McKennon Law Group, Author at McKennon Law Group

Was your life insurance claim denied in California? There are many reasons why a life insurance company might deny a claim. As Newport Beach life insurance lawyers, we commonly see cases that claim the insured individual made material misrepresentations on their life insurance application. When insurance companies believe an insurer misrepresented themselves on a claim, they have the right to deny the payout.

A denied claim is not the end of the road. It is important to remember that with any denied claim, you have the right to file an appeal and try again to get the life insurance money paid out, and what the insurance company claims is not concrete. You can always fight back against their accusations with the help of a lawyer.

Read on to learn more about life insurance claims that were denied due to alleged material misrepresentation. If you or a loved one are missing out on money that you rightfully deserve because of supposed material misrepresentation, don’t assume you are out of luck, and contact a Newport beach life insurance lawyer to help handle it.

How Do Insurance Companies Deny Material Misrepresentation?

When someone takes out a life insurance policy, they must first apply for consideration. On this application, they will be asked important questions. Among thee questions are:

Height
Weight
Smoking and use of tobacco, if any
Whether or not you use of marijuana or other recreational drugs
Any medical diagnosis you have received, recently or in the past
Any use of prescription medications, recently or in the past
Any previous or current treatments you’re receiving or expected to receive
History of medical procedures you’ve had in the past, including surgeries

Insurance companies use your answers to these questions to assess and evaluate how much risk they are taking on by insuring you. The answers to these questions will also establish the premium (how much you pay for the coverage). For this reason, some people are apparently tempted to provide false information on their application.

Material misrepresentation is “a false or misleading statement or a material omission which renders other statements misleading, with intent to deceive. Misrepresentation is one the elements of common insurance law fraud, and other causes of action for fraud, such as securities fraud.” Those who misrepresent information on their application may see their life insurance benefits get denied–but sometimes insurance companies deny benefits when no misrepresentation occurred.

What Are Other Reasons That Life Insurance Benefits Are Often Denied

There are many other reasons why an insurance company may deny a claim. Here’s an example of one commonly occurring scenario. If the insured individual passed away within the first two years that the life insurance policy was effective, the insurance company holds the right to contest the pay out.

In other cases, you may hear of insurance companies investigating the death of an insured person to ensure that the death was legitimate and that there was no foul play involved in order to cash out the policy.

What Is A Contestability Period

There is a two year window in which an insured individual holds the right to contest, or oppose, the denial of an insurance claim. This window of time is referred to as the contestability period. The insurance company uses this time to check the medical records of the insured person to make sure they provided truthful answers–in other words to ensure no material misrepresentation occurred. If, during this investigation period, the insurance company discovered untruths, they do have the right to deny paying out the life insurance claim.

Schedule A Free Consultation With A Newport Beach Insurance Attorney If Your Life Insurance Claim Was Denied Due To Material Misrepresentation

When you need an attorney to aggressively fight your insurance company, choosing the right law firm is the most important decision you will make. As Newport Beach insurance attorneys, we have seen many California residences get their life insurance claims wrongfully denied due to material misrepresentations. Accidents happen, and sometimes insurance companies do make mistake when the deny paying out certain claims

McKennon Law Group PC maintains offices throughout California, allowing us to serve you anywhere in the state, including the metropolitan areas of Los Angeles, Orange County, San Diego, San Francisco and the Central Valley. Our lawyers also represent insured policyholders nationwide. No matter what your situation is, our insurance attorneys have the experience to fight back against a denied claim and will always make sure you’re not being taken advantage of by your insurance company.

Schedule your free life insurance case evaluation with McKennon Law Group PC today.

According to the U.S. Department Of Labor, the Employee Retirement Income Security Act of 1974 (ERISA) is: “a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans. It requires plans to provide participants with plan information including important information about plan features and funding and sets minimum standards for participation.”

