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What to Do If Your Life Insurance Claim Is Denied

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Dealing with the loss of a cherished family member can be extremely difficult. Many people from Florida to Fort Charles that plan ahead for their passing have thought to provide for their family and heirs with a life insurance policy. Nothing can make grieving more difficult than finding out that the policy that was meant to bring you financial peace of mind has been denied or rejected.

It is unusual for life insurance policies to be denied, but they happen occasionally. Receiving a denial for your life insurance claim can be upsetting and confusing. Your insurance provider is obligated to explain why the denial was handed down, but you may still have a lot of questions. 

If you are dealing with one of the thousands of Florida Life Insurance Claims that are filed each year, you have some recourse at your disposal if your claim is denied. Let’s take a closer look at what you should do if your life insurance claim is denied. 

Reasons Life Insurance Claims Are Denied

Faith Based Events

When you receive a denial letter from your life insurance company, the reason for the rejection should be clearly outlined. The most common reasons that a claim would be denied include:

Suicide

  • If the policy owner commits suicide within two years of taking out the policy, it will be denied. This is commonly called “death by self-harm.”

Excluded Activities

  • Each life insurance policy will contain a list of exclusions. These can include activities that are considered high risks like skydiving, scuba diving, rock climbing, or car racing.

Illegal Activity

  • Some life insurance policies will deny claims where the holder died as a result of illegal activity. In some cases, claims could be denied if the policyholder dies as a result of taking illegal drugs or other substances. 

Misrepresentation

  • If any fraudulent statements on the policyholder’s application are found following their death, the claim is often denied. 

Premium Payments

  • If the policyholder has missed multiple payments on their account, it is likely to be canceled.

What Happens When a Claim Is Denied?

When a life insurance claim is denied, the beneficiaries will receive a denial letter. This correspondence will outline the reasons behind the denial. The insurance provider will pay back premiums and cancel the account. You can file an appeal against the decisions.

What to Do After Your Claim Is Denied

If your life insurance claim is denied, you need to contact your insurance provider. You should be given a piece of contact information when you receive your denial letter. An insurance representative can explain the reasons behind the denial.

If you want to refute the denial of a life insurance claim, you will need inscrutable evidence. It is rare that an appeal committee overturns a claim denial. Depending on the reason behind your denial, you may have to gather particular items of evidence, including an autopsy report, proof of premium payments, or medical documents. Your insurance company will inform you of what documentation you will need for your appeal.

When seeking an appeal to a claim denial, your next step is to contact a lawyer with insurance experience. While it is possible for you to contest the decision on your own, it may be too much stress during an already emotional time. An insurance lawyer can help walk you through your appeal process and act on your behalf. 

How to Protect Your Beneficiaries From a Claim Denial

For most policyholders, paying out their claim to beneficiaries is easy and shouldn’t cause any anxiety. To ensure that your heirs will not have to deal with a denial, it’s important to take steps including:

  • Automate your life insurance payments through your bank so that your premiums will always be up to date
  • Be honest and open on your insurance application
  • Investigate all exceptions that are outlined in your policy. Do not assume that certain activities will be approved during the claim process. Try to avoid participating in high-risk activities that are excluded from your coverage parameters
  • Keep your policy updated with your current and additional beneficiaries’ names, addresses, and contact numbers
  • Share your plans with your family members. Let your family know the generalities of your policy, the insurance company’s name, and where they can find the documents they will need to make their claim