Life Insurance Denial Attorney
Professional Life Insurance Denial Attorneys Serving Clients Around the United States
Life insurance is a vital financial safety net designed to ensure financial security for loved ones in the event of a policyholder’s death. However, not all claims are processed smoothly, and policyholders may face the distressing situation of a life insurance denial. In such cases, seeking the assistance of a qualified life insurance denial attorney from Eric Buchanan & Associates becomes essential to navigate the complex legal landscape and fight for the rightful benefits.
Common Reasons for Life Insurance Denials
Life insurance denials can arise for various reasons, ranging from technical mistakes in policy language to alleged misrepresentations. Some common reasons for denials include:
Misrepresentation: If the insurance company claims that some of the information provided during the application process was either incomplete or misleading, they may deny the claim. This can often be due to minor errors or omissions that the policyholder might not have realized were significant. For example, an applicant might have forgotten to disclose a minor medical condition or a change in lifestyle that the insurance company later deems critical.
Contestability Period Issues: A contestability period is a typical provision in most life insurance policies, usually applying during the first two years after the policy becomes effective. During this period, the insurer can investigate and reject claims based on material misrepresentations. This period is essentially a safeguard for insurance companies to ensure that all information provided at the time of application was accurate and complete. Any discrepancies found during this time can lead to a claim being denied.
Policy Lapse: When premiums are not paid, a policy lapse occurs, resulting in denied benefits. However, some situations may involve special circumstances that a denial lawyer can argue in favor of the policyholder. For instance, if the policyholder missed payments due to a critical illness or financial hardship, a lawyer might argue that the lapse should not negate the benefits.
Exclusions and Limitations: Some policies have specific exclusions or limitations, and the insurance company will deny a claim when death arises from such causes. Common exclusions might include deaths related to high-risk activities such as skydiving or scuba diving, or deaths that occur in war zones. Understanding these exclusions is crucial for policyholders to know what is covered and what isn’t.
Suicide Clause: Many policies include a suicide clause that leads to rejection if the insured person commits suicide within a stipulated time following policy initiation. This clause is typically designed to prevent individuals from taking out policies with the intent of committing suicide shortly thereafter, leaving the insurance company liable for a large payout.
How a Life Insurance Denial Attorney Can Help
Policy Review and Analysis
Our life insurance denial attorneys will first review the policy and denial letter to understand why the claim was denied. They possess the legal expertise required to interpret complex policy language and identify any loopholes that might benefit the policyholder. This detailed analysis often involves scrutinizing the fine print and understanding the legal jargon that can be challenging for a layperson.
Gathering Evidence and Documentation
We will gather all necessary evidence to support the claim. This could involve obtaining medical records, witness statements, or any other documentation that strengthens the claim and undermines the reason for rejection. For instance, if the denial was based on a supposed misrepresentation of medical history, obtaining comprehensive medical records can demonstrate the accuracy of the information provided.
Negotiating with the Insurance Company
In most cases, we can negotiate with the insurance company on behalf of policyholders. This may involve providing additional evidence, addressing the insurer’s concerns, or finding a mutually agreeable compromise. Negotiations can be complex and time-consuming, requiring patience and persistence. Our life insurance denial attorneys are skilled in presenting strong cases and can often resolve disputes without the need for litigation.
Filing a Lawsuit
If negotiations fail, our attorneys are well-versed in the applicable laws and regulations, ensuring a strong legal argument in court. Filing a lawsuit can be a daunting process, but with experienced legal representation, policyholders can feel confident that their rights will be vigorously defended. Our team will prepare all necessary legal documents, represent you in court, and fight to ensure you receive the benefits you are entitled to.
Alternative Dispute Resolution
In some cases, alternative mechanisms for settlement, such as arbitration and mediation, can be invoked to resolve the conflict outside of court. We can help the policyholder navigate these procedures and advocate for a fair outcome. These methods can often be faster and less adversarial than going to court, providing a more amicable resolution.
Contact Our Life Insurance Denial Attorneys Today
Dealing with a life insurance denial is a challenging situation that policyholders should not face alone. Our life insurance denial attorneys play a crucial role in challenging denials, negotiating with insurers to recover owed benefits, and, if necessary, pursuing lawsuits. In times of need, having a competent and seasoned representative by your side can make the difference between justice and injustice. We are dedicated to ensuring that our clients receive the support and representation they deserve during these difficult times.
Case Example: Matthews v. Sun Life Assurance Company
Case Details: 345 Fed. Appx. 161 (6th Cir. 2009) (Unpublished)
Our life insurance denial attorneys helped our client obtain life insurance benefits under a policy that allowed him to keep his life insurance if he was disabled when he stopped working. Our client became disabled due to a cerebral hemorrhage (stroke), which forced him to stop working. After a few months, he attempted to return to work but was unable to perform his job effectively, leading to his permanent cessation of work.
Initially, the employer provided life insurance under a Jefferson Pilot policy. However, while our client was off work, the employer switched to a policy offered by Sun Life. After his failed attempt to return to work, he applied to retain his life insurance due to his disability. Jefferson Pilot denied coverage, claiming he had returned to work after their policy ended and was not “totally disabled.” Similarly, Sun Life denied coverage, stating he was not “actively at work” enough to be covered by their policy.
After filing a lawsuit, the court ultimately held that our client never truly returned to work and was not “gainfully employed” enough to be considered not “totally disabled.” Although our client passed away during the process, we successfully obtained life insurance benefits for his widow. This case highlights the importance of experienced legal representation in navigating the complexities of life insurance policies and fighting for the benefits that policyholders rightfully deserve.