Among these other benefits, ERISA includes the right to file a lawsuit to recover the benefits you are entitled to in your plan. ERISA law can seem complex, especially if you are unfamiliar with how it all works. Since ERISA is such a complex federal law, it can change the way a lawyer takes care of claims and the litigation process. Read on to learn more about how ERISA litigation works, and if you are experiencing problems due to a denied ERISA claim, contact McKennon Law Group PC for a free phone consultation about your case.

Does ERISA Litigation Take Place In Court?

Generally speaking, ERISA litigation is handled within the federal court system. If your life insurance was denied, the life insurance denial lawsuit will be filed initially within the state court system, and then will more than likely be transferred over to a federal court. There are time limits that govern when you can and cannot file an ERISA litigation claim, so check the specifics of your individual coverage plan to be sure–or hire an attorney to make sure you don’t miss any important deadlines.

How Are ERISA Claims Handled In Court?

When you undergo an ERISA claim trial, the process is much different than if you were in criminal case proceedings or even civil case proceedings. One of the reasons why these cases are different is that ERISA court judges decide the outcome of that case simply based upon the pleadings filed with the court. The court reviews all relevant records and uses that as evidence to make the decision of whether or not you are entitled to the ERISA claim money. It is the responsibility of the judge to decide if the insurance company was acting in bad faith when denying your ERISA claim, or if they had the right to deny the claim.

What Steps Do I Have To Take Before Filing An ERISA Claim?

Before filing an ERISA claim, be sure to contact a Newport Beach, California ERISA attorney to supervise and assist you in filing a successful claim. It’s crucial to have a qualified insurance attorney look over all important documents to ensure you have a strong claim. If your claim was wrongfully denied, you could be missing out on money that is rightfully owed to you, and you shouldn’t have to fight for it alone. McKennon Law Group PC has the skill and experience to help you fight back against a bad faith insurer who wrongfully denied you money.

Before you file an ERISA lawsuit, you have to file an administrative appeal first. This is a mandatory first step before you attempt to pursue litigation. Be sure to file this appeal by the pre-designated deadline. This deadline is often sixty or one hundred and eighty days from the date on the letter of benefits denial.

How Do I Recover Benefits On Behalf Of My Lost Loved One If My ERISA Claim Was Denied?

As long as you can prevail in your ERISA litigation and file a successful claim, you can recover the death benefits you were wrongfully denied. As you may already know, this process can be difficult, so it’s best to do so with the help of a Newport Beach insurance attorney by your side. There are many important steps and documents that must be filed in a timely manner, so never gamble with the outcome of a case by attempting to handle all the small details on your own.

Getting the money you deserve, as your loved one intended, is crucial, so call a lawyer as soon as you discover your benefits have been denied. At McKennon Law Group PC, our team of attorneys have extensive experience helping California residents in this situation, and will fight on your behalf to get what you deserve.

Schedule A Free ERISA Claim Consultation Today With McKennon Law Group PC

The attorneys at McKennon Law Group PC understand the unique laws that surround ERISA and how this federal law can protect you from missing out on your loved one’s financial benefits. For more information, schedule a free consultation with our law firm. We help clients throughout California and nationwide.

In Winters v. Liberty Life Assurance Co. of Boston, 2022 WL 6170588 (D. Mass. 2022), the First Circuit recently denied Liberty’s motion for a judgment on the administrative record on the basis that Liberty had not sufficiently analyzed whether the claimant, Winters, could perform his own occupation. Winters had been receiving long-term disability (“LTD”) benefits, which Liberty terminated based on its review of the medical evidence and occupational analysis of Winters’ occupation as a mortgage consultant for Wells Fargo. The court found, inter alia, that Liberty failed to properly investigate Winters’ job duties and apply them to the medical evidence. The court stated that Liberty’s decision to terminate Winters’ LTD benefits was “unreasonable based on the record before it because Liberty did not complete an assessment of whether Winters was able to carry out all of the material and substantial duties of his own occupation as defined by the relevant disability plan. Rather, Liberty made a determination that Winters could perform sedentary or light physical work.” (Emphasis added).

