Our firm recently recovered a $350,000 life insurance payout that Pacific Life had wrongfully denied. The insurer rescinded the policy based on the insured’s alleged failure to disclose prior legal issues on the application. After reviewing the claim documents, application responses, and internal underwriting protocols, we determined that Pacific Life had misclassified the omission and overstepped its legal authority during the contestability period. Our attorneys presented a compelling argument that the conviction in question was not material to risk and that the denial lacked a factual and legal basis. The insurer ultimately reversed its position and paid the full death benefit to our client. If you have South Carolina life insurance claim issues call us.
How Failure to Disclose Criminal History Can Trigger Denial
One of the more damaging oversights on a life insurance application is failing to report a prior conviction. Life insurance companies treat criminal history as a potential indicator of high-risk behavior. Even nonviolent offenses such as DUI, disorderly conduct, or drug possession can result in elevated premiums or outright rejection of the application. If the applicant fails to disclose a conviction, and the insurer discovers it during a post-claim investigation, the company may rescind the policy for material misrepresentation.
In this Pacific Life case, the insured had a misdemeanor conviction from years earlier that was never listed on the application. The policy had been in force for just over one year when the insured passed away unexpectedly. Although the cause of death was entirely unrelated to the prior offense, the insurer took the position that it would not have issued the policy had it known about the conviction. Our legal team pushed back by showing that Pacific Life had not inquired further into criminal background during underwriting and that similar applicants with identical convictions had been approved for coverage under similar terms. The denial collapsed under legal scrutiny.
Common Omissions That Lead to Disputes After Death
While criminal history is a major flashpoint in post-claim reviews, it is far from the only reason insurers deny benefits. Life insurance applications are often filled out under time pressure, with the help of agents who may not clearly explain the importance of certain questions. Small omissions—like forgetting to report a previous surgery or underreporting tobacco use—can snowball into claim denials if they are later framed as concealment.
Here are real-world examples of omissions that have resulted in claim disputes our firm has resolved:
An insured failed to disclose outpatient treatment for anxiety five years prior; a $200,000 claim was denied even though death was due to a cardiac event. We overturned the denial by proving the condition was minor and not material to underwriting.
A $500,000 claim was denied after the insurer discovered that the policyholder had traveled to a country under State Department advisory within weeks of application. Although the trip had been brief and uneventful, the insurer claimed nondisclosure. Our attorneys showed that the question was ambiguously worded, and the claim was paid.
In another case, a $250,000 policy was rescinded due to a failure to disclose prior insurance denials. The applicant had misunderstood the question, thinking it only referred to active policies. We proved that the misstatement was accidental and the claim was reinstated.
Application Errors Are Common But Denials Are Not Always Justified
Insurers often rely on rigid interpretations of application answers when evaluating post-death claims, particularly during the two-year contestability period. Any discrepancy whether caused by misunderstanding, agent input error, or honest oversight can be cited as a basis for rescission. But not every omission rises to the level of a material misrepresentation. The law requires insurers to prove that the omitted fact would have changed their underwriting decision. In many cases, they fail to meet that burden.
In the Pacific Life case, we also uncovered that the company had access to public records that would have revealed the conviction at the time of underwriting. By proceeding with the policy despite that information being available, Pacific Life essentially waived its right to later rescind the policy based on that same fact. These legal nuances are critical and often missed when claimants attempt to contest a denial on their own.
Legal Help Makes the Difference in Rescinded Life Insurance Claims
Insurers are quick to deny claims over mistakes in the application but often slow to justify those denials when pressed. Our firm specializes in uncovering errors in the insurer’s own procedures, highlighting inconsistencies in how they assess risk, and applying legal pressure to force fair outcomes. The $350,000 recovery in this case is just one example of how a denied claim can be reversed with experienced legal advocacy.
If you’ve received a life insurance denial citing omissions in the application whether related to criminal history, medical background, or lifestyle factors contact us. We may be able to secure the benefits your loved one intended you to receive.