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What Do You Do if an Insurance Company Contests Your Claim?

Insurance companies have a right to question, delay, or deny your life insurance claim. Normally, the beneficiaries will receive the payout several weeks following the death of the policyholder. But the insurance company has many reasons to hold or refuse the release of your insurance benefits.

In such a scenario, it’s best to have the legal advice of an experienced life insurance lawyer. They’ll help you defend your claim and make sure that you receive a fair settlement.

Below are the most common circumstances where a lawyer can help you with a contested life insurance claim.

  1. The policy holder died during the contestability period

 Most insurance providers set a contestability period when activating a new policy. Under California law, this period lasts two years, starting from the day of the first payment. This clause gives the insurer the right to investigate the death of the policyholder if it occurred anytime during the contestability period. The insurance company will check if you withheld or misstated any relevant information that may have influenced the death.

One example is if the policyholder failed to indicate that they’re a heavy drinker, then died of liver damage several months following the insurance application. The insurance company can cancel the policy due to insurance fraud.

Insurance misstatements are subjective, which means you have the opportunity to defend your insurance claim. Plus, misstatements should be material. Their nature should be grave enough for the insurer to terminate or alter the insurance agreement. A life insurance lawyer will help you negotiate or fight for your settlement by backing up your claim with the appropriate documents and information.

  1. The policy has lapsed before the policyholder died

 Missed and incomplete payments are common reasons insurance providers refuse to pay out the death benefit. All life insurance policies require a steady payment of premiums to remain active. Otherwise, they’ll lapse. This invalidates your entire claim, even if the policyholder has made payments prior to it lapsing.

However, a missed payment doesn’t automatically deny you of your benefits. The chances of getting a death benefit are higher if the death occurred within 30 days of the policy lapsing.

Your insurance attorney can also investigate if the insurer is in any way responsible for your failure to reinstate your policy. Many states require insurance companies to notify clients before and after they cancel a policy, giving you an opportunity to renew it. If you prove that the insurance company failed to send the necessary notices, you may get the chance to recover the policy.

  1. The death involves unusual circumstances

Many life insurance companies refuse to cover deaths that involve unusual circumstances, such as suicide, homicide, or if the beneficiary is a suspect. Almost every insurance policy involves a clause that exempts coverage for applicants who committed suicide. Some also refuse to pay benefits to policyholders who were intoxicated at the time of their death.

A life insurance attorney will assist you in proving that you’re not complicit to the policyholder’s demise, if ever the case is established as a homicide. A lawyer can also help disprove that the death is due to suicide if necessary.

Defending a contested life insurance claim can get complicated, potentially involving a legal process. This is why you’ll need the experience of a capable attorney who has handled similar cases.

A Capable Lawyer on Your Side

 Our Los Angeles life insurance lawyers will work with you to determine exactly what was wrong with your claim to file a successful appeal. We’ll review your policy together to ensure that your claim falls in line with what you’re owed. Haffner Lawyers will build your claim, support it with strong, concrete evidence, to get you the settlement you deserve.

Contact us at 1-844-HAFFNER (423-3637) to schedule a consultation today.

(This is an attorney advertisement by Joshua Haffner)


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