Liberty’s position when it terminated Winters’ benefits was that according to the medical evidence, he should be able to perform the duties of his own occupation. Liberty’s review included independent medical review reports, vocational review reports, and a labor market survey. However, the court, citing McDonough v. Aetna Life Insurance Co., 783 F.3d 374 (1st Cir. 2015), stated that the relevant question “is not whether Winters is able to perform sedentary or light physical work. The proper inquiry is whether he is able to perform the Substantial and Material Duties of his Own Occupation – his particular position as a Mortgage Consultant or Financial Services Sales Agent.” Because Liberty’s vocational review reports and labor market survey focused on the physical demands generally associated with “sedentary” or “light physical” work, rather than on the substantial and material duties of Winters’ own occupation, Liberty had performed only part of the inquiry required of it under ERISA.

The court distinguished between physical and non-physical duties of Winters’ occupation and concluded that Liberty’s analysis as to whether Winters could perform sedentary or light physical work was only part of the relevant inquiry of whether Winters could perform the material and substantial duties required of a Mortgage Consultant or Financial Services Sales Agent. Liberty identified non-physical duties of Winters’ occupation in his employer’s job description, but it did not analyze the non-physical duties in the context of the medical evidence, did not include them in its labor market survey, and did not discuss them in the denial letters it sent to Winters. The court concluded that while Liberty may have properly reached its decision to terminate Winters’ LTD benefits, it was not apparent from the administrative record, as Liberty never made the requisite comparison of the medical evidence against the non-physical duties of Winters’ occupation. The court stated that “[i]t was insufficient for Liberty to rely on blanket statements from the doctors that restrictions and limitations are not supported by the record without addressing the duties Winters was called upon to perform.” The court also noted that Liberty was obligated to analyze the medical assessments as compared with the job requirements, rather than in the abstract context of whether Winters could perform “sedentary” or “light physical” work.

In response to Winters’ contention that Liberty should have provided his job description to its reviewing doctors, the court explained that the proper focus of the inquiry was not Winters’ job description or whether he could perform the duties of his particular position at Wells Fargo, but whether he could perform the duties of his own occupation, as defined in the local economy. While Winters’ job description may accurately describe the duties of his own occupation, Liberty was also permitted to draw on other sources, like the Department of Labor Dictionary of Occupational Titles, to determine the duties of Winters’ own occupation.

The court ultimately concluded that Liberty did not adequately explain how Winters would be able to perform the duties of his own occupation (particularly the non-physical duties), but rather only analyzed whether Winters could perform sedentary or light work. Whereas Winters’ job may have been properly described as “sedentary” or “light,” Liberty’s determination that Winters could perform the duties of his job because he had the physical capacity to perform such work failed to take into account other requirements of Winters’ occupation not adequately contemplated by the definition of “sedentary” or “light” work.

The court’s decision makes it clear that insurers like Liberty must apply the medical and vocational evidence to the occupational profile and determine whether a claimant like Winters is disabled. Liberty’s flaw was that in its analysis, it “improperly conflated Winters’ Own Occupation with general sedentary or light work” (citing McDonough, supra, at 380). The court went on to explain that while it was possible that Liberty’s decision was sufficiently supported by the medical evidence, it was not evidenced from the administrative record and Liberty did not communicate it properly in its decision letters to Winters.

The subtle distinction discussed by the court in Winters presents a nuance that is often overlooked. Therefore, it is critical for a claimant like Winters to retain legal counsel who will know and understand the distinction and how it can impact a given disability claim.

The attorneys at McKennon Law Group PC are highly experienced in handling ERISA claims, including claims for LTD benefits like in Winters.

If you or someone you love needs to file a disability insurance claim due to a mental health condition that makes it impossible to perform your occupational duties, you are going to need the advice, insights and services of a California disability insurance claims attorney.

