When a loved one passes away and you file a life insurance claim, it’s common for the insurance company to request the deceased person’s medical records. Many beneficiaries are surprised by this request and wonder whether it is legal, necessary, or a sign that the claim may be denied.
In Florida, life insurance companies can request medical records after death, but there are limits on what they can request and how those records can be used. Understanding your rights can help protect your claim and avoid unnecessary delays.
Why Do Life Insurance Companies Request Medical Records?
Life insurance companies typically request medical records to verify information related to the policy and the cause of death. Common reasons include:
- Confirming the cause of death
- Reviewing pre-existing medical conditions
- Determining whether application information was accurate
- Evaluating whether policy exclusions apply
- Investigating claims filed during the contestability period
This review is part of the insurer’s standard claim investigation process, especially if the policy is relatively new.
The Contestability Period in Florida
Most life insurance policies include a two-year contestability period. If the insured person dies within that period, the insurer may conduct a more thorough investigation. This often includes requesting:
- Hospital records
- Primary care physician records
- Specialist records
- Pharmacy records
- Prior diagnostic testing
- Autopsy reports (if applicable)
During this time, the insurance company is looking for material misrepresentations in the policy application—such as undisclosed medical conditions, smoking history, or prior treatment.
Are Medical Records Still Requested After Two Years?
Yes, but typically for more limited purposes. After the contestability period expires, insurers generally focus on:
- Confirming the cause of death
- Determining whether a policy exclusion applies (such as suicide or risky activity exclusions)
At this stage, they usually cannot deny a claim based on application misstatements unless fraud is involved.
Do Beneficiaries Have to Authorize the Release?
In most cases, yes. The insurer will ask the beneficiary or personal representative to sign a HIPAA-compliant authorization allowing the release of medical records.
However, you are not required to sign overly broad authorizations. Some requests may seek:
- Entire lifetime medical records
- Records unrelated to the cause of death
- Records from decades before the policy was issued
These broad requests may be excessive and can unnecessarily delay the claim.
Red Flags to Watch For
A request for medical records does not automatically mean your claim will be denied. However, certain behaviors may signal problems:
- Repeated requests for additional records
- Requests covering decades of medical history
- Long delays after records are submitted
- Requests for unrelated specialists or conditions
- Silence from the insurer after receiving documents
These tactics are sometimes used to delay payment.
What Information Can the Insurance Company Use?
Insurance companies may use medical records to:
- Verify accuracy of the application
- Determine whether exclusions apply
- Confirm the cause and manner of death
They cannot use irrelevant medical information to deny a claim improperly. For example, an unrelated condition should not affect a claim unless it directly relates to policy terms.
Can You Limit the Scope of the Request?
Yes. Beneficiaries often have the right to:
- Narrow the timeframe of records
- Limit requests to relevant providers
- Require written explanations for broad requests
- Submit records directly instead of blanket authorizations
Limiting the scope can speed up the claim process.
What Happens After Records Are Submitted?
After reviewing the records, the insurance company typically will:
- Approve the claim and issue payment
- Request additional documentation
- Place the claim under further investigation
- Deny the claim (rare, but possible)
If a claim is denied, the denial must usually include a written explanation.
When Should You Contact a Florida Life Insurance Attorney?
You may want to speak with an attorney if:
- The insurer keeps requesting more records
- The claim is delayed for months
- The insurer alleges misrepresentation
- The policy is within the contestability period
- The claim is denied
Early legal involvement can sometimes prevent unnecessary delays and help ensure the insurer does not overreach.
The Bottom Line
Yes, life insurance companies can request medical records after death in Florida, and this is often a normal part of the claims process. However, beneficiaries are not required to agree to overly broad requests, and insurers must use those records appropriately.
Understanding your rights can help you avoid delays and ensure the claim is handled fairly.
If you are facing delays, repeated record requests, or a denial, consulting a Florida life insurance attorney can help protect your rights and move the claim forward.
Have you or someone you know been denied a life insurance claim? Contact Florida Life Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Miami Attorney Gonzalez-Sirgo directly at jp@yourattorneys.com or by text at (305) 929-8935.
This article is for informational purposes only and does not constitute legal advice.
