Life Insurance Claim Denial Lawyers

Life insurance, a contract between an individual and an insurance company, plays a pivotal role in providing financial security for beneficiaries. Policyholders pay regular premiums to secure a lump sum payout to their dependents after they have passed. However, beneficiaries may sometimes face hurdles in claiming this amount due to various reasons, leading to a dispute with the insurance company.

The passing of a loved one is difficult enough without also having to contend with a life insurance company denying your financial benefits. With the help of the experienced team of life insurance denial lawyers at Pond Lehocky Giordano LLP, you stand a much better chance of receiving the benefits that you and your family need and deserve.

With over 250 years of combined courtroom experience and more than 100,000 cases won, we have the grit and acumen necessary to help victims secure their insurance benefits and face the future with confidence. We will support you against insurance companies and opposing legal counsel and advocate on your behalf to maximize your compensation and preserve your rights. To schedule a free, no-obligation consultation with the expert legal team at Pond Lehocky Giordano LLP, call 1-800-568-7500 or fill out our contact form today.

At the end of the day, life insurance companies are businesses that prioritize their own financial interests over paying their policyholders. As such, there are a number of reasons they may deny your life insurance claim. If your life insurance benefits have been denied for any of the reasons below, there is still hope. With the help of an experienced life insurance claim denial attorney, you can still appeal the insurance company’s decision.

Retroactive cancellation

Retroactive cancellation or “rescission” occurs when a life insurance company retroactively cancels your policy from its effective date. This usually happens when the insurance company alleges that you provided false or misleading information on your insurance application. It’s an extreme measure, and one that insurance companies don’t take lightly. When it happens, however, it can leave beneficiaries in a difficult and deeply unfair position.

Death doesn’t qualify

Insurance companies often specify certain types of deaths that they do not cover in their policy. For instance, most life insurance policies do not cover suicides within the first two years of the policy. Also, deaths due to risky activities like skydiving or car racing may not be covered. If the insured’s death falls under these non-qualifying categories, the life insurance company may deny the claim.

Misrepresentation on the policy

Misrepresentation or providing incorrect information in the policy application can lead to claim denial. For example, if the policyholder concealed their smoking habits or gave incorrect information about their health conditions, that could constitute misrepresentation. Insurance companies sometimes deny claims when they suspect these details may be inaccurate.

Policy exclusions

Every life insurance policy comes with a list of exclusions that the policy does not cover. Common examples include death due to acts of war, participation in criminal activities, or specific medical conditions. If the cause of the policyholder’s death falls under these exclusions, the insurance company can deny the claim.

Lapsed policies

Life insurance policies require regular premium payments to remain in force. If the policyholder fails to make these payments, the policy could lapse. A lapsed policy means that coverage is no longer in effect. In that case, an insurance company often has the right to deny any claims made.

Other possible reasons

Apart from the reasons mentioned above, there could be other grounds for a claim denial. This includes death during the contestability period (usually the first two years of the policy), not meeting policy terms and conditions, or the beneficiary not being named correctly. It’s crucial for policyholders to understand these potential pitfalls and ensure they comply with all policy requirements.

If you book a free consultation with Pond Lehocky Giordano LLP and we determine that you may have a case, our lawyers would methodically walk you through the process of appealing your claim and potentially pursuing litigation, which typically involves the following steps:

Scrutinizing the insurance policy

The first step a lawyer takes in handling a life insurance claim denial is examining the insurance policy. They scrutinize every clause and term to understand the policy’s scope and limitations. This in-depth analysis helps them determine whether the claim denial was warranted or unjust. Knowledge of the policy’s fine print forms the backbone of their legal strategy.

Evaluating the reasons for denial

Once they have a comprehensive understanding of the policy, lawyers examine the reasons provided by the insurance company for the claim denial. Common reasons include policy exclusions, misrepresentation, non-qualifying death, lapsed policies, or retroactive cancellation. The lawyer’s objective is to ascertain whether these reasons are valid. Have they been interpreted correctly by the insurer? Or is there room for dispute?

Gathering additional evidence to support the claim

To build a strong case, lawyers may gather additional evidence to support the claim. This could include medical records, correspondence with the insurance company, proof of premium payments, or any other documents that strengthen the case. Evidence plays a crucial role in both the negotiation and litigation stages, giving weight to the lawyer’s arguments and increasing the chances of a successful claim.

Formulating a legal strategy

Armed with the policy details and the denial reasons, lawyers formulate a strategic plan of action. This strategy depends on several factors, including the claim’s validity, the insurance company’s stance, and the feasibility of challenging the denial. This plan could involve negotiating with the insurer, gathering more evidence to support the claim, or proceeding with litigation.

Negotiation with the insurance company

One common strategy is negotiation with the insurance company. Lawyers use their negotiation skills and knowledge of insurance law to challenge the claim denial. They present strong arguments supported by evidence to convince the insurer to reconsider the denial. In some cases, this step can lead to a successful claim without the need for court intervention.

Pursuing litigation

When negotiations fail to achieve the desired results, or if the insurance company remains unyielding, lawyers may decide to escalate the case to court. During litigation, they present the case before a judge, providing evidence and legal arguments to challenge the insurer’s decision. Litigation can be a lengthy process, but it’s often a necessary step to secure a rightful claim.

Handling a life insurance claim denial can be a complex process, but with the right legal representation, it’s a challenge that can be overcome. At Pond Lehocky Giordano, we have a team of attorneys that specialize in life insurance claim denials and who consistently bring their expertise, strategic planning, negotiation skills, and litigation experience to the table. They are relentless advocates for their clients’ rights, helping them navigate through the intricacies of insurance law to secure the claims they rightfully deserve.

If you’re considering consulting with a life insurance claim denial lawyer, it’s important to be prepared for your initial meeting. Here are some tips to help you get ready:

Gather documents related to the claim. This should be your first step. This includes the life insurance policy, any correspondence with the insurance company, the denial letter, proof of premium payments, and any other documentation that supports your case. Organize these documents in a logical manner, as this will make it easier for your lawyer to review and understand your case.

Understand the life insurance policy. The life insurance policy is a critical document that outlines the terms, conditions, exclusions, and benefits of the coverage. Make sure you read and understand the policy before your consultation. Look out for any terms you don’t understand and jot down your questions. This will help your lawyer explain the policy’s implications and identify any potential areas of dispute.

Gather information about the deceased. The lawyer will also need information about the deceased, such as medical history, occupation, lifestyle habits (like smoking or alcohol consumption), and the cause and circumstances of death. Any misrepresentation or omission in these details can lead to claim denial. Gathering this information beforehand will help your lawyer evaluate the validity of the denial.

Write down your questions. You likely have countless questions swirling around in your mind. Write these questions down. This not only helps you remember to ask them during the consultation, but it also gives the lawyer a clearer understanding of your concerns. Questions can range from the reasons for claim denial to the lawyer’s experience in handling similar cases, their fees, or the legal process ahead.

Understand your legal rights. Before your consultation, do some preliminary research on your legal rights in a life insurance claim denial situation. Understanding your basic rights will empower you during the consultation. It will also help you to better comprehend the legal strategy your lawyer proposes.

Choose the right lawyer. Not all lawyers are created equal. Choosing the right life insurance claim denial lawyer can make a significant difference in your case. Look for a lawyer who specializes in life insurance claims and has a proven track record. You may want to consider their reputation, years of experience, client reviews, and success rate. Making the right choice will ensure that you have a competent and reliable legal professional representing your interests.

By following these tips, you can help ensure that your consultation with a life insurance lawyer is productive and informative, and that you’re well-prepared to take the next steps in your case.