When Can You Sue a Life Insurance Company in Florida?

You may be able to sue a life insurance company in Florida when it denies, underpays, or fails to pay a death benefit that is due under the policy. If your loved one had an individual policy governed by Florida law, the usual lawsuit seeks payment for breach of contract. If the coverage came through work, federal law may require you to appeal the denial before suing.

The first step is to identify the type of coverage and find out why the insurer has withheld payment. The policy, the claim correspondence, and the dates on those documents can determine both when you can file and how long you have to act.

When can a denied life insurance claim lead to a lawsuit?

A beneficiary generally has grounds to pursue a breach-of-contract claim when the policy provides coverage, the beneficiary is entitled to the proceeds, the applicable claim requirements have been satisfied, and the insurer fails to pay as required. A written denial helps identify the dispute. Compare the insurer’s explanation with the actual policy, application, and supporting records.

Common disputes include:

• Alleged misrepresentation. The insurer says an answer on the application was inaccurate or incomplete. The exact wording of the question matters. A medical record entry may have a different meaning from the question the applicant was asked. Florida law sets out when a misstatement or omission can prevent recovery. 

• Lapse for nonpayment. The insurer says coverage ended before death. Review the premium history, the applicable grace period, any notices, and any reinstatement records.

• A policy exclusion. The insurer relies on a provision such as a suicide exclusion or a restriction in an accidental death rider. Read the specific provision and check whether the denial affects the base death benefit, the additional benefit, or both.

• Underpayment. The insurer paid part of the claim but withheld an amount the beneficiary believes the policy provides. Compare the payment breakdown with the policy’s benefit schedule and riders.

What if the insured died during the two-year contestability period?

A death during the first two years can prompt an investigation into the application. The insurer still needs a valid basis to deny payment. For policies subject to Florida’s incontestability statute, the policy generally becomes incontestable after it has been in force for two years during the insured’s lifetime, measured from issuance. The statute preserves an exception for nonpayment and permits certain exceptions involving disability and additional accidental death benefits. The contestability period concerns the insurer’s ability to challenge coverage. Your deadline to sue is a separate calculation. 

Can you sue if the life insurance company keeps delaying payment?

Possibly. A formal denial is one way an insurer can fail to honor a policy. An unpaid benefit that is already due can also support a breach-of-contract claim. If the insurer is still reviewing the claim, ask in writing what it has received, what remains outstanding, and when it expects to decide. Keep copies of your submissions and proof of delivery.

Florida’s individual life insurance settlement provision requires policies to provide for settlement upon receipt of due proof of death and surrender of the policy. For a covered lump-sum payment, Florida law also requires interest from the date the insurer receives written due proof of death. Confirm which documents the insurer considers missing and preserve the date it received your written proof of death. 

If two people claim the same proceeds, the insurer may file an interpleader action and ask the court to determine who should receive the money. If you are served with an interpleader complaint, follow the response deadline in the court papers. An open claim or ongoing correspondence with the insurer does not extend that court deadline.

How long do you have to sue a life insurance company in Florida?

Florida generally allows five years to bring a breach-of-contract action founded on a written insurance policy when Florida’s statute of limitations applies. The period generally begins when the last element of the claim occurs. In a life insurance dispute, the date the insurer allegedly breached its payment obligation matters. A denial letter can help establish that date, but payment may have been due earlier. Have the deadline calculated from the policy and the full claim history. 

A request for reconsideration, settlement discussions, or a consumer complaint should never be treated as an extension of your filing deadline without confirming that a legal basis for an extension applies. If your loved one had employer-provided coverage, check the plan’s appeal deadline and any separate deadline for filing suit as soon as you receive the denial.

Do you have to file a Civil Remedy Notice before suing?

For an ordinary Florida breach-of-contract lawsuit seeking the unpaid policy benefits, the Civil Remedy Notice required by section 624.155 generally does not apply. Review the policy for applicable claim conditions before filing.

A Florida statutory bad-faith claim is different. It concerns conduct such as an insurer’s failure to attempt in good faith to settle a claim when it could and should have done so under the circumstances. Section 624.155 requires advance notice to the Florida Department of Financial Services and the insurer, and gives the insurer 60 days after it receives notice from the department to cure. An incorrect denial alone does not establish bad faith. The timing also depends on whether the underlying coverage and benefit dispute has been resolved. 

What if the life insurance was through an employer?

Many private-sector employer life insurance plans are governed by the Employee Retirement Income Security Act, commonly called ERISA. If ERISA applies, beneficiaries generally must complete the plan’s required administrative appeal process before suing for benefits. Federal claims regulations generally give beneficiaries at least 60 days after receiving the denial to appeal a life insurance claim. Check the denial letter and plan documents for the actual deadline and submission instructions.

Request the plan documents and the records relevant to the denial promptly. Use the appeal to address each reason the insurer gave and submit the documents that support your claim. Evidence left out of the administrative record may be difficult to add later in court.

Calendar the lawsuit deadline separately. An enforceable ERISA plan deadline can begin running before the administrative appeal ends. 

What should you gather before challenging a life insurance denial?

1. The complete policy or plan documents, including riders, amendments, and any group insurance certificate.

2. The denial letter and claim correspondence, including emails, requests for records, and any appeal instructions.

3. The claim form, death certificate, and proof of delivery showing when the insurer received them.

4. The application and underwriting documents, especially if the insurer alleges an inaccurate answer.

5. Beneficiary forms and premium records, especially if the insurer questions who should be paid or whether coverage was active.

Keep a dated timeline. Record when the insurer received your claim, when you received any denial or request for information, and when you responded. If coverage came through work, include dates when employment ended, leave began, or coverage changed, if relevant.

Frequently asked questions

Can I sue a life insurance company after it denies my claim once?

For an individual policy, you may be able to sue after an initial denial if the benefit is due and you have satisfied the applicable claim requirements. If ERISA governs the plan, you generally must complete the required administrative appeal first. 

Can I file a complaint with Florida’s Department of Financial Services?

Yes. You can contact the department’s Division of Consumer Services for assistance with an insurance complaint. Keep track of your appeal and lawsuit deadlines independently. A consumer complaint serves a different purpose from the statutory Civil Remedy Notice used for a bad-faith claim.

What can I recover in a life insurance lawsuit?

A lawsuit for policy benefits generally seeks the unpaid death benefit. Interest may also be available, including the interest Florida requires on qualifying lump-sum payments. Additional damages depend on the legal basis for the claim and the law that governs the policy or plan. 

Talk to a Florida life insurance claims attorney

If a life insurance company denied, delayed, or underpaid a substantial death benefit, contact J.P. Gonzalez-Sirgo, P.A. to request a case review. Have the denial letter, policy or plan documents, and any appeal instructions available. Those documents can help identify the next step and any deadline that requires immediate attention.

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.