$78,500 Kemper Life Insurance Claim Successfully Resolved After Denial
We’re pleased to share that our firm successfully overturned a $78,500 claim denial from Kemper Life Insurance. This case involved several complex issues, including alleged misrepresentation, contestability period scrutiny, and questions about the insured’s pre-existing conditions. Denied life insurance claims can devastate families, especially when the denial is based on vague or technical grounds. At the Lassen Law Firm, we specialize in resolving these disputes and securing rightful payouts for beneficiaries across the country. Our legal team regularly handles claims denied by major insurers like Kemper, MetLife, AARP, and Lincoln Heritage, among many others.
Why Life Insurance Claims Get Denied
Life insurance companies often deny claims based on specific policy provisions, underwriting issues, or discrepancies found during claim investigations. One of the most common reasons is non-disclosure, where the policyholder unintentionally or deliberately omits vital health or lifestyle information during the application process. For example, if a policyholder fails to disclose a pre-existing medical condition or claims to be a non-smoker despite regular tobacco use, companies such as Midland National, Reliance Standard, and American General may deny the claim, arguing that the policy would not have been issued under truthful circumstances.
Misrepresentation and the Contestability Period
The contestability period—typically the first two years after a policy is issued—gives insurers the right to closely investigate any claim, especially if the insured dies during this window. Providers like Jackson Life, Foresters, and Hartford Life often scrutinize the original application and medical history for inconsistencies. Even if the cause of death is unrelated to any error, a misstatement about something like weight, prescription use, or prior hospitalizations can lead to denial. This legal loophole is often used to avoid paying legitimate claims during an already tragic time for beneficiaries.
Pre-Existing Conditions and Medical Disclosure
Insurers such as USAA, Lumico, and Boston Mutual are known for reviewing the insured’s medical records after a death, especially if there’s any suspicion of withheld information. If the policyholder had a known condition—like heart disease or diabetes—but failed to disclose it, the insurer may deny the claim based on misrepresentation. These issues are especially problematic within the contestability period but can sometimes result in retroactive rescission even afterward, depending on the policy and jurisdiction.
Policy Lapse Due to Non-Payment
Another leading cause of claim denials is non-payment of premiums. If the policyholder misses payments and fails to reinstate the policy within the insurer’s grace period, the coverage can lapse. Companies such as VOYA, Symetra, and Transamerica frequently deny claims based on lapse provisions. While some insurers like Globe, Ameritas, and AAA offer reinstatement options, these often require medical re-evaluation and back premiums paid in full—something many don’t realize until it’s too late.
Missing or Incomplete Documentation
Even when the policy is active and all information is accurate, claims can be delayed or denied due to incomplete documentation. Insurers such as Columbian Mutual, Horace Mann, and Integrity require a complete claims packet, including a certified death certificate, completed claim forms, and proof of beneficiary identity. Failing to submit all required items can stall or derail the claims process. If inconsistencies appear in any documentation, insurers may delay further while conducting internal investigations.
Exclusions and Clauses Hidden in the Fine Print
Policy exclusions are another area where insurers deny claims. Most policies contain clauses that exclude deaths caused by:
Suicide within the first two years (suicide clause)
Illegal activity
Participation in high-risk hobbies like scuba diving or skydiving
War or acts of terrorism Providers such as Pekin, MassMutual, and Corebridge enforce these provisions rigidly. Additionally, alcohol-related deaths or drug overdoses can result in denials if the policy excludes such causes, as seen with Anthem, CMFG, and Dearborn. In some cases, even ambiguous language can be used by insurers to deny coverage unless challenged by legal counsel.
Occupational and Travel-Related Exclusions
Life insurance policies often include hazardous occupation exclusions, which are particularly relevant to workers in construction, mining, or law enforcement. If death occurs during the course of dangerous work and the policy includes an exclusion rider, insurers like First Colony, Humana, or Mutual Savings may deny the claim. Travel exclusions also appear in many policies. If the insured died while visiting a country classified as high-risk, insurers like State Life, TIAA, and Alfa may reject the claim on that basis—even if the trip seemed harmless at the time.
