The contestability period is a limited time, usually the first two years after the policy takes effect, when the life insurance company has the legal right to investigate the application for errors. If the insured passes away during this window, the insurer may try to void the policy based on something the applicant said or failed to say. This clause is not automatic grounds for denial, but it often becomes a weapon in the insurer’s hands to delay or avoid payment.
Even honest mistakes can be scrutinized. A forgotten trip to the emergency room, a misdated prescription, or an overlooked past surgery might be labeled a “material misrepresentation.” If the insurer believes the information would have changed their decision to offer coverage, they may attempt to rescind the policy and refund the premiums instead of paying the benefit. If you need Wisconsin life claim denial help call us.
Real Examples of Contestability-Based Claim Denials
Misreported Blood Pressure
A man in Ohio applied for life insurance and stated he had no issues with hypertension. He later died of a stroke within 18 months of buying the policy. The insurer denied the claim, citing a past medical record showing a borderline high blood pressure reading during a work physical. We proved this reading was never diagnosed or treated and that the application question lacked clarity. The insurer settled the claim for the full $250,000.
Tobacco Use Misunderstanding
In Georgia, a young woman was denied after dying in a car accident just 14 months after her policy was issued. The insurer claimed she lied about smoking because a toxicology report showed nicotine. However, she had recently quit and was using nicotine patches during the application process. We demonstrated that she disclosed her cessation efforts to the agent, and the case was resolved in the beneficiary’s favor.
Omitted Mental Health Counseling
A policyholder in Illinois had attended several therapy sessions for anxiety but did not disclose them on the application. After his sudden death, the insurer used this omission to deny a $500,000 claim. We showed that the client had not been formally diagnosed and was not prescribed medication, and the sessions were not material to the underwriting decision. The denial was reversed after legal pressure.
Minor Surgery Not Disclosed
In Texas, a woman underwent an outpatient procedure to remove a benign skin cyst but forgot to mention it on her life insurance application. She passed away within the contestability period due to an unrelated heart condition. The insurer attempted to rescind the policy. We argued that the surgery had no relevance to the cause of death and would not have changed the underwriting decision. Full benefits were paid following a formal appeal.
When the Contestability Period Ends
After the two-year contestability window closes, most policies become incontestable. This means the insurer can no longer void the contract based on errors or omissions on the application unless they can prove intentional fraud. Even then, fraud must be clearly documented. Most post-contestability denials are based on other grounds, such as nonpayment of premiums, exclusions like suicide clauses, or criminal activity.
However, insurers sometimes attempt to revive contestability arguments even after the two years have passed. We’ve seen insurers claim the clock did not start due to delayed premium payments or argue that the policy never properly took effect. These tactics can be challenged and often fail under legal scrutiny.
Insurers Often Misuse the Contestability Clause
While the clause is intended to protect insurers from fraud, it is frequently abused. Companies investigate nearly every death within the first two years, regardless of how minor the issue. They dig through old medical records, pharmacy logs, and even social media posts to find discrepancies. Families expecting a payout are instead met with investigative letters, delay tactics, and complex legal arguments.
We frequently see denials based on:
Innocent mistakes or forgotten details
Vague or poorly worded application questions
Information the insurer could have discovered during underwriting
Issues unrelated to the cause of death
These denials can be overturned. We have successfully challenged dozens of them by gathering complete medical records, proving immateriality, and showing that answers were given truthfully and in good faith.
How We Fight and Win Contestability Denials
Our attorneys understand the legal nuances of contestability disputes. In one recent case, a policyholder was accused of misrepresenting their weight. The insurer found an old medical note listing a higher weight than what was written on the application. We showed that the weight had fluctuated and that the agent had recorded it during an in-person visit. The discrepancy was minor, and the policy would have been approved regardless. The insurer reversed its denial after we submitted a legal brief highlighting their obligation under state law.
In another case, we helped a California family recover $200,000 after the insurer denied the claim based on a missed colonoscopy disclosure. The policyholder had rescheduled the procedure, which never occurred. There was nothing to disclose. The insurer folded once we provided email confirmations and physician notes.
Our team works with beneficiaries across the country and has recovered millions from denials tied to contestability claims. We understand how to present the facts, apply pressure, and, when necessary, take legal action.
What You Should Do If Your Claim Was Denied
Do not accept a refund of premiums or a generic denial letter without speaking to a qualified life insurance lawyer. Many families lose out on hundreds of thousands of dollars simply because they didn’t know they could fight back. Denials based on the contestability period often fall apart under legal scrutiny.
We offer free consultations and can review the denial letter, the original application, and relevant documents. If we take your case, you pay nothing unless we recover benefits for you.