$350,000 Denied Pacific Life Insurance Claim Successfully Recovered
Our life insurance dispute law firm is proud to announce the resolution of a $350,000 denied life insurance claim from Pacific Life. The insurer initially denied the claim on the basis of alleged misrepresentations in the application related to undisclosed legal history. After a comprehensive legal investigation and advocacy by our attorneys, we overturned the denial and secured the full payout for our client. This case highlights a common and preventable issue—failing to disclose key facts on a life insurance application. When insurance companies discover omissions after a claim is filed, they often use those omissions to rescind the policy. However, with experienced legal support, many of these denials can be challenged and reversed.
Why Failing to Disclose Criminal Convictions Can Lead to Life Insurance Denial
One of the more overlooked—but critical—application questions concerns criminal history. Insurance companies consider prior convictions material because they may increase the risk profile of the applicant. A person with a criminal conviction may be perceived as engaging in higher-risk behaviors, particularly if the offense involves violence, substance use, or reckless conduct. For example, a conviction for driving under the influence (DUI) might suggest a higher chance of accidental death, especially in an auto-related incident. If an applicant fails to disclose a conviction on the application, and that omission is later discovered—especially during the contestability period (typically the first two years after policy issuance)—the insurer may deny the claim, asserting that it would not have issued the policy or would have issued it under different terms. Even if the conviction seems unrelated to the cause of death, it can be enough to void the policy if it is considered a material misrepresentation. However, applicants are not always trying to deceive—many simply misunderstand the application or don’t realize they need to include minor or older convictions. In such cases, legal defenses are available.
Other Common Application Omissions That Can Lead to Claim Denials
Life insurance applications are long, complex, and often confusing. Unfortunately, even minor omissions or misunderstandings can give insurers grounds to deny claims. Below are common areas where failing to disclose information can jeopardize a life insurance policy:
Pre-existing medical conditions like diabetes, cancer, or heart disease
Past surgeries or hospitalizations that may indicate chronic illness
Tobacco, alcohol, or drug use, including occasional or recreational use
High-risk occupations such as mining, construction, or offshore work
Dangerous hobbies like skydiving, scuba diving, or motor racing
Travel to high-risk countries, particularly those with travel advisories or conflict
Mental health history, including treatment for depression or anxiety
Reckless behavior, such as multiple traffic violations or substance-related arrests
Changes in health between application and policy issuance
Prior denials of insurance, which may indicate high-risk classification
Pending lawsuits or criminal charges that raise liability or risk concerns
Financial instability, including bankruptcies or foreclosures
Military service or deployment, especially to combat zones
Family history of serious illnesses, like early-onset heart disease or cancer
Significant weight changes, which may signal an underlying health problem
Participation in extreme sports, such as mountaineering or base jumping
Planned international travel that may put the insured at risk
Existing life insurance coverage from other providers
Use of different names or aliases, which may cause identity verification issues
Any one of these omissions—if considered material to the underwriting decision—can be used by the insurer to deny a future claim. That’s why it is essential for applicants to provide full and honest answers on every part of the application. However, if a denial occurs, it is not always final. Our law firm regularly challenges denials stemming from application errors, helping families recover benefits they were rightfully promised.
FAQ: Failing to Disclose Information on a Life Insurance Application
Can my life insurance claim be denied if the insured had a criminal conviction?
Yes, if the conviction was not disclosed on the application and is considered material to the underwriting decision, the insurer may deny the claim, especially if the policy is within the contestability period.
Do I have to disclose misdemeanors or only felonies?
You must follow the specific wording on the application. If it asks for all convictions, both misdemeanors and felonies must be disclosed. Omitting either could be used to deny a claim.
Is a DUI conviction considered high-risk by insurers?
Yes. A DUI is often treated as a red flag for increased mortality risk, particularly in auto-related deaths. It’s a common reason for denied claims if not disclosed.
Can my claim be denied for forgetting to list a past surgery?
Yes, especially if the surgery was related to a serious or chronic condition. Omissions involving medical history are among the most common reasons for claim denials.
Is failure to disclose therapy or counseling a problem?
It can be. Mental health treatment, even for anxiety or depression, may be considered material by insurers. If asked on the application, it must be disclosed.
Can the insurer deny the claim if the applicant didn’t disclose travel plans?
Yes. Some policies exclude coverage for high-risk travel or require prior disclosure of international trips. Failing to disclose this can affect the payout.
What happens if I didn’t mention another life insurance policy I already had?
Omitting existing coverage can raise concerns about over-insurance or application fraud. This omission is often considered material and may be grounds for denial.
How long does the insurer have to contest the policy based on omissions?
Most life insurance policies include a two-year contestability period during which the insurer can deny claims for misstatements or omissions, regardless of cause of death.
Can the insurer deny the claim even if the omission had nothing to do with the death?
Yes. During the contestability period, insurers can deny claims based on material misstatements, even if the omitted fact had no connection to the insured’s death.
What if the omission was unintentional or a misunderstanding?
You may still be able to recover the benefit. Courts consider whether the misstatement was material and whether the insured acted in good faith. An attorney can help prove the claim should be paid.
Can name changes or use of an alias affect my claim?
Yes, if the insurer cannot verify the identity of the applicant or discovers inconsistencies. Always provide accurate identifying information.
Is financial history like bankruptcy relevant to life insurance applications?
In some cases, yes. Insurers may ask about bankruptcies or foreclosures as part of financial underwriting. Omitting this information can raise red flags.
Do insurers look into prior insurance denials?
Yes. If you fail to disclose a previous denial and it is discovered later, the insurer may question why coverage was denied elsewhere and use it to contest your claim.
What if I didn’t disclose military service or deployment?
Military service, especially in conflict zones, can impact insurability. If omitted, the insurer may argue that the risk was misrepresented and attempt to deny the claim.
Are weight changes considered material?
They can be. Unexplained or rapid weight loss or gain may indicate a serious condition. If related to an undisclosed health issue, it could be used against the claim.
Is it illegal to omit information on a life insurance application?
It may be considered insurance fraud if the omission is intentional and material. Even unintentional errors, however, can still lead to a claim denial.
Can a lawyer help if a claim is denied for non-disclosure?
Yes. A skilled life insurance attorney can review the application, assess whether the omission was truly material, and build a case to challenge the denial.
Will every omission lead to a denial?
Not necessarily. If the omitted information is not material to the underwriting process, or if the policy is beyond the contestability period, the claim may still be payable.
Can an insurer deny a claim for behavior like reckless driving or substance abuse?
If those behaviors were not disclosed and are discovered after death, especially if they contributed to the cause of death, insurers may use that as a basis for denial.
How do I avoid these issues when applying for coverage?
Be honest, thorough, and consult with a licensed insurance agent or attorney. Disclose everything that may be relevant—even if it seems minor—to protect your beneficiaries.