How can you prove to an insurance company that you are suffering from a disabling mental health condition, a condition that cannot be observed or measured? What steps can you take if an insurance company denies your mental health disability insurance claim?

Keep reading this article concerning disability insurance mental health claims and you will learn why you may need the advice and services of a California disability claims lawyer in order to prevail with your disability insurance claim.

What Should You Know About Filing a Disability Insurance Claim?

People who struggle with certain mental health conditions may be eligible for benefits through employer-sponsored short-term disability insurance (STD) or long-term disability insurance (LTD). There are also STD and LTD policies purchased directly from an insurance company, typically through a life and disability insurance agent or broker.

Qualifying mental health conditions may include anxiety, depression, eating disorders, obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder (PTSD). These conditions are often as debilitating as any physical illness or injury.

Most STD and LTD policies require you to be covered by the policy for a certain period of time – called an “elimination” or “qualifying” period – before you may file a claim for benefits. That time period may vary, but most policies establish a two-year qualifying period.

In addition, most employer-sponsored STD and LTD policies have a limitation on the time period for which you can receive disability benefits. This period is typically 24-36 months. Most individual disability income policies have no time limitations for receiving disability benefits based on a mental health condition.

How Can You Prove a Mental Health Disability?

To prove your mental health disability claim to your disability insurer, you will need to submit a disability insurance claim form along with an attending physician statement signed by your treating physician or other medical provider who provides a statement of your mental health conditions and how and why you have restrictions and limitations as a result. You will also be required to provide your disability insurer with your medical records, test results and any other pertinent medical evidence which indicates that you are unable to perform your work or maintain full-time employment.

A comprehensive professional letter that discusses your condition should include a clinical diagnosis for the condition (i.e., depression, bipolar disorder or schizophrenia) and indicate that you cannot perform work or maintain employment because of that condition. The statement should also address how your mental health condition affects your activities of daily living. A statement of the restrictions and limitations you have should be clearly stated and your medical health professional should state why your medical condition renders you unable to perform your occupational duties.

Provide the insurance company with as much medical evidence as you can in order to strengthen your claim. Include statements from those who are closest to you (e.g., friends, co-workers and family members) because they are the ones who see how your mental health affects your ability to perform work, maintain employment and your activities of daily living.

If Your Claim is Denied, Can You File an Appeal?

In most situations, you will be able to appeal the denial of a disability insurance claim. Whether you are required to do so depends on whether your claim is covered by a federal law called the Employer Retirement Income Security Act of 1974 (ERISA). Often, an appeal will be necessary since insurers or their hired medical consultants will work hard to uncover any evidence to deny your claim for disability insurance benefits. For example, we often see insurers hire medical consultants who misrepresent that they attempted to contact our clients’ medical health professionals but were unable to do so. The insurer will then use this information to deny the claim, asserting that our clients’ doctors did not cooperate with claim investigation and infer that the clients’ doctors were afraid to have contact because they did not truly have support for the mental health disability claim. These medical consultants who are beholden to the insurers that pay them will ignore medical evidence or misconstrue it to justify a conclusion that you are not disabled.

If your disability claim is denied, you typically have the right to appeal the disability denial decision within a limited time period. To begin the process of filing an appeal, you should contact an experienced disability insurance claims attorney for help. You can appeal a denial of your claim for mental health disability insurance benefits, but the appeals process is usually more complicated if your insurance is employer-provided than if you purchased the policy privately.

Private sector, employer-provided disability policies are governed by ERISA, the federal law which sets legal requirements for group insurance, retirement and pension plans provided by private employers. As discussed in more detail below, if your disability insurance claim is governed by ERISA, you will be required to file an appeal of your denied disability insurance claim.

What Does ERISA Require?

ERISA requires you to pursue at least one “administrative” appeal through your insurance company before you may take the company to court. In most cases, you will have 180 days from the date you receive a claim denial letter to file an administrative appeal with the company.

