Life insurance claims are frequently denied when insurers discover a past mental health diagnosis that was not disclosed on the application. In this case, Prudential Life Insurance relied on that exact tactic. The denial was aggressive, emotionally devastating, and legally flawed. With the right legal pressure, it was reversed and the family received the benefits their father intended them to have.
How Prudential Used Mental Illness to Deny the Claim
After Robert passed away unexpectedly, his daughter Sarah submitted a life insurance claim believing the policy was secure. Prudential denied the claim after reviewing medical records and discovering that Robert had a history of depression that was not disclosed on the application. The insurer alleged material misrepresentation and attempted to void the policy entirely.
Like many families, Sarah and her siblings were blindsided. Robert had managed his condition privately, had no intent to deceive, and his death had nothing to do with depression. None of that mattered to the insurer at first. Prudential treated the omission as an automatic escape hatch from paying the policy.
Our firm stepped in and immediately challenged the denial.
Why the Prudential Denial Was Legally Weak
Mental health omissions do not automatically justify denying a life insurance claim. Insurers must prove far more than the existence of a diagnosis. In this case, Prudential failed on several key legal points.
First, there was no evidence Robert intended to deceive the insurer. Courts routinely distinguish between fraud and good faith misunderstandings, especially where applications ask vague or broad health questions.
Second, the depression diagnosis had no causal connection to the death. Material misrepresentation generally requires that the omitted information would have affected underwriting in a meaningful way or contributed to the loss. Prudential could not establish either.
Third, the application questions themselves were ambiguous. When insurers ask general questions about mental health without clear definitions, the burden is on them to clarify before issuing the policy. They did not.
Once these flaws were documented and presented, Prudential reversed its position and paid the claim.
How Insurers Use Mental Health as a Denial Strategy
Mental illness is one of the most frequently exploited areas in life insurance litigation. Insurers often treat it differently than physical conditions, even when symptoms are mild, controlled, or remote in time. Common denial tactics include:
Non disclosure allegations
Insurers argue that any failure to disclose therapy, medication, or diagnosis is material, even if it occurred years earlier and had no relevance to death.
Contestability period fishing expeditions
If death occurs within the first two years, insurers pull full medical records and look for any mental health reference they can use to justify rescission.
Suicide misclassification
Ambiguous deaths are sometimes labeled as suicide to trigger exclusion clauses, even when evidence does not support that conclusion.
Pre existing condition arguments
Insurers attempt to claim mental illness contributed indirectly to death, even when medical evidence does not support that theory.
These tactics rely on stigma, fear, and the assumption that families will not fight back.
Why Mental Health Denials Are Often Reversible
Mental illness alone does not void a life insurance policy. Insurers must prove materiality, intent, and policy compliance. Many cannot. Courts routinely reject denials where:
• The insured answered application questions honestly based on their understanding
• The condition was managed, remote, or unrelated to death
• The insurer failed to clarify vague application responses
• The suicide exclusion period had expired
• The insurer acted unreasonably or in bad faith
In Robert’s case, Prudential could not meet its legal burden.
How Our Firm Fights Mental Health Based Denials
We approach these cases aggressively and methodically. Our strategy includes:
• Analyzing application language for ambiguity
• Reviewing underwriting guidelines to test materiality claims
• Examining medical records for causation gaps
• Challenging misuse of suicide exclusions
• Asserting breach of contract and bad faith liability
That pressure is what forces insurers to reverse wrongful denials.
You Do Not Have to Accept a Mental Health Denial
Life insurance is meant to protect families, not punish them for seeking mental health care. If your claim was denied because of depression, anxiety, PTSD, therapy, or medication history, that denial may be unlawful.
We routinely challenge insurers that attempt to avoid payment based on mental health, including Prudential, New York Life, AIG, Mutual of Omaha, and others. These cases are winnable, even after an initial rejection.
If your life insurance claim was denied due to an alleged mental health misrepresentation, legal review can make the difference between nothing and full recovery.