Life Insurance Claim Denial

Individuals most often purchase life insurance to protect their loved ones in case of their death.  When someone passes away, the spouse or other dependants have to figure out how to pay the mortgage, bills, car loans and other debts.  Life insurance can provide the income supplement necessary to avoid a drastic change in lifestyle for those left behind.

After a loved one dies, the beneficiary of the life insurance policy will need to submit a claim form and an official copy of the death certificate to the insurance company.  In the situation where a death occurred less than two years after the policy was issued, the insurance company may want to rule out suicide as a cause of death.  Most insurance policies have a clause that states that a benefit will not be paid if the person committed suicide.

The insurance company will carefully analyze a claim before paying the benefit and unfortunately, sometimes a life insurance claim is denied.  Some of the most common reasons for life insurance claim denials include fraud by the insured or beneficiary and material misrepresentation on the life insurance application.  The material misrepresentation can occur on the original application or an amendment to the application.

A material misrepresentation is defined as a statement that if fully disclosed, would have most likely led to the denial of the life insurance application or a premium charged at a higher rate.  These misrepresentations can include just about any information listed on the application, such as age, income, employment history, smoking habits, drinking history, hobbies and driving record.  If the insurer believes that the policyholder was not truthful regarding a statement on the application, then the claim will be denied and no money will be paid to the beneficiary.

Disputing a life insurance claim denial is difficult, but it can be done.  The first step in fighting a life insurance claim denial is to contact an experienced Florida life insurance claims attorney, such as J.P. Gonzalez-Sirgo, P.A.  An attorney can review the life insurance company’s reasons for the denial and help build a strong case.  Many times, a lawyer will be able to show that the material misrepresentation, if it existed, was not serious enough to cause the life insurance claim to be denied.