Beneficiary Designation Disputes
Errors in beneficiary designations can also result in claim denials or interpleader lawsuits. If the named beneficiary is deceased, or if multiple people claim entitlement to the policy, insurers such as Progressive, Assurant, and National Western may deposit the funds with a court and let the parties fight it out. This can delay the benefit for months or even years, depending on the dispute. Regularly reviewing and updating beneficiary information is a critical but often overlooked responsibility for policyholders.
Fraud and Application Errors
Insurers have the right to investigate suspected fraud, especially when claim circumstances seem irregular. Whether it's falsifying age, gender, or financial interest, fraud accusations can void the policy. Companies like Equitrust, American Memorial, and New Era are known for conducting rigorous reviews of claim submissions. Application errors caused by the insurer’s own agent can also complicate matters. If the agent incorrectly records information or provides incomplete answers on behalf of the policyholder, insurers like Sagicor, Protective, or Prudential may still deny the claim and leave the burden on the beneficiary to prove intent or correct the record.
Challenging a Denied Claim
Denied claims are not the end of the road. Beneficiaries have the right to appeal and, if necessary, pursue litigation. Reviewing the denial letter, gathering medical records, and providing updated documentation are often part of the first appeal. If the insurer is acting in bad faith, such as delaying communication or rejecting a claim without proper justification, legal action may be warranted. Our attorneys routinely challenge insurers like Unum, Physicians Mutual, and CUNA Mutual, forcing them to honor valid policies and pay rightful beneficiaries.
Let Us Help You Recover a Denied Claim
Our life insurance lawyers understand the tactics used by insurers to delay or deny claims. Whether your issue involves non-disclosure, a lapsed policy, misrepresentation, or a contestability period denial, we have the experience to fight back. In the Kemper Life case, we gathered supporting documents, demonstrated policyholder intent, and held the insurer accountable for its unjust denial—securing the full $78,500 payout. If your claim was denied, contact us today for a free consultation. When you have a Georgia life insurance dispute, we are here for you.
Frequently Asked Questions About Denied Life Insurance Claims
Why was my life insurance claim denied? Common reasons include misrepresentation, non-payment of premiums, exclusions in the policy, errors in the application, or incomplete documentation.
What is the contestability period in a life insurance policy? It is a period, usually the first two years, during which the insurer can investigate and deny claims based on inaccuracies in the original application.
Can a life insurance policy be canceled after the insured dies? Yes, if the insurer discovers misrepresentation or fraud during the contestability period, they can rescind the policy and deny the claim.
What happens if the policy lapsed before the insured died? If premiums were not paid and the grace period expired, the policy likely lapsed, and the insurer may deny the claim unless the policy was reinstated.
Can missing documents delay a life insurance claim? Absolutely. Missing death certificates, incomplete claim forms, or lack of identity verification can all cause delays or denials.
Are drug and alcohol-related deaths usually covered? Not always. Many policies exclude deaths caused by substance abuse, especially if explicitly stated in the policy exclusions.
What if my loved one had a hazardous occupation? If the policy contained a hazardous work exclusion rider, the claim could be denied unless the cause of death was unrelated or not covered by the rider.
Can travel to dangerous countries impact a life insurance claim? Yes. Policies may include travel exclusions for specific high-risk regions, and death in those areas can void coverage.
What if there’s a mistake in the beneficiary designation? If the beneficiary is deceased, missing, or unclear, the insurer may delay payment or file an interpleader action to let the courts decide.
Can life insurance be denied due to a past illness? Yes, if that illness was not disclosed and is deemed material to the underwriting process, the claim may be denied.
How do I appeal a denied life insurance claim? Start by reviewing the denial letter and gathering all supporting documentation. Contacting an experienced life insurance attorney can significantly improve your chances of success.
Do insurance companies have to explain why a claim was denied? Yes, they are legally required to provide a written reason for denial, and in many states, they must do so within a specific timeframe.
Can I sue the insurance company for a denied claim? Yes, if the denial was wrongful or in bad faith, you may pursue a lawsuit for breach of contract or bad faith insurance practices.
Is there a time limit for appealing a denied claim? Yes. Each insurer sets a specific window—often 60 to 180 days—for filing an appeal. Failing to act within that period can result in losing your right to challenge the denial.