What to do if your life insurance claim is denied

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“The life of the dead is placed on the memories of the living. ”

— Cicero

Follow these 4 steps if your life insurance company denied your life insurance claim.

Step 1

Contact the insurance company. Ask them for a letter explaining why the claim was denied. The letter should include both facts and policy language. The company is generally required to tell you why the claim was denied.

Also ask them to provide copies of the documents they relied on in denying the claim.

Step 2

Review the life insurance policy. Compare it to the policy language used in the denial letter. Does the insurance company’s denial make sense in light of the policy language?

Don’t despair if it doesn’t make sense, because these policies are extremely confusing. They are not written to be readable. Insurance companies take advantage of poorly written policies because they are stuffed full of exceptions, conditions, and bewildering language. But at least spend 15 minutes skimming through it, especially the language cited by the insurance company in its denial letter.

Step 3

Appeal the denial. Most insurance companies have an internal appeal process. You can guess the likely scenario in that outcome, but at least try. Submit relevant documentation with your appeal (e.g. medical records).

Step 4

Contact an attorney who handles life insurance disputes and denials.

Of course in most cases Steps 1 to 3 are superfluous and you should just start at Step 4. In fact, most attorneys would start working on the case by doing Steps 1 to 3.

An attorney should provide a free consultation, so you have nothing to lose. And most cases will be handled on contingency.

Postscript

Here are a few things to consider as well:

  • Essentially what you have is a contract dispute. You and the life insurance company entered into a contract, the life insurance policy, which sets out obligations you have (e.g. paying the premium) and obligations the life insurance company has (e.g. paying out the policy according to the contract). You need to determine whether the life insurance company failed to fulfill its obligations under the contract.
  •  Prepare for a long fight if the life insurance company denies your claim. Preparing for litigation, and litigation itself, takes a lot of time. Don’t expect the life insurance company to cut a check right after you contest its denial.
  • Keep all relevant documents like medical records, death certificates, letters to and from the life insurance company, and the life insurance policy.
  • Don’t assume a life insurance company made the right decision in its denial. Consult with an attorney. Don’t ever assume the life insurance company has your interests at heart.

Questions? Contact Me for a free consultation.

Evan Walker

Evan W. Walker is a La Jolla attorney who has practiced law since 2008. He is licensed to practice in California, Connecticut, and Louisiana. His entire practice has been in litigation.

Evan is from a small town outside of New Orleans. He attended law school in New Orleans, which was interrupted by Hurricane Katrina. After evacuating to Houston, Evan graduated in 2008 as part of the ‘Hurricane Katrina Class.’

After graduation, Evan worked for a New Orleans insurance defense firm. He defended insurance companies against Hurricane Katrina lawsuits brought by homeowners and business owners.

In 2010, he and his wife moved to New Haven, Connecticut, so his wife could complete a medical residency at Yale. During the next few years, Evan worked for Travelers Insurance Company defending countless personal injury lawsuits.

In 2014, he moved to San Diego so his wife could complete a medical fellowship at UCSD. He then opened his own firm to represent people after years of defending insurance companies.

Evan is a Featured Faculty at Attorney Credits, a CLE company, and a regular contributor to various podcasts and publications. He has also been interviewed by San Diego television stations about his cases and practice.

Evan spent almost a decade as a defense attorney who defended insurance companies from personal injury and property damage lawsuits. He knows how insurance companies bully people and deny claims. And he knows how to fight them.

Bar Admissions: California Connecticut (inactive) Louisiana (inactive)

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