If you fail to follow the insurance company’s administrative appeal process, you could waive your right to continue to pursue your disability claim. If you do not present adequate evidence of your disability claim to the insurer on appeal, you will likely have waived the ability to provide any further evidence in your subsequent court case against the insurer. Therefore, you can ensure that no mistakes are made by asking an experienced disability insurance claims attorney to handle your administrative appeal on your behalf.

Federal courts have jurisdiction in ERISA-related legal matters, but if you purchased disability insurance privately in California, and if you believe that your claim has been wrongly denied, a California disability insurance claims attorney can negotiate with the company on your behalf, or if necessary, take your case to the California or other state courts. Many attorneys handle disability claims nationwide, including the McKennon Law Group PC.

What is Bad Faith?

In California as in most states, if your disability claim for your mental health condition is denied by your insurance company, you may be able to bring a bad faith lawsuit against the insurer for your unpaid disability benefits as well as for:

emotional distress and other damages caused by the company’s bad faith
interest on past-due benefits
your attorney’s fees
possible punitive damages

Bad faith is the legal term for what happens when an insurance company handles a claim unfairly or, more precisely, unreasonably. An insurance company’s bad faith practices may include but are not limited to:

persistently trying to settle your claim for less than it is actually worth
unreasonable delays
rejecting your claim for disingenuous or false reasons
threatening to cancel your coverage unless you accept a “lowball” settlement amount
continually demanding more information as a delaying tactic
inadequate investigation of the disability insurance claim

How Will a Disability Insurance Claims Attorney Help You?

If you are struggling with either the claims process or the appeals process, contact a California disability claims lawyer at once for the legal assistance you need. In fact, the smart move is to consult an attorney even before you submit your initial mental health disability insurance claim.

Your disability claims attorney will ensure that all of your paperwork is accurate, complete, and on time, and your attorney will additionally ensure that there are no misunderstandings or mistakes on your part that could delay or derail the claims or appeals process.

If you let an experienced California insurance claims lawyer guide you through the claims or appeals process, you will be much more likely to prevail. In order to prevail, you should work from the beginning of the process with an attorney who has thorough knowledge of ERISA, disability insurance claims, your rights, and the law.

If you need to file a mental health disability insurance claim, or if you have already filed a claim that has been denied, arrange a legal consultation – at no cost and with no obligation – to discuss your case with an experienced and capable disability insurance claims lawyer as soon as possible. We believe McKennon Law Group PC should be that law firm.

State and federal laws obligate disability and life insurance companies to treat every policyholder fairly and to act in good faith. If your insurance company is not treating you fairly, or if it is acting unreasonably and in bad faith, you will need the advice and services of a California insurance claims attorney. You may need to take legal action against an insurer and it will be critical that you consult with the best and most experienced life and disability insurance attorneys you can find.

How is insurance bad faith defined? If an insurance company does not meet its legal obligations to you, what are your rights? What steps can you take? If you will keep reading this article discussion of insurance bad faith and your rights, you may find some of the answers you need.

What do we know about Bad Faith?

Your insurance policy is a contract and a pledge that it will pay your covered claim expeditiously and fairly. It is your insurance company’s commitment to provide coverage when you require it. If you are paying for a life, accidental death or disability insurance policy, the insurance company may have the legal duty to provide coverage and to negotiate in good faith any claim you submit.

When your insurance company violates what is known as the implied covenant of good faith and fair dealing implied in all life and disability insurance policies, by for example unreasonably denying your life or disability insurance claim, you have the right to file a lawsuit to recover what the company owes you. This may include not only contract damages, but also extracontractual damages, such as emotional distress, consequential damages and punitive damages. Insurance bad faith includes but is not limited to an insurance company’s failure to:

pay a claim in a reasonable amount of time
offer a settlement figure that represents the claim’s actual value
pay or negotiate a claim, or clarify the reason for rejecting it
reasonably investigate a claim
use a non-biased expert who evaluates the claim
follow reasonable claim standards

When Should You Contact a Life or Disability Insurance Claims Attorney?

