A life insurance denial often comes with vague wording, shifting explanations, and repeated requests for documents you already sent. The fastest way to regain control is to make one organized, written request in the first week that forces the insurer (and sometimes the employer or plan administrator) to disclose what they relied on, what they are missing, and what deadlines actually apply.
Below is a practical, copy and paste document list you can use immediately. It is written for both individual life insurance and group life insurance, including ERISA plans. If you are not sure which one you have, request everything that applies. You can always narrow it later.
Why week one matters
In the first week after a denial, the insurer is usually still shaping the “story” of the claim. If you quickly demand the underlying records, you reduce the chance that the carrier will later say something was unavailable, destroyed, overwritten, or never part of the file. You also learn whether the denial is based on policy language, coverage status, underwriting allegations, or a beneficiary dispute.
How to send the request
Send your request by a method that creates a paper trail: email plus certified mail, or portal upload plus email confirmation. Save the sent email, the PDF you uploaded, and any portal confirmation number. Put “Document Request” and the claim number in the subject line.
If the claim involves an employer plan, also send a copy to the plan administrator (often the employer) and any third party administrator handling enrollment.
The exact document list to request in week one
Use the sections below as a checklist. You can request them all at once.
1) The denial package and internal claim file
Ask for:
The complete claim file, including the activity log, claim notes, diary notes, and internal “worksheet” documents
All letters, emails, faxes, and portal messages sent or received about the claim
Any recorded statements, transcripts, summaries, or interviewer notes
All phone call recordings related to the claim, including call center and adjuster calls
A list of every document the insurer says it considered in making the denial
A list of every document the insurer says is missing, with a specific explanation of why it matters
Why it matters: many denials are built on internal notes and summaries that do not match the actual records.
2) The policy, plan documents, and amendments
For individual policies, ask for:
The full policy, including all riders, endorsements, and amendments
The application and every page of the application packet
The policy delivery receipt and any “good health” statements at delivery
Any policy change forms and policy illustrations issued after the policy began
For group life or employer coverage, ask for:
The plan document and the complete summary plan description (SPD)
Any wrap document, amendments, and updates effective on the date of loss
The insurance certificate booklet and any booklets provided to employees
The policy between the carrier and the employer, including schedules and eligibility definitions
Any administrative services agreement if a third party administrator is involved
Why it matters: a surprising number of group denials rely on a definition that is not in the document the employee received.
3) Proof of coverage and premium history
Ask for:
A coverage verification document showing effective date, coverage amount, and beneficiary designation on file
Premium payment history and billing statements
Any lapse, termination, reinstatement, or grace period notices
Any refund checks issued, with explanation and accounting
For group plans: payroll deduction records, employer remittance records, and carrier invoices
Why it matters: “not in force” denials often collapse when you show deductions, remittances, or reinstatement processing.
4) Beneficiary and ownership records
Ask for:
All beneficiary designation forms ever submitted, including drafts and rejected submissions
Portal audit logs showing submission date and acceptance or rejection
Any correspondence about beneficiary changes or disputes
Ownership change forms and processing notes
Any interpleader evaluation notes if there is a beneficiary dispute
Why it matters: beneficiary disputes commonly turn on timing and whether a change was processed or merely received.
5) Underwriting, contestability, and rescission materials
If the insurer mentions misrepresentation, contestability, or rescission, ask for:
The full underwriting file, including underwriting notes and internal worksheets
The Medical Information Bureau (MIB) inquiry results, if any
All prescription database reports and query results
All motor vehicle reports, credit based insurance reports, and third party consumer reports
Any “post claim underwriting” referral, checklist, and communications
The rescission review memo or committee notes, if any exist
The exact questions the insurer claims were answered incorrectly, with the insurer’s evidence for each
Why it matters: insurers often cherry pick records to argue a misstatement was “material.”
6) Medical records and cause of death materials relied on
Ask for:
The specific medical records the insurer relied on, not just the ones you submitted
The complete attending physician statement (APS) request and responses
Toxicology, autopsy, and medical examiner reports if used
Police reports, incident reports, and investigative summaries if used
Death certificate and all amendments or corrected versions if there is a discrepancy
Any medical chronology or summary prepared by the insurer or its vendors
Why it matters: even when the insurer has records, it may be quoting them inaccurately or leaving out key context.
