What to Do If The Savings Bank Mutual Life Insurance Company of Massachusetts Denied Your Life Insurance Claim

When The Savings Bank Mutual Life Insurance Company of Massachusetts (SBLI) denies a life insurance claim, it can leave you feeling overwhelmed. These benefits are often essential to maintaining your family’s financial security, so a denial may create additional stress during an already difficult time. However, a denial doesn’t have to be the end of the process. Many denied claims can be successfully appealed. If your claim has been denied, call the Law Offices of Jason Turchin at 800-337-7755 or chat with us live. We can help you understand why the claim was denied and guide you through the steps to appeal it.

Why Claims Might Be Denied by SBLI

Understanding the reasons behind a denial is the first step toward mounting a successful appeal. The Savings Bank Mutual Life Insurance Company of Massachusetts may deny claims for several reasons, including:

• Policy Lapse Due to Missed Premiums:
  A policy lapse is one of the most common reasons for a denial. If premiums aren’t paid on time, coverage may lapse. However, if SBLI didn’t follow the state’s required procedures for notifying policyholders of lapses, the policy may still be valid. Reviewing the company’s notification process can help determine whether the denial was appropriate.
• Application Errors or Misrepresentations:
  Inaccuracies or omissions on the policy application, whether intentional or unintentional, can lead to claim denials. For example, if the insured forgot to disclose a medical condition, SBLI might reject the claim. By providing medical records and additional documentation, it may be possible to demonstrate that these errors were not material to the policy’s issuance.
• Policy Exclusions or Restrictions:
  Some policies contain exclusions that prevent payouts under specific circumstances. For instance, certain high-risk activities or pre-existing conditions might be excluded. Carefully reviewing the policy’s language can help determine if the exclusion was applied correctly. If it wasn’t, you may have grounds to appeal.
• Beneficiary Disputes:
  Disputes over the rightful beneficiary can lead to claim denials or delays. If there have been recent changes to the beneficiary designation, or if multiple parties claim the benefits, SBLI may hold or deny the claim until the matter is resolved. Clear documentation showing the insured’s intent can help address these issues.
• Missing or Incomplete Documentation:
  Claims may be denied if important documents—such as a certified death certificate or completed claim forms—are missing. Ensuring that all required paperwork is submitted and accurate can help prevent denials or support a strong appeal.

What Steps to Take After a Claim Denial

If SBLI denies your claim, consider these steps to build a solid case for appeal:

1. Review the Denial Letter Carefully:
   The denial letter should explain why the claim was denied and provide instructions on how to appeal. Understanding the insurer’s reasoning is key to preparing an effective response.
2. Gather All Relevant Documentation:
   Collect everything you might need to support your appeal, including:
   • The full policy and any amendments
   • Proof of premium payments
   • Certified death certificates
   • Medical records if the claim involves a health-related denial
   • All correspondence with SBLI
3. Write a Detailed Appeal Letter:
   Your appeal letter should address the reasons for the denial directly. Provide additional documentation, correct any errors, and explain why the claim should be approved. A clear, well-organized appeal can make a big difference.
4. Consult a Life Insurance Attorney:
   If you’re unsure how to handle the appeal or if you’ve already been denied once, consulting an attorney who specializes in life insurance disputes can help. An experienced attorney can identify errors in the denial reasoning, collect more evidence, and advocate on your behalf.
5. File a Complaint With the State Insurance Department:
   If your appeal isn’t successful, you may have the option of filing a complaint with your state’s insurance regulator. This can prompt further review of SBLI’s actions and possibly lead to a reconsideration of the claim.

Example of a Claim That Could Be Denied

A claim might be denied if the insured failed to disclose a prior surgery on their application. If SBLI later finds this omission and believes it affected their underwriting decision, they may reject the claim. However, if the surgery had no connection to the cause of death, you could provide medical records and other documentation to show that the omission was immaterial and try to argue that the claim should still be honored.

Interpleader Lawsuits and Beneficiary Disputes

If there’s a dispute over the rightful beneficiary, SBLI may file an interpleader lawsuit. This means the insurer deposits the policy proceeds with a court and allows the court to decide who should receive the benefits. If you’re involved in an interpleader, it’s important to have clear documentation of the insured’s intent—such as original and updated beneficiary forms—and to seek legal counsel to ensure that your interests are protected.

Florida Claims Against SBLI

If you’re filing a claim in Florida, state-specific regulations might provide additional protections. Florida law requires insurers to adhere to strict notification and claims handling procedures. If SBLI failed to follow these rules, it could strengthen your appeal. Working with an attorney familiar with Florida’s life insurance laws may help identify any procedural errors and use them to bolster your case.

Frequently Asked Questions (FAQs)

What if my claim was denied because of missed premium payments?
If SBLI denied your claim for nonpayment, confirm whether they sent the required lapse notices. If proper notice wasn’t provided, the policy may still be valid, and you may have grounds for appeal.

Can I appeal a denial based on an error in the application?
Possibly. If the error didn’t affect the policy’s approval or wasn’t related to the cause of death, you can provide medical records, corrected forms, and additional evidence to demonstrate that the error shouldn’t disqualify the claim. A lot depends on the application and policy language.

How do I resolve a beneficiary dispute?
Disputes over beneficiaries often require clear documentation. Providing original and updated beneficiary forms, along with any written correspondence that clarifies the insured’s intent, can help resolve the dispute. Consulting with an attorney can also help protect your rights.

What if SBLI applied an exclusion that shouldn’t apply?
If you believe the exclusion was incorrectly applied, review the policy terms and gather evidence that supports your case. A well-prepared appeal can show that the exclusion doesn’t apply and that the claim should be approved.

How the Law Offices of Jason Turchin May Help

If The Savings Bank Mutual Life Insurance Company of Massachusetts 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 and work to secure the benefits you deserve. Call us at 800-337-7755 or start a live chat today to learn more.