By itself, a reasonable disagreement about the value of your life or disability insurance claim is not bad faith, but if the insurance company has not treated you fairly, has not negotiated with you in good faith, or fails to pay a claim within a reasonable amount of time, then you should take the case to a life, disability or accidental death insurance claims lawyer.

A fight with an insurance company is the last thing that a seriously ill person or a disabled person needs. If your claim has been denied – or ignored – and you believe that an insurer has acted in bad faith, you may have to take legal action to recover your damages caused by the insurer denying or ignoring your life, accidental death or disability claim. .

How can you know if your insurer has acted in bad faith? Schedule a consultation with a California life or disability insurance claims attorney. That attorney will review your situation and help you determine if filing a lawsuit is the best way for you to proceed.

How Will Your Life or Disability Insurance Lawyer Fight on Your Behalf?

A California life and disability insurance claims lawyer will investigate your claim of bad faith and your insurance company’s practices, policies and procedures. That attorney will file a lawsuit against the insurance company and then conduct discovery, such as taking depositions of the disability or life insurance claims representative or other representatives of the company or may subpoena one of those parties to testify in court.

Your attorney may also hire appropriate experts, such an experienced life or disability insurance claims expert that will provide a report about the insurer’s bad faith and/or to testify about the insurance industry’s procedures, standards, and practices.

How Do You Prevail With an Insurance Bad Faith Claim?

Lawsuits that assert bad faith on the part of an insurance company must include specific facts that are evidence of that bad faith. Your life or disability insurance claims lawyer must show that rejecting or mishandling your claim was not simply a mistake but was instead either intentional bad faith or neglect amounting to unreasonable behavior.

You can help your own case by making and storing copies of the documents related to your case: medical bills, policies, and correspondence, for example. Take notes when you have discussions with the company representatives; include the date, time, and the name of the party you spoke with.

Insurance bad faith cases are about betrayal. Particularly after paying your insurance premiums, the product and services that you have paid for should be provided.

What Else Should You Know About Insurance Bad Faith?

If you are convinced that your insurance company is negotiating or acting in bad faith, sometimes merely sending a letter to the company – or asking your attorney to send a letter on your behalf – may prompt the company to take the action you need.

In fact, merely retaining an experienced and aggressive life or disability insurance claims lawyer will often persuade an insurance company to treat you properly. If the company knows you may take legal action, and that it could be ordered to pay additional damages along with your contract damages, it may be willing to deal properly with your claim.

The prospect of paying additional damages is one reason insurance companies try to avoid going to court, but a top California life or disability insurance attorney will use every appropriate legal tool to hold your insurance company accountable and recover your payout.

Can You Receive Punitive Damages?

If you prevail in court with your insurance bad faith claim, you will be entitled to damages. Along with the payout on your contract claim, you may also receive punitive damages, which are intended to penalize and deter insurance bad faith. When are punitive damages awarded?

If your lawsuit prevails, you may receive compensatory damages: the payout of your original claim along with your attorney’s fee and other quantifiable financial damages (such as lost income) that were the result of a bad faith delay of your payout or denial of your claim.

California also allows a court or jury to order the payment of punitive damages when a company’s bad faith amounted to intentional fraud, oppression or malice. However, punitive damage awards are rare in California. Your attorney will explain whether or not your own case may qualify for punitive damages.

What Will It Cost You to Seek Your Damages?

Only by retaining a California insurance attorney who routinely handles life, disability or accidental death bad faith insurance cases will you be able to recover your damages from your insurance company based on its bad faith behavior.

Your first consultation with a California insurance attorney is provided with no cost or obligation, and it typically costs you nothing to begin the legal process. Life and disability insurance attorneys in California work on a contingent fee basis, so if for any reason your claim does not prevail and you do not receive a recovery, you will owe your attorney nothing.

