Life Insurance Lawyer

Life Insurance Claim Denial Appeal: Legal Process Explained

Can you appeal a life insurance claim denial? Yes!

Are you a life insurance beneficiary whose claim was denied? This article will explain exactly what to do if your claim for death benefits was denied, how to appeal insurance claim denial, and how to win an insurance appeal. Don’t take no for an answer! 

If your life insurance claim was denied, our life insurance lawyers can help you. We’ve helped beneficiaries around the country get their life insurance payout after their claim for death benefits was initially denied. Call us for your free, no-obligation case evaluation. Our life insurance attorneys work on contingency, which means we don’t get paid unless you do.

The Typical Life Insurance Claim Process

A loved one dies and you discover you’ve been named as a beneficiary to a life insurance policy. You go online, complete the claim form, and within 30 days the life insurance company will notify you that they either approve and will pay your claim, deny and will not payout, or that one of the many reasons a life insurance claim is delayed applies.

What to Do if Your Life Insurance Claim is Delayed

A claim may be delayed for any number of reasons the life insurance company require further investigation, including:

  • The insured was murdered
  • The insured died overseas
  • There is a life insurance beneficiary dispute
  • There was a last-minute life insurance beneficiary change
  • The insured died during the contestability period
  • The primary beneficiary is deceased or cannot be found
  • The insured failed to name ex-spouse as a beneficiary in a community property state
  • The insured named an ex-spouse as beneficiary in a revocation-upon-divorce state
  • The insured used marijuana and it is unclear whether that use was legal or prescribed

If your claim is delayed, you need the help of an experienced life insurance lawyer to get your payout. Insurance companies only make money for their shareholders when they don’t pay claims or delay paying claims, so they have little incentive to pay you or pay you timely. So-called “investigations” into the death of the insured can take months or even years. Don’t be a victim of the life insurance company! Call us for your free evaluation.

Why Do Life Insurance Companies Deny Claims?

There are many reasons a life insurance company claim is denied, including:

  • Claim denied because life insurance lapsed or terminated due to nonpayment of premiums
  • Claim denied due to misrepresentation on the application for life insurance
  • Claim denied due to alcohol use by the insured
  • Claim denied due to drug use by the insured
  • Claim denied due to smoking
  • AD&D claim denied because the death was not accidental;
  • Claim denied due to Acts of War or Terrorism
  • Claim denied because the death was excluded from coverage;
  • Claim denied due to suicide of the insured
  • Claim denied because the insured died overseas
  • Employer-provided group life insurance claim denied because employer failed to provide conversion forms to the insured and the policy lapsed
  • Claim denied because the insured was eligible for disability waiver of life insurance premiums, did not get the waiver, and the policy lapsed

If your life insurance claim was denied, you are afforded the opportunity to appeal life insurance claim denial. Here’s how.

How to Appeal in the Case of Life Insurance Claim Denial

When you receive the life insurance claim denial letter from the life insurance company, read it carefully. Does it provide a clear reason for the claim denial? If not, call or email them for an explanation. They must provide one. If an appeal form was not included with your denial letter, ask to be sent that form or where the form is located online.

How to Write an Life Insurance Appeal Letter

Wondering how to write an appeal letter to the insurance company? You will need to include the policy number, the full name and address of the insured, the date of death, and attach a death certificate. You will also need documents to support your assertion that your claim should be paid.  The best way, however, is to contact a lawyer at Boonswang Law to help you with your appeal.  They take care of all the intricacies involving the appeal for you.

An insurance claim appeal is a legal process. There are procedural requirements and deadlines, and these vary by state and by policy. If you try to appeal on your own and make a mistake, that may affect what a life insurance lawyer can do for you thereafter.

What you should do is get the help of an experienced life insurance attorney as soon as you get your denial letter. Our life insurance attorneys are the best in the country and handle all of the paperwork, forms, and documentation, investigate the denial, and make sure you present your best case. We have gotten beneficiaries paid nationwide and are familiar with the life insurance laws in every state as well as the policies of every life insurance company. Put our experience to work for you so you have the best chance of getting a payout.

The Process of Appealing a Denied Employer Group Life Insurance Claim

Appeal of a claim denial of employer-provided group life insurance is governed by the federal Employment Retirement Income Security Act of 1974, known as ERISA, 29 U.S.C. §§ 1001-1461. This statute supplies, among other things, the procedure for appealing a life insurance claim denial.

You must file what is called an “administrative appeal” within a certain period following the life insurance claim denial letter. If that administrative appeal fails, you will have the opportunity to litigate in court, but the information and documents you submit in the administrative appeal will be relied upon by the court.

For this reason, it is essential to thoroughly investigate and perform legal research on the merits of your claim prior to the administrative appeal, again, to give you the best chance of overturning the claim denial.  Most importantly, call Boonswang Law to assist you with your ERISA appeal.  It is vital that the appeal be performed properly in order that your rights are protected at all times.

Our experienced ERISA attorneys can help get your life insurance claim paid upon an administrative appeal and are prepared to litigate for you if the administrative appeal is unsuccessful.

Our Life Insurance Beneficiary Attorneys Can Help You Appeal Your Denied Life Insurance Claim

If you feel your life insurance claim was unfairly delayed or denied, call us. We will thoroughly review your case free of charge, and if we decide to take your case, know that we expect to win!

Written By: Chad Boonswang
Chad G. Boonswang, Esquire is a litigation lawyer based in Philadelphia, PA. Selected as an ASLA 2014, 2015, 2016, 2017 and 2018 Top 100 Litigation Lawyer, Mr. Boonswang plays to win. As a lawyer, athlete, and scholar, he has always put in the energy, time, and commitment to be the best. After working for several prominent law firms in Philadelphia, including Montgomery McCracken Walker & Rhoads LLP, he founded his own practice in 2002.  Since then Chad has recovered tens of millions of dollars on behalf of his clients from life insurance claims and catastrophic injury cases.  Year after year, he has earned a 10.00 Superb rating on Avvo.

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