- Life Insurance
- Denied Claim
Denied Life Insurance Claims
At Germain Law Group, we can help you recover the full amount of your life insurance policy claim quickly. The attorneys at Germain Law Group help clients after a life insurance claim is delayed or denied. We can help you file an administrative appeal or sue the life insurance company in state or federal court. If you don’t recover, then there is no fee for our services.
Our goal is to protect your rights as the policyholder or beneficiary. We can help you recovered money quickly. We understand the best way to proceed with various forms of life insurance including policies for whole life, universal life, and variable life policies.
The insurance companies make money by collecting premiums, not by paying out on life insurance policies. Some life insurance companies use illegal practices to delay paying the claim or deny the claim entirely. The insurance companies hire lawyers and adjusters that are trained on how to deny the claim or convince you to settle for less than you deserve.
Attorney for a Denied Life Insurance Claim in Sarasota County, FL
Michael Germain is extremely experienced in helping his clients recover the full amount of the life insurance policy. He understands the tactics used by the insurance companies and their lawyers. He knows how to file a claim against the insurance company in court when they don’t settle the case for the full amount.
When a loved one dies, the life insurance policy provides the family with the money they need. If the life insurance company denies coverage or delays settling the claim, it can cause the family additional stress and grief. If the insurance premiums were paid over the life of the policy, the insurance company needs to live up to their end of the bargain and pay the claim quickly.
Michael Germain has experience representing policyholders and beneficiaries against major national life insurance companies. He can settle the claim quickly or begin the litigate in state or federal court. Michael Germain represents clients throughout Florida, including in Sarasota and Sarasota County, FL. and the surrounding areas throughout the greater Tampa Bay area.
And the surrounding areas throughout the greater Tampa Bay area.
Overview of Denied Life Insurance
- What Happens If I Can't Pay My Premiums?
- How Can a Contestability Period Affect My Claim?
- How Can Misrepresentation or Fraud Affect a Claim?
- What If a Family Member Was Not Covered?
- Why Is Life Insurance Important?
Why Did the Life Insurance Company Deny My Claim?
We can help you determine why the life insurance company denied the claim and what you can do about it. The most common reasons for the denial of a life insurance claim include any of the following:
- a failure to pay the life insurance policy premiums;
- the death occurred during the contestability period;
- the policyholder failed to disclose relevant personal information; or
- the type of death wasn't covered in the life insurance policy (i.e., the suicide clause).
Denial Because of the Failure to Pay the Life Insurance Premiums
Many policies have a grace period of at least 30 days during which you can pay the premium due and not be charged interest. The best way to avoid having a lapse in your life insurance policy is to have the premium payments deducted automatically from your bank account.
Whole life insurance policies have a cash value. Those whole life insurance premiums often have a provision that allows the carrier to borrow from the policy value to pay overdue premiums. This procedure protects the policy only so long as a sufficient cash value remains.
Denial Because the Death Occurred During the Contestability Period
If the death occurs during the contestability period then the life insurance policy can be denied. Many life insurance policies have contestability periods that remain in effect for a term of years after the policy begins. The contestability period is usually two year. If the policyholder dies within that time period, then an investigator with the life insurance company will determine whether the information on the application is correct.
Any false statement on the application can cause the insurer to refuse to pay the death benefit, even if the cause of death had nothing to do with the false statement or misrepresentation.
Denial Because of a Failure to Disclose Information, Misrepresentation or Fraud
If the policyholder fails to disclose relevant personal information or commits fraud, then the claim can be denied. Example of misrepresentations on the life insurance application can include failing to disclose a medical condition even if the death had nothing to do with that medical condition. Another example would be failing to disclose a DUI conviction. After the contestability period, the previously undiscovered misrepresentations don’t normally prevent the benefits from being paid.
Although a minor misrepresentation probable won’t be enough for the denial of the claim, an intentional fraud can result in a detail of the claim even after the contestability period. For example, if the insurance company believes that a life insurance policy was purchased in a plot to murder and collect a benefit, the claim will be denied even if the contestability period has passed.
Denial Because the Type of Death Wasn't Covered by the Policy
Fourth, not all types of death are covered by the life insurance policy. Life insurers once used a variety of exclusions that focused on type of death. For example, the policy could include an exclusion for engaging in a dangerous hobby, such as skydiving or scuba diving. Dying in a war was also a common exclusion in the earliest versions of life insurance policies.
Today, the most common life insurance policy exclusion is death by suicide. Although even that exclusion typically doesn't apply after the contestability period has passed.
What is the Purpose of the Life Insurance Policy?
A life insurance is a contract between an insurer and the insurance policyholder. Under a life insurance policy, the insurer promises to pay the designated beneficiary a benefit (usually a sum of money) in exchange for the payment of a premium. For life insurance, the payment of the benefit is payable upon the death of an insured person. Some life insurance policies also pay a benefit in the event the insured person is diagnosed with a terminal or critical illness.
Under most life insurance policies, the policyholder pays a premium on a regular basis or as one lump sum. The benefit under the life insurance policy might also include the payment of other expenses such as funeral or burial expenses.
The terms of the contract are described in the life insurance policy. Exclusions are written into the contract. For a life insurance policy, those exclusions can be based on the way the death occurs when the insured commits suicide.
Life-based insurance contracts can include both protection policies and investment policies. The protection policy is designed to provide a benefit in the event the insured dies within a certain term of years. The investment policy is used to facilitate the growth of capital by regular or single premiums.
If you received a life insurance denial letter from the insurance company, then act quickly to hire an attorney to help you through the process. An experienced life insurance attorney in Sarasota, FL, can help you understand why it is worth the fight for justice to make the insurance company pay out the full amount quickly.
We can also represent you when there are competing beneficiary making a claim for the life insurance benefits. Let us put our experience to work for you.
Call (941) 316-0333 today.
This article was last updated on Thursday, February 15, 2018.
Meet Our Attorney
Michael B. Germain
Michael B. Germain is the founder of the Germain Law Group. For over a decade, Michael has been involved in litigating insurance claims and complex commercial matters.