Insurance companies deny thousands of life insurance claims a year. Many denials are decided quickly based on the information in front of the person processing the claim. However, the information before that person may be wrong. Still, once a claims processor receives correct information, the claim may be changed from denied to approved.
So how does a beneficiary change a life insurance claim denial to an approval?
Consult With an Expert
Insurance companies have teams of lawyers working full time to minimize insurance payouts. They know every possible reason a claim can be delayed or denied, and they know how to word notifications to discourage questioning of their decisions.
As a beneficiary requesting a life insurance payout, having an attorney who is experienced at dealing with insurance companies puts you on a more equal footing with the insurance company. If you have an attorney who understands how insurance companies work, the reasons claims may be denied, and how to respond to a denial, you have a better chance of receiving the benefits to which you are entitled.
Understand the Reasons For Denial
The communication stating why your claim was denied must include the specific reason or reasons your claim was denied. Understanding the reasons is key to a successful appeal. Your response, and any information you provide in support, must directly address the reasons for the denial.
If you have not done so already, organize the insurance policy documents. The applicant should have maintained a copy of his or her original application. If the applicant underwent any physical exam as a prerequisite to obtaining the insurance, you should also obtain a copy of the results of that exam. Additionally, make sure you have a certified copy of the death certificate.
The reason(s) for the denial will guide what other records you will need to collect. Your goal is to assemble factual evidence showing that your claim was wrongfully denied. For example, if there was an error on the original application, gather documentation to support why the error was not material or why it was based on information provided by the insurance company. If the cause of death is disputed or there are questions about the insured’s medical history, gather documents and other information related to those reasons.
Respond to the Denial
When a claim is denied, information is provided about how to dispute the denial. Follow the instructions exactly. Keep detailed records of when and how you respond (by phone, email, letter), with whom you speak or to whom you write and any communications that occur between you and the insurance company. Also, keep copies of everything you send to the insurance company. If you are following instructions that are on a website, take a screenshot of the page. That way, if the page is later updated, you have a record of the instructions as they were when you read them.
Keep a calendar of deadlines related to your claim and log every action on the calendar, such as when you received the denial letter, when your response is due and when you submitted a request for the death certificate or medical records.
Most people who are told “life insurance payout denied,” believe that the denial is a final decision, when in fact, many challenged denials end in some level of payout to the beneficiary. Experienced life insurance attorney Chad G. Boonswang has helped life insurance beneficiaries across the country receive the benefits to which they were entitled. Call Boonswang today at 1-855-865-4335 to find out how he can help you.