A life insurance denial is more than just shocking. A benefit denial can be a major blow during an incredibly difficult time in your life. Fortunately, there are measures you can take to appeal your denied claim and receive any benefits that you are entitled to receive. Below are seven steps to take if your life insurance claim is denied and the key to successfully overcoming a life insurance denial.
Step One: Request an explanation of your life insurance denial
The path to resolving a life insurance denial begins by understanding exactly why your claim was denied. The insurance company should send a letter explaining why your claim was denied. But it is also helpful to reach out to your insurer yourself to clarify the reason why they denied your benefits. Some common reasons for denial include failure to pay premiums, risky behavior, and failure to respond truthfully to questions on an initial policy application.
Step Two: Inquire about the appeals process
Once you know why your insurance company denied your claim, you need to educate yourself about your insurance company’s appeal process. No two companies are exactly alike in terms of their appeal process, so you will need to reach out to your insurer and request instructions. Here are some questions to ask:
- “What paperwork am I required to submit for my appeal?”
- “How long do I have to submit my appeal?”
- “Do you require appeal documents to be submitted electronically or should I send a hard copy to a special address?”
Step Three: Decide who will handle your appeal
At this point, you need to decide whether you would like to file your own appeal or hire an attorney to file your appeal. While both options are permissible, an attorney can play a critical role in securing a favorable outcome with your appeal.
Step Four: Gather documentation to support your appeal
Now that you have a working knowledge of the appeals process, it’s time to gather documentation to present along with your appeal. While every case is unique, there are some core documents that are often helpful in supporting appeals. They are as follows:
- Death certificate: Presenting a certified copy of the policy holder’s death certificate will build authenticity and help safeguard against fraud.
- The life insurance policy itself: The insurance company will review the copy of this policy with their own records to verify benefit amount and terms.
- Insurance payment receipts: Proof of payment for insurance premiums is especially helpful if failure to pay premiums was the reason for denial.
- Doctor’s notes and reports: Sometimes there are doctor’s notes or other key pieces of information in a patient’s file that will support your claim.
Be sure to carefully organize your documentation to ensure that your life insurance company can clearly see that you rightfully deserve your claim to be paid. Remember that any information you forget to include will not be taken into account by the court. So make sure you are thorough when collecting information.
Step Five: File your appeal
Once you have organized your appeal paperwork, it is time to file your appeal. Before filing, make copies of your appeal documents and keep them stored in a secure location like a safe deposit box. You may also wish to give a copy to your attorney or a trusted family member for added security. Then, file your appeal, making sure to carefully follow all instructions provided by your insurance company.
Step Six: Confirm receipt of your appeal
Some people think they are finished with the appeal process once they officially submit their paperwork. Ultimately, however, it is up to you or your attorney to ensure that your appeal documents were received and the appeals process is underway. You can do this by tracking the package containing your appeal documents and requesting written receipt by your insurance company.
Step Seven: Request regular status updates
Once you receive written confirmation that your materials have been received, it’s a good idea to remain actively involved in the appeal process while your appeal decision is pending. The best way to do this is to contact your insurer and request regular status updates on your appeal until a decision is finalized.
What is the single best step you can take to reverse a life insurance denial?
By following the seven steps above, you can boost your chances of reversing a life insurance denial. However, the single best way to ensure that you receive the benefits you deserve is to contact a life insurance lawyer right away. Many insurance companies require appeals to be submitted within a specified time frame, so it is important to seek legal representation as soon as possible.
With an accomplished life insurance attorney in your corner, you can approach the appeals process with confidence and increase your chances of a favorable outcome. Most importantly, you can rest assured that an experienced lawyer is leaving no stone unturned to ensure that you receive the life insurance benefits that you deserve.
Following graduation from Loyola Law School in New Orleans in 1990, Price McNamara served as a Federal Judicial Law Clerk to the Honorable John M Shaw, Chief Judge, United States District Court Western District of Louisiana.
Mr. McNamara founded the Law Offices of J. Price McNamara, and began putting his past experience to work for the injured and disabled clients he now represents against the insurance companies in personal injury and long term disability and other insurance disputes in both federal and state courts