Denied life insurance claims are far more common than most families expect. Premiums may have been paid for years, yet when a loved one dies, the insurer issues a denial instead of a check. These denials often rely on technical language, selective interpretation of records, or procedural traps that beneficiaries are not equipped to navigate on their own.
At LifeInsuranceAttorney.com, our life insurance lawyers focus exclusively on denied and delayed life insurance claims nationwide. We routinely challenge wrongful denials issued by insurers such as Assurity Life, Great-West Life, Gerber Life, Brighthouse Financial, AIG, Primerica, Penn Mutual, Sammons, Bestow, Ethos, Ladder Life, and others.
Understanding the terms insurers rely on is the first step in fighting back.
1. Material Misrepresentation and Non Disclosure
Material misrepresentation refers to information the insurer claims was false, incomplete, or omitted on the life insurance application. This may include:
• Failure to disclose a medical diagnosis such as heart disease, diabetes, or cancer
• Omission of mental health treatment or prescription medications
• Not reporting hazardous hobbies or occupations
• Errors involving age, income, or employment history
Insurers argue that had they known the omitted information, they would not have issued the policy or would have issued it on different terms. These allegations are most aggressively used during the contestability period, which is typically the first two years after the policy begins.
Importantly, not every mistake qualifies as material. Many denials hinge on vague questions, misunderstandings, or information that had no impact on underwriting.
2. Pre Existing Conditions and Policy Exclusions
Life insurance policies often contain exclusions tied to specific medical conditions or causes of death. Insurers may deny claims by arguing that:
• A known condition existed before the policy was issued and was not disclosed
• The death resulted from a condition excluded under the policy
• The insured was engaged in an excluded activity at the time of death
Common exclusions involve suicide during the suicide clause period, illegal activity, extreme sports, or hazardous occupations. These exclusions must be clearly written and narrowly applied. Many denials fail because the insurer stretches the exclusion beyond what the policy actually allows.
3. Policy Lapse and Missed Premium Payments
A policy lapse occurs when premiums are not paid on time and the insurer claims coverage ended before death. Families are often unaware a lapse occurred until after the claim is filed.
Lapse denials frequently involve:
• Missed grace period notices
• Bank or automatic payment errors
• Cognitive decline or illness affecting the policyholder
• Improper cancellation procedures
State law often requires strict notice and timing rules before a lapse is valid. Insurers do not always comply.
4. Incomplete or Inaccurate Claim Documentation
Insurers require specific documentation to process a claim. Missing or inconsistent paperwork is often used to justify delay or denial, including:
• Incomplete claim forms
• Errors on death certificates
• Missing medical or identity records
• Conflicting dates or personal information
These denials are procedural, not substantive. They are often designed to exhaust beneficiaries rather than resolve the claim.
5. Beneficiary Disputes and Interpleader Actions
When multiple parties claim entitlement to the same policy, insurers frequently refuse to decide who should be paid. Instead, they file an interpleader lawsuit and deposit the funds with the court.
Common triggers include:
• Conflicts between current and former spouses
• Outdated beneficiary designations
• Claims by children from prior relationships
• Allegations of undue influence
Interpleader protects the insurer, not the family. Legal representation is usually required to resolve these disputes efficiently.
6. Foreign Death and International Documentation Issues
Deaths occurring outside the United States often lead to denials based on documentation concerns. Insurers may challenge:
• Foreign death certificates
• Autopsy or medical records from abroad
• Identity verification
• Translation or authentication issues
These denials are frequently procedural. With proper validation through consular records, sworn statements, and certified translations, many foreign death claims can be recovered.
7. Prescription Medication and Substance Related Deaths
Claims involving prescription drugs, alcohol, or controlled substances receive heightened scrutiny. Insurers may rely on toxicology reports to argue:
• Overdose or misuse
• Undisclosed addiction history
• Intentional self harm
A positive toxicology result does not automatically justify denial. The insurer must prove the exclusion applies under the policy language and that the substance caused the death.
8. Fraud Allegations
Fraud involves intentional deception, not mistakes. True fraud includes falsified documents, staged deaths, or deliberate concealment of material facts.
Insurers frequently misuse fraud allegations to justify denials based on minor errors or ambiguous records. These denials often collapse when intent is examined closely.
9. Misunderstanding of Policy Terms
Many denials stem from confusion over policy provisions such as:
• Contestability clauses
• Suicide exclusions
• Coverage effective dates
• Eligibility requirements
Insurers rely on the assumption that beneficiaries will not challenge their interpretation. Courts often interpret ambiguous policy language in favor of coverage.
We Fight and Win Denied Life Insurance Claims Nationwide
A denial letter is not the final word. Many denied life insurance claims are overturned once the policy language, facts, and insurer conduct are properly examined.
Our firm focuses exclusively on life insurance claim disputes, including denials, delays, beneficiary conflicts, and interpleader cases. We routinely reverse denials involving major insurers across the country.
If your claim has been denied by Assurity Life, Gerber Life, Great-West, Brighthouse, Penn Mutual, AIG, Primerica, Ethos, Ladder Life, or any other insurer, legal review is critical. If you have a Pennsylvania life insurance policy dispute, contact us today.
Frequently Asked Questions
Why was my life insurance claim denied
Common reasons include alleged misrepresentation, missed premiums, policy exclusions, documentation issues, or beneficiary disputes.
What is the contestability period
Usually the first two years after a policy is issued, during which insurers may investigate application statements.
Can a claim be denied after the contestability period
Only in cases of proven fraud. Most application based denials are barred after this period.
What if the policy lapsed
Lapse does not automatically end the analysis. Improper notice or administrative error can invalidate the lapse.
Can overseas deaths be denied
Yes, but many such denials are procedural and can be challenged successfully.
Do I need a lawyer
Yes. Insurers use specialized denial strategies. An experienced life insurance attorney can identify weaknesses and pursue recovery.