If you believe that your insurance company is not treating you properly, take advantage of your first free legal consultation to learn more about your rights as a policyholder and to learn how the law applies to your own bad faith case. McKennon Law Group PC has over 75 years of collective insurance bad faith experience handling life insurance, disability and accidental death insurance claims.

Life insurance policies are a smart way of financially protecting your loved ones in the future. If anyone in your family relies on your income and financial support, and will experience hardship if this financial support no longer exists, life insurance will pay out a sum of money to these dependents once you’ve passed away. The insurer should pay out the full amount in the policy after the insured dies. But, sadly, this isn’t always the case.

Big life insurance companies have a bottom line, and are always trying to save money. Sometimes, these big life insurance companies will deny reasonable claims for simply no reason at all. When this happens, beneficiaries of the deceased may experience serious financial hardship without the life insurance money that was intended to protect them.

Read on to learn what you can do if your life insurance claim was denied by the insurance company. We’ll break down what you can do and, if you have any questions about life insurance policies or about filing an appeal for a denied claim, contact us for a free consultation regarding your situation.

How Do I Know My Life Insurance Claim Was Denied?

You will be contacted by the life insurance company in order to tell you that your life insurance claim has been denied. The insurance company sends the proposed beneficiary a formal letter by mail, which will break down the reasons why the life insurance claim was denied. In the letter, the insurance company will typically take this time to quote specific standards and provisions from the policy that apply to your specific case, listing documents that they reviewed and evidence they leveraged in order to make the decision to deny your claim.

In some random cases, a beneficiary’s claim may be denied via a phone call. If you have had your life insurance claim denied in a phone call, you have every right to contact your life insurance company and request a formal denial letter in writing. It will be helpful to have this document on hand. A denial letter not only outlines important information that is required to fight back against the denied claim, but it also demonstrates exactly what day the life insurance company decided to deny your claim, and helps you outline a timeline for appealing the claim or deciding to file a lawsuit.

The denial letter that a beneficiary receives from the insurance company will be a crucial part of the appeal procedure, so be sure to have a physical copy for your records. With this information, a skilled California life insurance lawyer can outline a procedure for filing an appeal.

Why Did My Life Insurance Claim Get Denied In California?

There are a multitude of reasons why a life insurance claim can get denied in California. The following is a list of just a few examples, as there are many more reasons:

Policy was canceled or the life insurance lapsed because of a missed payment
Failure to reinstate the policy after a lapse or missed payment
Failure to provide correct or accurate information on life insurance application
The deceased passed away due to alcohol or drug use, including prescription drug misuse
The deceased passed away due to a sickness or treatment that is excluded from the policy
Failure to disclose a pre-existing medical condition
Failure to disclose frequency of medical check ups
Misrepresentation of the deceased’s weight, age or income
Denial under the two-year life insurance contestability clause
The deceased passed away via suicide
The deceased passed away in a foreign country
And much more

When filing for any kind of insurance, always be sure that you consult with a lawyer in order to know what you’re signing up for, and what is required of you to ensure you receive the full scope of benefits that you are requesting.

How Does A Lawyer Help Me File An Appeal For A Denied Life Insurance Claim?

First, your lawyer will help you contact the insurance company to find out why exactly the claim was denied. Sometimes, denial letters are hard to decipher, so we will help you figure out exactly what you need to do to proceed. Your insurance company will let you know if your policy allows you to file an appeal, and will let you know which documentation you need to do so. This may include medical records, reports of an autopsy, or receipts of your insurance payment. Your lawyer can help you collect all of this.

Our attorneys handle denied life insurance claims all the time. We will take the time to listen to your fears and concerns and, in a free consultation, will provide you with all of the resources you need to get help. To successfully file an administrative appeal for a denied life insurance claim, your California life insurance attorney will create and present a strong convincing argument that is based upon the facts of the case, which will be supported by the state and federal laws that govern it.