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.

Why do life insurance companies deny claims?

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.

How lawyers handle life insurance claim denials

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.

Frequently asked questions about life insurance claim denials

What does a life insurance claim denial lawyer do?

Life insurance claim denial lawyers represent policyholders in disputes with insurance companies. They offer legal advice, help understand policy terms, challenge unfair claim denials, and guide their clients through the legal complexities of the insurance claim process.

When should I hire a lawyer for a life insurance claim?

It’s advisable to hire a lawyer if your life insurance claim has been denied, if the claim process is overly complex and delaying delivery of your benefits, or if the insurance company is being uncooperative. Lawyers bring legal expertise and negotiation skills that can significantly increase your chances of a successful claim. The sooner you can bring a life insurance denial lawyer’s expertise to bear on your situation, the better.

How much does a life insurance claim lawyer cost?

Most life insurance lawyers work on a contingency basis, where they get paid only if they win your case. It’s important to discuss fees upfront to understand your financial commitment.

Can I challenge a life insurance claim denial?

Yes, most insurance companies have an appeals process allowing policyholders to challenge a claim denial. A lawyer can guide you through this process, prepare necessary documentation, and represent you in any legal proceedings.

What are the common reasons for life insurance claim denial?

Common reasons for claim denial include policy exclusions, misrepresentation on the application, lapse of policy due to non-payment of premiums, and death occurring during the contestability period.

How long does it take to resolve a life insurance claim dispute?

The duration to resolve a claim dispute can vary widely based on the complexity of the case, the willingness of the insurance company to negotiate, and the legal processes involved. Having a lawyer can streamline the process and potentially shorten the dispute resolution time.

How to prepare for a consultation with a life insurance lawyer

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.

Contact us today for a free case evaluation

Because life insurance claim denials can be legally complex cases to pursue, it’s important to have an expert legal team involved. Our life insurance lawyers handle claim denial cases in all 50 states. There is no charge to speak with our attorneys about your situation and legal rights. For more information, call Pond Lehocky Giordano LLP at 1-800-568-7500 or fill out our contact form today.