Losing a loved one is already an emotionally difficult experience. But when a life insurance company denies your claim, the pain can be compounded by financial stress and frustration. In Florida, life insurance companies are regulated by strict laws, but denials still happen — sometimes for valid reasons, and other times in bad faith. This blog explores common reasons life insurance claims are denied in Florida and what legal remedies may be available to beneficiaries.
Common Reasons Life Insurance Claims Are Denied in Florida
1. Material Misrepresentation on the Application
If the insured provided incorrect or incomplete information on the application — such as failing to disclose a medical condition or smoking habit — the insurer may argue that it would not have issued the policy had it known the truth. Florida law allows life insurers to rescind a policy within the contestability period, typically two years from the date of issuance, if they discover a material misrepresentation.
2. Lapse in Policy Due to Non-Payment
One of the most common reasons for denial is a policy lapse due to missed premium payments. If the policyholder failed to pay premiums and the grace period expired, the insurer may cancel the policy. However, Florida law requires insurers to give proper notice of lapse and may offer protections for elderly or incapacitated policyholders.
3. Death Occurred Outside Coverage Terms
Some policies exclude certain types of death, such as suicide within the first two years, or death during the commission of a felony. If the death falls under one of these exclusions, the insurer may deny the claim. Whether these exclusions are enforceable depends on the specific language of the policy and Florida law.
4. Beneficiary Disputes
Disagreements between family members, competing beneficiaries, or claims involving divorced spouses may delay or derail payments. If more than one person claims they are entitled to the proceeds, insurers may file an interpleader lawsuit to let a court decide.
5. Employer or Group Policy Issues
Group life insurance provided by employers may present additional hurdles. Denials may be based on claims that the employee was not actively employed, failed to convert to an individual policy, or missed enrollment deadlines. These cases often involve ERISA (federal law) as well as Florida insurance law.
Legal Remedies for a Denied Life Insurance Claim in Florida
If your claim has been denied, you are not powerless. Florida law provides several potential remedies:
1. Appeal the Denial
Start by requesting a written explanation of the denial and submitting a formal appeal directly to the insurer. Insurers are legally required to explain the reason for denial and provide access to relevant documents.
2. File a Civil Lawsuit for Breach of Contract
If the denial is unjustified, you can file a lawsuit for breach of contract. Courts may award the full death benefit plus interest. Florida law generally gives beneficiaries five years from the date of denial to file suit.
3. Pursue a Bad Faith Insurance Claim
Under Florida Statutes § 624.155, if the insurer acted in bad faith — such as denying a valid claim without proper investigation — the beneficiary may be entitled to additional damages beyond the policy amount.
4. Hire an Experienced Life Insurance Attorney
Navigating a life insurance denial requires knowledge of policy language, Florida statutes, and case law. A skilled attorney can investigate the denial, negotiate with the insurer, and file suit if necessary.
Final Thoughts
A denied life insurance claim doesn’t always mean the end of the road. Whether it’s a misunderstanding, a lapse in coverage, or bad faith conduct by the insurer, beneficiaries in Florida have legal rights and options to fight for the benefits they were promised.
If your life insurance claim was denied in Florida, don’t give up. Speak with a Florida life insurance attorney to understand your rights and take the necessary steps to protect your family’s financial future.
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.
