Life insurance policies include several conditions that could void coverage. Similar to renters and auto insurance, every life insurance provider has their own process for handling claims which is unique to every policy. No matter the reasons, denial of a claim within the time of grief following the death of a loved one can complicate the situation for poorly prepared families and their heirs.
Certain situations are where life insurance claims are rejected. If you have a life insurance claim that is rejected, you may do a few things to help you get the benefits you deserve. This article can help know the reasons that insurers might deny the claim for life insurance and what you can do to fix it.
The reasons why life insurance claims are not accepted
Insurance companies deny death benefits in life insurance claims due to reasons such as policy delinquency and material misrepresentation. They also deny claims based on contestable circumstances , and failure to document.
In more detail, insurers deny a life insurance claim for:
Materially incorrect representation
An error in the information on the first life insurance application. No matter if a heart condition is present or a smoking history or information about weight gain false statements on an insurance application can void the policy.
Other false representations include:
Making up earnings
The non-disclosure of another life insurance policy
Incorrect information on the application provided by the agent
The failure to mention treatment options for minor conditions
False representation of the status of immigrants
A death that is considered contestable falls that is not covered by the policy most likely due to the fact that the time of death falls within a time frame that is contestable. The contestability period is the first two or three years from the policy’s date of effective when insurers refuse to pay claims in certain circumstances. These include suicide or death during the course of an unlawful act. Although exclusions from policy have been decreasing in modern policy, older ones may prohibit death in military service or war-related acts, flying, and dangerous activities like scuba diving and climbing mountains, as well in the case of health risks like HIV.
Documentation failure is the result of family members or heirs who fail to submit the proper documentation required for the benefit of death. At a minimum insurance companies require an official death certificate to initiate the payment process.
The contestability period is important.
The contestability of the first few months or less of brand new life insurance policy is an initial period of probation in which the insurer’s rights are a part of an examination of a death benefit in order to check the amount for fraud or misrepresentations in the application.
Although an investigation can delay the payment for a funeral benefit insurance companies pay out the policy for as long as investigations yield no conclusive evidence of wrongdoing committed by the beneficiary. In the event of murder, for example insurance companies will pay out only after the police have cleared policy beneficiaries.
What should you do if a claim is rejected
The receipt of an insurance claim denial letter smacks terror into the hearts of those who depend on the replacement of the policyholder’s earnings. In reality the only assurance of a payout is once the cash is settled into the beneficiary’s account. If an insurer discovers that there was a fundamental indiscretion by the policyholder cancels the policy as well as the applicable death benefit. In addition, an self-harming act or any other breach within the contestable period can disqualify the right to appeal a denial of claim.
For help with a life insurance denied claim contact Resolute Claims.
Contact the insurance company
Insurance companies outline the reasons behind denial of claims in their initial denial letters. However, if the reasons do not seem clearor lack sufficient supporting informationthe proper option is to demand for more details about the specific issues that prevent the payment of the death benefits.
In the event that the beneficiaries who have been denied appeal their claim, the required documentation could include autopsy reports, medical records or insurance receipts for payments.
In the case of the employer-sponsored group life insurance policy or similar policies, there’s only 60 days are available to contest the decision.
Contest and be rejected
Beneficiaries who are denied benefit appeal must prove their claim as per the procedures that is set forth by the insurance company. Although self-representation has no cost to the taxpayer the process is complex and adding anxiety to an emotional situation can come at emotional costs.
How can you avoid being denied a claim
Naturally, stopping claims denials is the best result for both the policyholder and the beneficiary. Tips to prevent the possibility of a denied claim are based on the approach of the policyholder to applying for insurance. Particular considerations are:
Responses to applications – comprehensive responses regarding health-related and health-related behavior such as smoking cigarettes prescription or other medication and dangerous hobbies
Understanding of application the terms and conditionsClarity about the conditions under which insurance companies pay the death benefit , and the conditions under which they don’t pay the benefit.
Review of the application-Re-read and read the application completed that was filled out by the agent.
Frequently asked questions
What is the most effective life insurance?
Finding the most suitable life insurance plan involves many moving parts, which are dependent on individual circumstances and preferences. It all is dependent on.
When choosing an insurance company for life include the history of the company and popularity for providing excellent customer care, its financial stability , and the pricing. These factors will ultimately impact satisfaction for customers and insurance value.
What type of medical exam are required for the buying of the life insurance policy?
A life insurance medical examination will require a physical exam of a standard that includes height and weight measurements as well as a blood pressure test. The medical examiner can also request previous medical examinations as well as history, blood and urine samples.
What are the most important factors that determine whether an insurance company pays an amount for death benefits?
If there are no problems in the the terms of a policyholder’s life insurance application , and there are no contestability issues that come into the equation, financial stability is an important role in the heir’s eligibility for an inheritance upon death.