When a loved one passes away, life insurance benefits are meant to provide financial stability during a difficult time. Unfortunately, insurance companies in Florida sometimes deny valid claims—leaving beneficiaries facing unexpected financial hardship. If your life insurance claim has been denied, you may have the right to file a lawsuit to recover the benefits owed.
Common Reasons Life Insurance Claims Are Denied
Insurance companies often cite one or more of the following reasons when denying a claim:
-
Alleged Misrepresentation on the Application – The insurer claims the policyholder gave false or incomplete information about health history, lifestyle, or other material facts.
-
Policy Lapse – The insurer argues that premiums were not paid on time, causing the policy to lapse before death.
-
Excluded Causes of Death – Some policies exclude coverage for certain causes of death, such as suicide within the first two years of the policy.
-
Contestability Period Issues – If the death occurs within the first two years of the policy, the insurer may investigate and attempt to rescind coverage.
-
Employer or Group Policy Disputes – With employer-provided policies, disputes may arise over eligibility, enrollment, or coverage levels.
Florida Laws Protecting Life Insurance Beneficiaries
In Florida, life insurance contracts are governed by both the terms of the policy and Florida statutes, such as:
-
Florida Statutes § 627.455 – Addresses policy incontestability after two years, except for nonpayment of premiums.
- Florida Unfair Insurance Trade Practices Act (F.S. § 626.9541) – Prohibits insurers from engaging in unfair claim settlement practices, such as misrepresenting policy provisions or failing to conduct a reasonable investigation.
Understanding these protections is crucial when challenging a denial.
Steps to Take Before Filing a Lawsuit
Before going to court, take the following steps:
-
Request a Written Denial Letter – This should explain the specific reason(s) for denial.
-
Review the Policy and Application – Compare the insurer’s stated reason with the actual policy language and application records.
-
Gather Supporting Documentation – Obtain medical records, premium payment records, and any correspondence with the insurer.
-
Appeal Internally – Some insurers have an internal appeal process that may resolve the dispute without litigation.
Filing a Lawsuit in Florida
If the insurer refuses to reverse its decision, you may file a lawsuit in Florida state or federal court (depending on jurisdiction) for breach of contract and, in some cases, insurance bad faith.
-
Breach of Contract – The primary claim alleging the insurer failed to pay benefits owed under the policy.
-
Bad Faith Claim – If the insurer’s denial was unreasonable, delayed without cause, or conducted in bad faith, you may be entitled to additional damages under F.S. § 624.155.
A successful lawsuit may recover:
-
The full policy benefit amount
-
Interest on delayed payments
-
Attorneys’ fees and costs (in certain cases)
-
Additional damages for bad faith (if proven)
Why Legal Representation Matters
Life insurance disputes often involve complex policy language, strict deadlines, and aggressive defense tactics by insurers. An experienced Florida life insurance attorney can:
-
Analyze policy terms and Florida insurance law
-
Identify improper denial tactics
-
Handle negotiations and litigation
-
Maximize recovery for beneficiaries
Bottom Line: If your life insurance claim has been denied in Florida, do not assume the insurer’s decision is final. State law provides important protections for beneficiaries, and filing a lawsuit may be the only way to secure the benefits your loved one intended for you.
Have you or someone you know been denied life insurance benfits? Contact Florida 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.
