Types of Life Insurance Claims at LifeClaims.com

Jason Turchin, Esq. Team

At LifeClaims.com, we handle a variety of life insurance claim issues, each with its own set of challenges and nuances. Understanding these differences is often crucial for policyholders and beneficiaries as they navigate the claims process. Here, we delve into several common types of life insurance claims, providing comprehensive insights and examples to illustrate how these issues may arise and how they can be resolved.

1. Denial Due to Policy Lapse

Overview: A policy lapse occurs when premium payments are not made, causing the policy to terminate before a claim is made. Insurance companies often deny claims based on lapsed policies, but there may be valid reasons why payments were missed, such as billing errors or financial hardship.

Example: Consider a policyholder who had set up automatic payments for their life insurance premiums. If their bank account details changed and the insurance company was not notified, resulting in missed payments and a lapsed policy, we could argue that the lapse was not due to negligence on the part of the policyholder.

Resolution: We assist clients by reviewing the circumstances surrounding the lapse, communicating with the insurance company, and seeking to reinstate the policy or negotiate a settlement where possible. Some state laws also require certain notices to be sent by the life insurance company prior to a valid lapse. We can review the claim to see if all required notices were sent properly.

2. Disputes Over Policy Terms and Beneficiary Designations

Overview: Disputes can arise over the interpretation of policy terms or beneficiary designations, especially when the policy language is ambiguous or if there have been multiple changes to the beneficiary designations.

Example: A policyholder might have changed their beneficiary from an ex-spouse to a current spouse close to the time of their death, leading to disputes between the former and current spouses over who is the rightful beneficiary.

Resolution: Our team can work to clarify the contractual beneficiary, whether through documentation analysis or through litigation.  

3. Claims Delayed by Insurance Companies

Overview: Insurance companies sometimes delay processing claims by requesting unnecessary documentation or failing to make a decision within a reasonable timeframe, which can be financially and emotionally draining for beneficiaries.

Example: A beneficiary files a claim after the policyholder’s death, and the insurance company takes an extended period to request additional unnecessary proof of death and medical records, delaying the claim process.

Resolution: We advocate for expedited claim processing, engaging with the insurance company to ensure they adhere to industry standards and state regulations regarding timely claim processing. If delays are unreasonable, we can pursue legal action to compel a decision.

4. Allegations of Fraud or Misrepresentation

Overview: Claims are often denied if the insurer alleges that the policyholder misrepresented information on their application, such as failing to disclose a medical condition or risky hobby.

Example: If a policyholder did not disclose their smoking habit on their life insurance application and later died of lung cancer, the insurer might deny the claim, alleging misrepresentation.

Resolution: We closely analyze the initial application alongside medical records and other evidence to contest the insurer’s allegations of misrepresentation. Our goal is to prove that the nondisclosure was not material to the policy or that the insurer had accepted the risk by not verifying the information earlier.

If you were denied a life insurance claim, contact us for a free consultation to see if you may be entitled to benefits.

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