disclosed, you generally cannot be held accountable for it. The insurer has a duty to clearly state all requirements.
Can the insurer delay the claim indefinitely while investigating?
No. Most states have regulations requiring claims to be paid within a reasonable period—often 30 to 60 days—unless there is a clear reason for delay.
Do I need an attorney to fight an unfair denial?
Yes. Insurers have legal teams on their side. An experienced life insurance lawyer can level the playing field and help recover full benefits.
How long does it take to resolve a denial based on unfair eligibility?
It varies, but many cases settle within a few months. Litigation may take longer. Legal representation often accelerates the process.
What should I do if my claim was denied for vague or unexplained reasons?
Request the denial in writing and consult a life insurance attorney. Many denials based on vague or hidden criteria can be successfully challenged.
Does Globe Life frequently deny claims based on eligibility issues?
Our firm has handled numerous denied Globe Life claims. If your claim was denied, we can review your case and advise whether the denial can be overturned.