Most beneficiaries are caught off guard by a denial letter. After years of paying premiums, families expect the life insurance company to pay without question. But the reality is far more complicated. Many denials are issued based on technicalities, and few people realize how often they can be overturned. Below are five of the most common questions we hear—along with examples of how we’ve helped clients fight back and win. If you need legal help for life insurance disputes in Alaska call us.
1. Why was my life insurance claim denied?
The most common reasons include alleged misrepresentation on the application, a lapse in coverage, policy exclusions, or beneficiary disputes. But the reason listed in the denial letter is not always the full story.
We helped a woman in Florida whose husband’s policy was denied because he had "failed to disclose a heart condition." The truth? He had disclosed it to the agent, who failed to record it in the application. The insurer blamed the deceased and voided the policy, but we gathered internal communications and proved the agent’s error. The insurer paid the full $500,000 benefit after we filed suit.
Always request the denial letter and a copy of the policy. Review them with a life insurance attorney to determine whether the denial was lawful or just an excuse to avoid payment.
2. How do I appeal a denied life insurance claim?
Appealing involves more than just writing a letter. You’ll need to analyze the insurer’s reasoning, collect supporting documents, and present a legal argument backed by evidence. The appeal must usually be filed within 60 to 90 days of the denial.
We represented a family in New Jersey after a claim was denied due to an alleged lapse in coverage. The insurer claimed premiums hadn’t been paid. We obtained bank records and correspondence showing that the insurer had changed billing systems without notifying the policyholder, causing an unintentional lapse. Our appeal forced a reversal before litigation was needed.
A successful appeal requires strategy. An attorney can structure the argument, cite case law, and pressure the insurer to act in good faith.
3. What are my options if my life insurance claim is denied?
You typically have three paths: an internal appeal, a complaint to your state insurance department, or filing a lawsuit. Many clients attempt the first option on their own but come to us after hitting a wall.
In a recent ERISA case, a claim under a group employer policy was denied after the insured failed to complete one section of the enrollment form. The employer deducted premiums, but the insurer claimed the coverage was never activated. We filed a federal lawsuit arguing that the employer's conduct created a reasonable expectation of coverage. The court agreed, and our client received the full $250,000 benefit.
Each option requires different steps and deadlines, especially if the policy falls under federal law like ERISA or FEGLI. Legal guidance is critical.
4. Can I still get life insurance coverage if my claim is denied?
If you’re a beneficiary, a denied claim does not affect your ability to buy coverage for yourself. But if you’re a policyholder who was denied at the application stage, the reason for denial may impact future applications.
In one case, a man applied for life insurance and was denied based on a “fraud flag” tied to a previously denied claim involving his deceased brother. The issue was a misfiled document in the insurer’s internal system. We cleared the record by contacting the company’s legal department and submitting proof of the brother’s valid designation. The man was able to reapply successfully.
If your family is being penalized for a past denial, a lawyer can often resolve the issue without court.
5. How long does it take to receive a decision on a life insurance claim?
Straightforward claims typically resolve within 30 to 60 days. But delays can stretch for months when the insurer launches an investigation, especially if they question the cause of death, suspect misrepresentation, or there’s a conflict between beneficiaries.
We handled a case where the insured died while traveling overseas. The insurer delayed payment for nine months, citing the need to verify foreign medical records. During that time, they requested multiple documents already submitted. After we threatened litigation and highlighted the unreasonable delay, they released the benefit within 10 days.
When a claim drags on with no resolution, that may be a sign of bad faith. Legal pressure often accelerates the timeline.