7) Accidental death and dismemberment documents
If this is an AD&D denial or the insurer is saying “not accidental,” ask for:
The AD&D policy language defining “accident” and exclusions
The insurer’s medical consultant review and any independent review reports
Any causation analysis the insurer performed
The insurer’s guidelines for classifying deaths as accidental vs medical or natural
Any internal committee notes used to approve the denial
Why it matters: AD&D denials frequently rely on a classification framework that is never shown to families.
8) Employer records for group coverage disputes
If the insurer blames the employer, request from the employer and the carrier:
Enrollment forms and evidence of insurability submissions
Open enrollment elections and confirmation statements
HR portal records and audit logs showing elections, changes, and approvals
Job status records: active, leave of absence, termination, disability, FMLA dates
Hours worked records and eligibility calculations
Salary and coverage amount calculations used to set benefits
Any conversion or portability notices, and proof of mailing or delivery
Why it matters: group denials often turn on an administrative failure, not an actual eligibility problem.
9) Deadlines, appeal rights, and suit limitation language
Ask for:
The exact appeal deadline and the source of that deadline in the governing documents
Any contractual limitation period for filing suit and where it appears
A copy of all claim procedures used by the insurer or plan administrator
Confirmation whether the insurer considers the denial “final” and whether another internal review exists
Why it matters: missing a deadline can lock in a denial even when the denial is wrong.
10) Vendor and third party records
Ask for:
The names of all vendors involved, including investigators, medical review companies, and data vendors
All vendor reports, emails, and attachments
Any surveillance, social media review, or background report materials if used
Any data broker outputs used in the claim decision
Why it matters: a lot of “evidence” is actually third party summaries that contain mistakes.
A simple copy and paste document request letter
You can adapt the following and send it today.
Subject: Claim Number [______] Document Request and Written Explanation of Denial Basis
To Whom It May Concern:
I am requesting a complete copy of the claim file and all documents relied on in connection with the denial of the life insurance claim for [Insured Name], date of death [______]. Please include the entire claim file, all internal claim notes and activity logs, all correspondence, all recordings or transcripts, and a complete list of all documents considered and all documents claimed to be missing.
In addition, please provide the full governing policy or plan documents applicable on the date of loss, including all riders, endorsements, amendments, the SPD if this is a group plan, and all eligibility and benefit calculation materials.
If the denial involves coverage status, lapse, or termination, please provide the premium history, billing and remittance records, lapse or termination notices, reinstatement materials, and any refund check accounting.
If the denial involves beneficiary, ownership, contestability, rescission, or misrepresentation issues, please provide all beneficiary and ownership records, all underwriting and post claim underwriting materials, and the complete basis for each alleged misstatement including the insurer’s supporting evidence.
Please confirm in writing the applicable deadlines for appeal and any contractual limitation period for filing suit, and identify the exact document provisions that establish those deadlines.
Thank you. Please send the documents electronically to [email] and also by mail to [address]. If you contend any material is privileged or not available, please provide a privilege log or a written explanation identifying what is being withheld and why.
Sincerely,
[Name]
[Relationship to insured]
[Phone]
[Email]
[Mailing address]
What to do while you wait
While the insurer gathers the file, do three things:
Create a timeline: application date, effective date, premium payments, beneficiary changes, employment status changes, date of death, date of claim, date of denial.
Preserve evidence: screenshots of portals, enrollment confirmations, paystubs, emails with HR or the insurer.
Do not sign releases blindly: broad authorizations can let insurers fish for unrelated material. Use narrow, time limited authorizations.
Common “week one” mistakes families make
Sending documents repeatedly without demanding the claim file and the exact reason they matter
Relying on phone calls instead of written requests
Missing the appeal deadline because the denial letter was unclear
Accepting “we can’t provide the file” without escalating the request
When you should get help quickly
You should consider getting legal help early if:
The denial cites misrepresentation, contestability, or rescission
It is an ERISA group plan with a short appeal deadline
There is a beneficiary dispute or the insurer threatens interpleader
The insurer refuses to provide the policy or plan documents
Related reading
Life Insurance Claim File Checklist
Why Life Insurance Companies Ask for Documents Twice
Misleading Life Insurance Denial Letter Phrases
ERISA Administrative Record Traps in Life Insurance Claims
If you want help, use our contact form