Life Insurance Claim Denial Lawsuit Attorney

Was your claim for benefits denied by a life insurance company? It’s a disheartening and stressful prospect for loved ones when they are faced with a claim denial for money they need to cover expenses left behind by the deceased. If you are in this situation, you are likely to have many questions about your rights and legal options.

Sometimes, failure to pay life insurance claims is based on legitimate reasons under state or federal law. But there are plenty of scenarios where someone is unjustly turned down for payment when they try to claim what if rightfully theirs. These people may be victims of insurance bad faith, meaning that the company is intentionally acting in a manner that violates their obligation to a policy holder – or in this case, the beneficiary of a life insurance policy.

Trying to assert your rights can be very challenging, which is why our attorneys are here to fight for you and he compensation you deserve. Please contact our office for a free consultation with a California life insurance dispute lawyer.

Regulations on Life Insurance in the State of California

Both the federal government and the state of California have laws on the regulation of life insurance policies, including the terms for denying payment to the beneficiaries. There is a lot of confusion over which of these laws apply when a claim is rejected, but as a general rule, state laws apply if the policy was purchased privately. Alternatively, you would default to federal guidelines if you are claiming benefits from a policy through an employer. The specific law that governs group plan life insurance policies from an employer is known as the Employee Retirement Income Security Act (ERISA)..

To ensure that you are following the correct procedures in the event of a life insurance dispute, don’t hesitate to give us a call.

Is My Claim Denial Legitimate?

This is the first question most people ask when they get a notice of rejection from an insurance company. There are numerous reasons for why a beneficiary claim is denied, but in this section, we will go over a few of the most common:

Missing documentation – this is a fairly common situation where the claimant is missing certain documents that are needed to redeem the policy. Unfortunately, there are companies that impose unreasonable requirements on the beneficiary, which is an example of bad faith insurance.

Material Misrepresentation – some people may intentionally withhold information in order to qualify for a policy, like not disclosing a diagnosis for a serious medical condition. It’s valid for the insurer to deny a claim based on material misrepresentation. However, they cannot claim that any and every error on an application falls into this category. A life insurance attorney at our office can help you determine if the basis of your claim denial is indeed based on material misrepresentation.

Incontestability – a period of contestability is the amount of time that a life insurance company has to investigate information on the application and refuse coverage to the applicant. If they do not take these steps and there are issues or material misrepresentation later on, this information cannot be used to deny a claim for benefits.

Lapse in Coverage – Essentially, the claimant has failed to pay their premiums, which effectively cancels the coverage they would have as a policy holder. But even if there is a failure to pay, proper notice must be given by the insurance company, similar to how a mortgage lender has to give notice prior to foreclosing on a house. Otherwise, the insurer must honor the obligations they have to the beneficiary based on the terms of the policy.

Evidence of Insurability – Many companies require you to see a doctor and submit health information as evidence of eligibility for a policy. No premiums should be collected until this process is complete, but it does happen in many cases due to greed or negligence by the company. Either way, the company cannot collect premiums for years, then try to renege on their end of the bargain when the policy holder dies.

Employer Group Plans have Additional Complications

Life insurance coverage through an employer comes with issues that do not apply when you purchase a plan on your own. This includes legitimate reasons to deny an insurance claim, which include:

• The insured was not a full time employee.
• At the time of death, the policy holder was out on sick leave.
• The duration of employment with the employer was not long enough.
• The employer did not deduct the correct amount for the premiums.
• The policy was not ported correctly to the new employer when the employee found another job.

Please note that even with these issues, you may have a claim to the funds from an employer group plan life insurance policy. In a lot of these cases, the fault lies with a party other than the deceased, like the claims administrator at their job. Thus, it’s important to find a lawyer who can investigate what happened and advise you on the best way to move forward.

The Life Insurance Lawsuit Attorneys of Kenmore

Right now, you can contact our law firm and schedule a time to discuss your case with one of our legal experts. With decades of experience in bad faith tactics by insurance companies, you can count on us to provide the advice and guidance you need if your claim for life insurance was denied.

All clients here at Kenmore Law Group are protected by the Zero Fee Guarantee. Instead of charging you upfront for the cost of legal fees, we wait until your settlement is recovered. At that point, a percentage of your check goes toward covering our expenses. If we fail to win your case, you won’t be charged for any legal fees.

If you’re ready to schedule a free case evaluation, please take a moment to contact our office.