People purchase life insurance policies to protect their loved ones. Life insurance is essentially a contract between the policy owner and the insurance company (insurer) where the insurer agrees to pay a certain sum of money upon the death of the insured. However, life insurance companies often look for an excuse to deny a valid claim.
With the exception of fraud committed by the insured, the most common reasons insurance companies deny a claim is that there was a misrepresentation, omission, or concealment by the insured at the time of application for the policy or a later amendment. Another common reason utilized by life insurance companies for denying claims is where a missed premium payment by the insured results in a lapse of coverage. These are only a few of the common strategies insurers employ to deny valid claims.
Many life insurance policies are governed by the Employee Retirement Income Security Act of 1974 (ERISA). If the insurance policy is subject to ERISA, you must appeal the decision of the life insurance company to deny the claim within sixty (60) days of the receipt of the notification of denial. While most life insurance policies governed by ERISA require a single appeal, some may require a second appeal. Since under ERISA you must exhaust your appeals before you are able to bring a lawsuit against the insurance company, it is important that you have experienced attorneys working to preserve your rights.
The denial of life insurance benefits is a contractual problem and requires an attorney that is familiar with ERISA, insurance law, life insurance applications, life insurance policies and terminology. Our firm has experience litigating life insurance denial cases against numerous life insurance companies. If you have a claim that has been denied, we may be able to get the insurer to pay the sum your loved one intended you to receive.