Life insurance provides financial protection to families and loved ones when someone passes away, offering peace of mind that beneficiaries will be supported. However, it can be devastating when a life insurance claim is denied, leaving families in a difficult financial situation. Understanding the reasons why claims are denied and the steps you can take to appeal such decisions is crucial. In this blog, we’ll explore the common reasons for life insurance claim denials in Ontario and how beneficiaries can navigate this challenging process, including when to seek help from a
life insurance lawyer.
Why Are Life Insurance Claims Denied?
Life insurance policies come with specific terms and conditions, and any violation of these can lead to a denied claim. One of the most common reasons for denial is
material misrepresentation
or
non-disclosure on the original insurance application. If the policyholder provided inaccurate information, such as failing to disclose a pre-existing medical condition or providing false details about their lifestyle, the insurance company may reject the claim.
Another reason for denial is
policy lapse due to non-payment. Life insurance policies require regular premium payments, and if a policyholder fails to pay their premiums on time and the policy lapses, the insurance company may deny any subsequent claims. This can be especially surprising for beneficiaries who may not have been aware that the policy had lapsed.
The
contestability period is another critical factor. Most life insurance policies include a contestability period, typically two years after the policy is issued. During this time, insurers can investigate and deny claims for any reason, including undisclosed health issues or misrepresentations. If the policyholder passes away within this period, the insurer may scrutinize the claim more closely.
Life insurance policies also often include
excluded causes of death. For instance, policies may not cover death due to suicide within the first two years, death occurring during illegal activities, or certain high-risk activities. If the cause of death falls under one of these exclusions, the claim may be denied.
Finally, some policies have
exclusions related to specific medical conditions. If the policyholder’s death is caused by an excluded condition, the insurance company may refuse to pay the claim.
What to Do When Facing a Denied Life Insurance Claim
A denied life insurance claim can be overwhelming, but it is not necessarily the end of the road. The first step is to carefully review the denial letter sent by the insurance company. This letter should explain the reason for the denial, which is essential for understanding the basis of their decision. If the reasons are unclear, you should contact the insurance company for a more detailed explanation.
Once you understand why the claim was denied, you should contact a lawyer or law firm that has experience in dealing with denied life insurance claimsOne of the most effective ways to challenge a denied life insurance claim is to seek help from a life insurance lawyer. An experienced lawyer can help you understand your rights, gather evidence to support your case, and communicate with the insurance company on your behalf. Lawyers who practice in the field of life insurance disputes are familiar with the tactics insurance companies use and can advise you on the best course of action. If necessary, they can represent you in court to ensure you receive the benefits you are entitled to.
How Can Aaron Waxman and Associates, P.C. Help?
At
Aaron Waxman and Associates, P.C., we understand how stressful it can be to deal with a denied life insurance claim. Our team is well-versed in handling disputes with insurance companies and can help you challenge a denial. We will review the details of your case, and, if needed, pursue litigation to recover the benefits you are owed.
We offer free consultations so you can speak to a
life insurance lawyer to understand your options without any financial obligation. Our firm is committed to ensuring that our clients receive the legal advice and representation they need to navigate this complex process. Contact us at
416-661-4878 or
[email protected] for legal assistance.