Fighting Life Insurance Denials Due to Misrepresentation: Common Cases and How We Can Help
Life insurance claims are often denied due to alleged misrepresentation on the part of the policyholder during the application process. Insurance companies claim that the insured person either failed to disclose important information or provided false details that could have affected their risk profile. While some misrepresentations may be intentional, others are due to misunderstandings, lapses in memory, or the insured’s lack of awareness about their own health or history. Our top-rated life insurance lawyers specialize in fighting these denials to ensure beneficiaries receive the death benefits they are entitled to.
Examples of Life Insurance Claims Denied Due to Misrepresentation
1. Physician's Mutual Life Insurance Claim Denied
Case Details: A woman applied for life insurance, claiming she had never been diagnosed with cancer. She died from ovarian cancer two years later. Physician's Mutual denied the claim, alleging she had previously been diagnosed with breast cancer and failed to disclose this information.
Outcome: The beneficiary contested the claim, arguing that the woman was unaware of her breast cancer diagnosis at the time of application and that it was not material to her risk of ovarian cancer.
2. NEA Life Insurance Claim Denied
Case Details: A woman applied for life insurance stating that she did not have any medical conditions or take any medications. Two months later, she died from a drug overdose. NEA Life denied the claim, alleging she had been prescribed medications for anxiety, depression, and insomnia, which she did not disclose.
Outcome: The beneficiary argued that the woman did not intentionally misrepresent her health status and that her medications were not material to her cause of death.
3. Military Life Insurance Claim Denied
Case Details: A man applied for life insurance, claiming he had no risky hobbies or occupations. He died in a skydiving accident six months later. Military Life denied the claim, alleging he had been an avid skydiver and failed to disclose this hobby.
Outcome: The beneficiary contested the denial, claiming that the man did not consider skydiving a hobby, and it was not material to his risk of death.
4. Texas Service Life Insurance Claim Denied
Case Details: A woman applied for life insurance, claiming she had no criminal records or traffic violations. She died in a car accident a year later. Texas Service Life denied the claim, alleging she had been convicted of DUI twice and had several speeding tickets that she did not disclose.
Outcome: The beneficiary argued that the woman did not intentionally misrepresent her driving history, and that it was not material to her cause of death.
5. Penn Treaty Life Insurance Claim Denied
Case Details: A man applied for life insurance, stating that he was single and had no dependents. He died of natural causes two years later. Penn Treaty denied the claim, alleging that he had been married with three children and had lied about his marital and family status.
Outcome: The beneficiary argued that the man did not know about his marriage or children and that it was not material to his risk of death.
6. Summit National Life Insurance Claim Denied
Case Details: A woman applied for life insurance stating she was 30 years old. She died of a stroke three years later. Summit National Life denied the claim, alleging she was actually 40 years old and had falsified her birth certificate.
Outcome: The beneficiary contested the denial, stating that the woman was unaware of her true age, and the misrepresentation was not material to her risk of death.
7. ALCPA Life Insurance Claim Denied
Case Details: A man applied for life insurance, claiming he had no family history of heart disease. He died of a heart attack three years later. ALCPA Life denied the claim, alleging that he had several relatives who had died from heart disease and had failed to disclose this information.
Outcome: The beneficiary argued that the man did not know about his family history and that it was not material to his risk of death.
8. Reliaster Life Insurance Claim Denied
Case Details: A woman applied for life insurance, claiming she did not have any foreign travel plans. She died in a terrorist attack in France one year later. Reliaster Life denied the claim, alleging she had booked a trip to France before applying for the policy and had lied on her application.
Outcome: The beneficiary argued that the woman did not intentionally misrepresent her travel plans and that they were not material to her risk of death.
9. Delaware Life Insurance Claim Denied
Case Details: A man applied for life insurance, stating he did not have any life-threatening illnesses. He died of AIDS six months later. Delaware Life denied the claim, alleging that he had been diagnosed with HIV before applying for the policy and failed to disclose this information.
Outcome: The beneficiary contested the claim, arguing that the man did not know about his HIV status, and that it was not material to his risk of death.
10. Iowa Farm Life Insurance Claim Denied
Case Details: A woman applied for life insurance, claiming she did not have a history of substance abuse. She died of a heroin overdose two years later. Iowa Farm denied the claim, alleging she had been addicted to heroin for years and failed to disclose this on her application.
Outcome: The beneficiary contested the denial, arguing that the woman did not intentionally misrepresent her substance abuse history, and that it was not material to her cause of death.
11. Western United Life Insurance Claim Denied
Case Details: A woman applied for life insurance, stating that she was a U.S. citizen. She died of natural causes three years later. Western United Life denied the claim, alleging she was an undocumented immigrant and had used a fake identity to obtain the policy.
Outcome: The beneficiary argued that the woman did not intentionally misrepresent her citizenship status and that it was not material to her risk of death.
12. Christian Fidelity Life Insurance Claim Denied
Case Details: A man applied for life insurance, claiming he did not have any other life insurance policies. He died of a heart attack five years later. Christian Fidelity Life denied the claim, alleging he had several other life insurance policies and failed to disclose them.
Outcome: The beneficiary contested the denial, arguing that the man did not know about his other policies and that they were not material to his risk of death.
13. Sagicor Life Insurance Claim Denied
Case Details: A woman applied for life insurance, claiming she did not have any history of mental illness. She died by suicide one year later. Sagicor Life denied the claim, alleging that she had been diagnosed with bipolar disorder before applying for the policy.
Outcome: The beneficiary contested the claim, arguing that the woman did not intentionally misrepresent her mental health status, and that it was not material to her cause of death.
How Our Life Insurance Lawyers Can Help
If your life insurance claim was denied due to misrepresentation, it is essential to seek experienced legal help. Our top-rated life insurance lawyers can assist in fighting these denials, even in cases where the misrepresentation was unintentional or due to misunderstandings. Here's how we can help:
Reviewing the Policy: We will carefully review the policy to identify any ambiguous language or misapplications of the terms that led to the denial.
Gathering Evidence: Our team will help gather medical records, witness statements, and any other necessary documentation to challenge the insurer’s claim of misrepresentation.
Appealing the Denial: We will assist you in filing an appeal and ensure that all the proper information is presented to the insurance company to get the claim approved.
Taking Legal Action: If the insurance company continues to deny the claim, we will take legal action to ensure that the policyholder’s rights are protected and that the rightful beneficiaries receive the benefits.
Insurance Companies We’ve Helped with Misrepresentation Denials
Our experienced attorneys have successfully resolved claims involving major insurers, including:
Physician’s Mutual Life
AIG Life Insurance
Prudential Life
Metlife Life Insurance
Transamerica Life Insurance
Protective Life Insurance
FAQ Section
What is misrepresentation in a life insurance application?
Misrepresentation refers to providing false, incomplete, or misleading information on the life insurance application, which the insurer claims affects the risk assessment.Can a life insurance claim be denied if the misrepresentation was unintentional?
Yes, insurers may deny claims based on misrepresentation, even if it was unintentional. However, we can help challenge these denials if the misrepresentation was not material to the cause of death.How can I challenge a life insurance denial due to misrepresentation?
Our attorneys will review the details of the claim and the policy language, gather necessary documentation, and file an appeal or pursue legal action to contest the denial.What happens if I didn’t know about a condition I failed to disclose?
If the condition was not known to the insured, this could be grounds to challenge the denial. We will investigate the facts and argue that the omission was not intentional or material.