An incontestability clause is a provision in an insurance policy that prevents the insurer from canceling or denying a claim due to misstatements after the policy has been in effect for a set period, usually two years.
Once this period passes, the insurance company can no longer use certain errors or omissions on the application as a reason to deny benefits.
This clause is common in both life insurance and disability policies. It provides important protection for policyholders by limiting the time an insurer has to challenge the validity of a policy. Without it, an insurer might delay reviewing a claim only to dispute the policy later based on something in the original paperwork.
If you have questions about how this clause affects your coverage or denial, a Baton Rouge life insurance claims lawyer may be able to help you understand your rights and options under the policy.
How a Law Firm Can Help With Incontestability Disputes
If your claim is denied after the incontestability period, you may have more legal leverage than the insurance company is letting on. Understanding whether the denial violates your policy rights takes experience with ERISA insurance disputes and claim timelines.
At ERISA Insurance Claim Attorneys, we help clients nationwide appeal denials involving life and disability insurance policies governed by federal law. Our team focuses exclusively on ERISA-regulated claims, and we work entirely remotely to make the process simple and efficient.
If the insurer is ignoring an incontestability clause or misapplying exclusions, we can help you take the next step.
For a free legal consultation, call (225) 201-8311
Why Do Incontestability Clauses Exist?
Insurance applications often include personal and medical information that can affect whether coverage is issued. If a person makes an honest mistake or forgets a detail, the insurer may later try to use that as grounds to deny a claim. To prevent this from happening indefinitely, incontestability clauses were introduced.
Here’s what these clauses do:
- Create a time limit for the insurer to investigate and challenge application details.
- Provide certainty that coverage will remain valid after the contestability period ends.
- Protect beneficiaries from losing coverage due to minor or unintentional errors.
Once the clause takes effect, the insurer must pay valid claims unless there is clear evidence of fraud. This gives policyholders peace of mind that their benefits will be honored after the initial review period.
How Long Is the Incontestability Period?
Under Louisiana Revised Statute § 22:942, the incontestability period is typically two years from the effective date of coverage. During those first two years, the insurer can:
- Review the application in detail
- Investigate medical history or reported conditions
- Deny a claim if they find inaccurate or incomplete information
After that time passes, the insurer can no longer deny a claim based on mistakes in the application unless the misstatement was intentional and fraudulent. It’s important to note that the two-year clock starts from the date the policy becomes active, not necessarily the date of application or approval.
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What Is Covered by an Incontestability Clause?
This clause generally applies to:
- Mistakes in medical history
- Missed details about past treatments
- Incorrect personal information (like age or weight)
- Minor omissions that were not intentionally misleading
As long as the misstatement was not fraudulent, the clause prevents the insurer from using it to cancel the policy or deny benefits after the two-year period ends. However, some situations are not protected by the clause.
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Why This Clause Matters in Disability and Life Insurance
In disability and life insurance cases, incontestability clauses can be the difference between a paid claim and a financial loss. Many denials occur because insurers claim the policyholder left out information on the original application. But if the clause has already taken effect, that kind of denial may no longer be allowed.
Examples of how it may apply:
- A life insurance claim is submitted three years after the policy started. The insurer tries to deny it due to a past medical condition that was not disclosed. The incontestability clause may prevent that denial unless there was fraud.
- A long-term disability policyholder begins receiving benefits but is later cut off based on a re-review of their original application. If the contestability period has expired, that cutoff may be unlawful.
Understanding this clause can help policyholders and beneficiaries push back against unfair denials.
How Legal Help Can Make a Difference
If your claim was denied and you suspect the insurer is relying on outdated or unfair reasons, legal support can help. A law firm that handles insurance claims can review:
- The terms of your policy’s incontestability clause
- The insurer’s denial letter and claim file
- Whether fraud is actually present or just alleged
- The timeline of your policy and benefit history
Many people assume they are out of options after a denial. But if the two-year period has passed and no fraud exists, that denial may be worth challenging. An attorney familiar with ERISA and insurance contracts can explain whether the insurer is violating the terms of your policy.
Contact a Long-Term Disability Lawyer
If your insurance claim was denied based on something in your application—even after the two-year contestability period—legal help may be your best next step. Many policyholders are unaware that their rights are protected under federal ERISA law, especially when incontestability clauses apply.
At ERISA Insurance Claim Attorneys, we have over 30 years of experience helping clients challenge wrongful denials and protect the benefits they were promised. Our remote, streamlined process makes it easy to get started no matter where you live in the U.S.
Contact us today to schedule a free consultation and learn how we can help you hold the insurer accountable.
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