Your loved one spent thousands of dollars every year to ensure that their surviving loved ones would be taken care of in the event of their death. When they died, the life insurance policy that they believed would pay out was denied. Now their beneficiaries are left without their loved one and without the money that they are owed.
This scenario is not as uncommon as it may seem. Insurance companies embed a number of contingencies in a life insurance policy that could void the contract. Sometimes they deny claims that are valid without doing the proper research. Or, sometimes they deny claims on lack of information or based on wrong information. And sometimes they just want to see what they can get away with. Regardless, if your loved one spent years of their life paying into a policy that an insurance company is later going to turn around and claim it was voided on a contingency, you may have cause to sue and recover at least some of the money.
At CJ Henry Law Firm
, we help those who have had death benefit claims denied. Our life insurance claim lawyers will fight aggressively to try to get the insurance company to honor its contract. Call us today.
How Do Insurance Companies Deny Claims?
Insurance companies cannot simply deny a death benefit claim without cause. They need a reason to deny the claim, and any will generally do. They’re counting on a beneficiary who is simply going to throw their hands up and walk away. They often quote specific provisions of the policy but they do so in a misleading way. They claim that their policy only includes certain causes of death but will deny a claim even when the policyholder dies in the specified way. In addition, they may claim that the policyholder violated some terms of the policy or misrepresented their health information.
Basing Denial on Material Misrepresentation During Contestability Period
Life insurance policies have a contestability period, usually two years though it can be longer. If a policyholder dies during this period, the insurance company can pore over their record to determine if any of the information is inaccurate. If they find that the policyholder misrepresented some information about themselves, they can deny the policy. But this is not always done in good faith.
Only information that was concealed that affects the insurance company’s risk can void a policy. Sometimes insurance companies will void policies based on information that does affect their risk. Again, they’re depending on you not doing anything about it or fighting them for your money. When even 10% of beneficiaries acquiesce this fattens their profit margins.
Realize that the only way that an insurance company can void a life insurance policy in this manner is by proving actual fraud. The burden of proof is on them.
Using Policy Exclusions
Life insurance policies may be worded in such a way as to exclude certain possible causes of death. For instance, a life insurance policy may only pay out in the event that a policyholder dies of “natural causes”. They key here is determining how the policy defines “natural causes”. Obviously, natural causes would exclude accidents, but there is a gray area as well. If the insurance company can categorize something as an accident or has cause to categorize something as an accident even though it’s not really an accident, they might try hoping that the beneficiaries will figure that they’re out of luck. But they might not be, given the situation.
Claiming That You Had a Pre-Existing Condition
Insurance companies can claim that a policyholder concealed a pre-existing condition that affected the insurance company’s risk. Nonetheless, the insurance company took the policyholder’s money, perhaps for years, without checking their medical records until it came time to pay up. In other words, they could have easily asked for a doctor’s examination or asked for more tests. Instead, they took the policyholder’s money and then claimed they were cheated.
Contact a Life Insurance Claim Lawyer at CJ Henry Law Firm
Insurance companies do not have to be enthusiastic about paying out on large policies, but they do have to honor contracts that they sign. They make money in a number of different ways, but one of those ways cannot be cheating their policyholders when it comes time to pay up. Nonetheless, they deny otherwise valid claims because some beneficiaries don’t care, give up, or believe that the insurance company is the final authority on the matter. They aren’t.
The experienced team at CJ Henry Law Firm
have successfully won reversals for clients who had been initially denied death benefits of a loved one. Remember, they’re counting on you not fighting back. We can help you fight back.