Life Insurance Claim Denials

J.P. Gonzalez-Sirgo
Founder of J.P. Gonzalez-Sirgo, P.A.

Individuals most often purchase life insurance to protect their loved ones in case of their death.  When someone passes away, the spouse or other dependents 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 will engage in post-claims underwriting. 

During post-claims underwriting, the insurance company will carefully analyze the claim and investigate the veracity of the statements made on the application for insurance.  This process often leads to the denial of the life insurance claim.  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 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, medical history, 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 an uphill batlle.  The first step in fighting a life insurance claim denial is to contact an experienced life insurance claims attorney.  An attorney can review the life insurance company’s basis for the denial and help build a strong case.   

You can reach Miami 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 Attorney Gonzalez-Sirgo directly at [email protected].

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