In the aftermath of a tragedy like the death of a spouse, a letter from a life insurance company can bring desperately needed financial assistance. The payout from a life insurance claim may be needed to pay debt that has accumulated from medical and burial bills, rent or mortgage payments and routine living expenses like food, gas and car loans.
Unfortunately, sometimes the letter contains bad news that the claim has been denied. Rather than accepting the denial at face value, beneficiaries need to understand how to appeal. For insurance claim denials, the letter of delay or denial may be just one step in the process. Insurance companies deny claims for a number of legitimate and illegitimate reasons, ranging from a missing death certificate to an assertion that the policy was obtained under fraudulent circumstances.
The Appeal: Responding to Denial Letters
The process of responding to the denial is considered the start of the appeal. For insurance claim denials, an immediate and thorough response to the insurance company’s correspondence is essential. Timeframes for appealing a denial are often short and the process for the appeal is usually quite rigid. If a beneficiary does not follow all the rules precisely as laid out by the insurance company, the individual may be out of luck in getting any kind of settlement.
When a life insurance claim is denied, obtaining the assistance of an experienced life insurance attorney may be the best way to proceed. An attorney who regularly handles life insurance claim denials will understand the exact reasons for the denial and the specific steps for responding to the denial.
For example, if the insurance company disputes the cause of death, more documentation about the circumstances surrounding the death may be needed. An independent investigation into the death or an independent medical review may be needed to resolve the insurance company’s concerns.
If the insurance company claims that the policyholder failed to disclose medical conditions or life activities that would have caused the company to deny the insurance policy or charge higher premiums, the beneficiary may need to provide evidence, such as copies of all information, including medical records, that were provided during the insurance application process. Evidence about the policyholder’s lifestyle (such as tobacco, alcohol, and drug use) may need to be provided by people who knew the policyholder well and have no financial or legal interest in the outcome of the life insurance claim.
Seek Help Early
Dealing with a life insurance claim denial is the last thing a grieving widow or widower wants to do. And it is the last thing a beneficiary should have to do. When a person considers obtaining life insurance, he or she should consult with experienced financial, legal and/or insurance advisors to make sure that the policy obtained is appropriate for that person’s situation, and that there are no errors or omissions in the application process. The goal is to make sure that if the policy is ever needed, there is no reason for a denial of benefits.
Insurance claim attorney Chad G. Boonswang has helped resolve many appeals of life insurance claim denials. Contact him today for a free consultation about your life insurance claim.