What to Do If Sun Life Assurance Company of Canada Denied Your Life Insurance Claim

When Sun Life Assurance Company of Canada denies a life insurance claim, it can be a frustrating and confusing experience. Life insurance benefits are designed to provide financial security during a difficult time, and a denial might leave you unsure of what to do next. The good news is that many denied claims can be successfully appealed. If your claim was denied, call the Law Offices of Jason Turchin at 800-337-7755 or chat with us live. We can help explain the reasons behind the denial and guide you through the steps to contest it.

Common Reasons Sun Life May Deny Claims

Understanding the reason for a denial is the first step toward resolving the issue. Sun Life Assurance Company of Canada may deny claims for several reasons, including:

• Policy Lapse Due to Missed Premiums:
  A policy may lapse if premiums are not paid on time, leading to a claim denial. However, insurers are typically required to provide proper lapse notices before canceling coverage. If Sun Life failed to issue these notices, the policy might still be considered active, giving you grounds to appeal.
• Application Errors or Omissions:
  Claims can be denied if discrepancies or omissions are found in the original application. Even minor mistakes, such as failing to disclose a medical condition, can result in denial. Providing additional documentation and clarifications can help address these concerns and support your appeal.
• Policy Exclusions or Limitations:
  Many life insurance policies have exclusions for certain causes of death or high-risk activities. Reviewing the policy terms carefully can help determine whether Sun Life applied an exclusion correctly. If the exclusion was used incorrectly, you may have grounds to challenge the denial.
• Conflicts Over Beneficiary Designations:
  If there’s uncertainty or a dispute over who should receive the policy’s proceeds, Sun Life may withhold payment until the matter is resolved. Providing clear documentation of the insured’s intent can help move the claim forward and resolve beneficiary disputes.
• Incomplete or Missing Documentation:
  A claim may also be denied if required documents—such as a certified death certificate or properly completed claim forms—are missing or incomplete. Ensuring that all paperwork is accurate and fully submitted can help prevent this type of denial and strengthen your appeal if it happens.

What You Can Do After Receiving a Denial

If your life insurance claim was denied, consider taking the following steps to improve your chances of a successful appeal:

1. Review the Denial Letter Carefully:
   The denial notice should explain why the claim was rejected and provide instructions on how to appeal. Understanding Sun Life’s rationale is critical for crafting a strong response.
2. Gather Supporting Documentation:
   Collect all relevant records, including:
   • A complete copy of the policy, including any riders or amendments
   • Proof of premium payments
   • Certified death certificates and medical records, if applicable
   • Correspondence with Sun Life Assurance Company of Canada
   • Beneficiary designation forms and updates
3. Prepare a Comprehensive Appeal Letter:
   Address the reasons for the denial directly. Provide additional documentation, clarify any errors or omissions, and present a well-organized argument. A strong appeal increases the likelihood of a favorable outcome.
4. Consult a Life Insurance Attorney:
   If your initial appeal is denied or if you’re unsure how to proceed, a life insurance attorney can provide valuable guidance. An experienced attorney can identify procedural errors, gather further evidence, and advocate on your behalf.
5. Consider Filing a Life Insurance Lawsuit:
   If the denial was unjust or if Sun Life acted in bad faith, you may have the option to file a lawsuit. Consulting with an attorney can help you determine whether legal action is appropriate and guide you through the litigation process if necessary.
6. File a Complaint With State Regulators:
   If all else fails, filing a complaint with your state’s insurance department may prompt additional scrutiny. Regulatory authorities can examine whether Sun Life followed proper procedures and may encourage them to reconsider the denial.

Example of a Claim That Could Be Denied

A life insurance claim might be denied if the insured omitted a medical condition on their application. If Sun Life later determines that this omission influenced their underwriting decision, they might reject the claim. However, if the condition was unrelated to the cause of death, providing medical records and a clear explanation can demonstrate that the omission was not material. This additional information might help support an appeal and lead to a successful outcome.

Interpleader Lawsuits and Beneficiary Disputes

If multiple parties claim the same life insurance proceeds or there is confusion over the rightful beneficiary, Sun Life may file an interpleader lawsuit. This involves the insurer depositing the policy proceeds with a court and asking the court to determine who should receive them. Providing original and updated beneficiary forms, along with correspondence that clarifies the insured’s intent, can help strengthen your case. Legal guidance can ensure your rights are protected and that your case is effectively presented.

Florida Claims Against Sun Life Assurance Company of Canada

For Florida residents, state-specific protections may apply. Florida’s insurance regulations often require insurers to follow strict notification and procedural requirements before denying a claim. If Sun Life failed to comply with these rules, it could strengthen your appeal. Consulting a Florida-based attorney experienced in these regulations can help identify procedural violations and support your case.

Frequently Asked Questions (FAQs)

What if my claim was denied due to a lapse in premium payments?
Check whether Sun Life sent proper lapse notices. If they failed to follow state notification rules, the policy may still be valid, providing grounds to appeal.

Can I appeal a denial based on a contestability period issue?
Maybe so. If the denial was due to discrepancies in the application, you can provide additional documentation and clarifications to demonstrate that the errors were immaterial or unintentional.

What if there’s a dispute over the rightful beneficiary?
Gather evidence of the insured’s intent, including original beneficiary forms and any updates. A life insurance attorney can help clarify your position and protect your rights.

What if Sun Life applied an exclusion incorrectly?
Review the policy’s terms carefully. If you believe the exclusion doesn’t apply, submit evidence that demonstrates why the denial was incorrect. A detailed appeal can help clarify the situation and potentially reverse the denial.

How the Law Offices of Jason Turchin May Help

If Sun Life Assurance Company of Canada denied your life insurance claim, the Law Offices of Jason Turchin may be able to help. With experience handling life insurance disputes, we can guide you through the appeals process or file a lawsuit if necessary. Call us at 800-337-7755 or start a live chat today to learn more.