The Mysteries of Life Insurance Claim Denial


Insurance, especially life insurance, can be a topic of extreme perplexity for most of us. In fact, life insurance claim denial is regarded as one of the most terrible experiences that one goes through if he or she is the beneficiary and is trying to stake a particular insurance claim received in the form of a life insurance policy payout. It is often acclaimed as an ignorant fact that once the beneficiary’s name is entered into the policy and as long as the policy is in action, the amount will be paid by the life insurer. In one way, this expectation of the beneficiary is nothing uncommon and a well-established insurance company certainly works in this way. The payout is generally claimed and given out within two weeks.

How does the process of Insurance Claiming work?
There are many factors that even these insurance companies look into before they make the payout. The most important aspect is to perform an investigation where the beneficiary is required to produce all the necessary documentation of the insured person’s death including the death certificate and a photo copy of the original insurance papers. The beneficiary is also required to prove his or her identity and relationship with the insured. If the associated insurance company is a reputed one, then there are hundred percent charges where the company records will match the ones submitted by the beneficiary and thus, the claim can easily be fulfilled. However, when there are situations like no company data, loss or damage of the original insurance policy papers, that is, when one can expect a life insurance claim denial.
The fact however remains that the insurance company is all about the money that is accumulated in the form of insurance by individuals of all sects. However, in any such case of denial, meeting an experienced attorney from Boonswang Law  will certainly help one to understand that next significant steps to be taken.
Reasons for Life Insurance Claim Denial

  • Invalid documentation
  • No proper documentation with relevant signatures from both insured and the beneficiary
  • Non-availability of the death certificate and valid authentication from the morgue, hospital or the funeral home
  • The copy of the insurance policy does not match the original one
  • The beneficiary details, photo ID and address proof

However, the most noticeable reason as to why a claim could be denied by the life insurance company is on the grounds of “material misrepresentation”. This is nothing but a state law that directs insurance practice in the state. In other words there are many rules that have been formulated by the government and the insurance company should deny instantly while covering the insured. This misinterpretation can happen in two ways – sin of omission or a lie and includes the following factors

  • Questions about personal health and/or medical history
  • Usage of tobacco and tobacco related products
  • Alcohol drinking limit and the regularity
  • Employment history in the last few companies – if application
  • Income level in the current and previous company
  • Lifestyle

Applying to the life insurance company in the form of beneficiary requires one to be extremely careful. Based on a close scrutiny only, the insurance company approves the claim. For best results and help in the complex issues, one can also contact experienced professionals from the Boonswang Law Company.


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