Life Insurance Litigation

Life insurance is intended to provide financial support to the bereaved family after the policyholder’s passing. But the insurance industry is a for-profit business, and all too often, insurance companies reject valid claims. For beneficiaries, this can add frustration and fear about the future to an already difficult time. However, you do have options.

Monahan Tucker Law is well-versed in life insurance law and can help you navigate a disputed claim. We have successfully challenged many insurance companies to help our clients get their benefits approved, and we are ready to help you, too.

What to Do If Your Life Insurance Claim Is Denied

There are several reasons why an insurance company might deny or reduce your claim. Here are some of the most common bases for denying a life insurance claim:

• Material Misrepresentation – Sometimes, an insurance company will deny a claim due to false or incomplete information on the application. This is usually an unintentional misrepresentation, but even something as trivial as a mistake in reporting your age can result in a denial. The insurance company has a “contestability period” of two years to identify any errors in your application. If your claim for benefits is brought in that two-year contestability period, the insurer is permitted under the law to review the insurance application for errors and to rescind the policy if it determines that material errors exist that would have resulted in them refusing to issue the policy.
• Exclusions Related to Suicide, Substances, or Intentional Acts – Many insurance policies involve language excluding death due to “intentional acts.” Insurance companies often rely on this language to deny claims that arose from accidents caused by the insured’s behavior. Examples include driving under the influence and autoerotic asphyxiation. Insurers often use the same rationale to exclude claims related to injuries caused while intoxicated or engaging in activities that could be perceived as reckless. They may even cast such activity as barred under a “suicide” exclusion.
• Lapse in Payment – If the policyholder does not make their payments, the insurance policy will lapse, and the beneficiary will not be entitled to benefits. Depending on the facts of the situation, a lapse in payment may not be the fault of the insured and the insurer can still be required to honor the contract.
• Accidental Death and Dismemberment Policies – An accidental death and dismemberment policy will only pay benefits if the death was an “accident,” not an illness. While this seems like a straightforward distinction, an insurer can easily blur it. Insurance companies have denied claims when someone fell in the shower, blaming an underlying illness for the fall. They have refused to pay claims involving a car accident, suggesting that the insured may have had a heart attack before the collision. These denials, once investigated, often do not stand up to close scrutiny and can be overturned.

Insurance Bad Faith and Elder Financial Abuse Claims

If the insured did not obtain their life insurance as an employment benefit, it may be possible to bring a cause of action against the insurer for bad faith. Bad faith insurance claims stem from situations where insurance companies unreasonably deny valid claims. If an insurance company is found to have denied your claim in bad faith, it can be required to pay punitive damages to you. Unreasonable denial of insurance benefits is also a basis for finding that an insurer has committed elder financial abuse. This also can lead to an award of additional damages.

At Monahan Tucker Law, we recognize that entering into a dispute with an insurance company can be scary and overwhelming. If you are making a life insurance claim, you are already dealing with the loss of a loved one. Insurance companies know this and rely on the expectation that you will be too overwhelmed to push back on their denial. Our job is to stand up for you to the insurance company, so you can focus on grieving and supporting your family in this difficult time. Contact us today to schedule your initial consultation.