Why Would Your Life Insurance Claim be Denied?

December 31, 2019 | J. Price McNamara
Why Would Your Life Insurance Claim be Denied? The main reasons why people purchase life insurance is so that their loved ones will be protected when they pass away. During the policyholder’s lifetime, the policyholder pays premiums. In return for those premiums, the insurance company agrees to pay out a specified amount of money to the beneficiary when the policyholder passes away.  However, it may surprise some individuals to know that life insurance claims are routinely delayed or denied for a variety of different reasons. The insurance company is supposed to state the reasons for a claim denial in a letter. However, these letters often include confusing policy language or statutory provisions.  If you are a beneficiary under a policy and your claim for life insurance benefits has been denied, you should contact the experienced Texas life insurance attorneys at J. Price McNamara ERISA Insurance Claim Attorney today. Our skilled legal team could help you appeal the denial of your claim and work to pursue the benefits to which you may be entitled. 

Common Reasons for Life Insurance Claim Denials

There are a variety of reasons why a claim for life insurance benefits might be denied. Some of the most common reasons for a claim denial include the following:
  • The insured individual passes away within the first two years of the policy, and the insurance company insists that the policy contains material misrepresentations – Whenever someone applies for life insurance, he or she must answer questions about his or her health, weight, age, income, and prior criminal history. The insurance company could deny a claim for benefits if it later uncovers additional information that does not match the information contained in the policy answers. The alleged misrepresentation, however, must be material for it to justify a claim denial. 
  • The employer fails to do something – Many employees pursue life insurance benefits through an employer-sponsored group plan. However, the employer may not properly represent certain information, which could result in a loss of benefits following the insured’s death. 
  • Premium lapse – In most cases, a life insurance policy only remains active during such time as premiums are being paid. If a covered individual misses a payment or fails to pay his or her premiums, it is likely that the policy will lapse. Insurance companies routinely use these premium lapses as a basis for denying coverage when the need arises. 
  • Exclusions – Insurance companies are typically very precise about certain instances or situations that the life insurance policy does not cover. If your situation fits into one of these exclusionary provisions, the insurance company might try and use the exclusion as a basis for denying the claim. 

Speak with a Texas Life Insurance Attorney Today

If you are a beneficiary under a life insurance policy and receive a claim denial letter from the insurance company, you should never accept this letter as the final verdict. At J. Price McNamara ERISA Insurance Claim Attorney, we could review the denial with you and present you with some legal options.  To schedule a free legal consultation and case evaluation with a Texas life insurance attorney, please contact us online today for more information. 
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J. Price McNamara


Losing my own brother, then my father and sister after long, disabling illnesses just a few months apart drove a career change for me. Before that experience, I never truly understood the place you’re in. I never understood the dramatic impact that receiving (or not receiving) the disability and life insurance benefits you paid for and counted on can have on your life especially when you need to focus on family and healing. What I experienced with my own family now drives the way I view my clients and my work, and I will never forget it!

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