Can a Life Insurance Claim Be Denied?

Can a Life Insurance Claim Be Denied? text overlaying image of a man shaking his hand no One of the best things you can do for your family is to protect their financial future with a life insurance policy. The last thing you want is for their death benefits to be denied after you’ve passed. It’s a rare possibility, but it can happen. If you buy your plan from a reputable life insurance company and make your payments on time, then you don’t have much to worry about. However, it’s important to understand how and why an insurer can contest or delay payment on a claim so you can avoid this problem for your family.

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Reasons A Claim Could Be Denied

Like we said, a life insurance claim denial isn’t common. In fact, it’s fairly easy to avoid. Below we’ve highlighted the reasons a claim can be denied or delayed so you understand what to do to avoid this situation.

Failure To Pay Policy Premiums

If you are not up to date on your premium payments when you pass away, your family may not be eligible for a payout. In fact, this is the most common reason for life insurance claim denials. So, it’s important that you pay your premiums on time, every time. If you don’t keep up with the payments your policy will eventually lapse. However, your insurance company typically notifies you of the late payment. Depending on your state, your insurance company may have to legally give you a grace period, typically about a month to pay the outstanding balance before they cancel the policy. This helps for those times when you need a little extra time to catch up.

Lying On Your Application

You are generally required to disclose any medical conditions and other risks such as dangerous hobbies when you apply for life insurance. The life insurance claim can be denied if you fail to give accurate information on your application. This is because your life expectancy is the base factor in determining your premiums, and whether or not you are eligible for a policy at all. Omitting important details on your application is known as “material misrepresentation”.

 

An incomplete or false application is another common reason for denials. Life insurance policies generally have a contestability period, which lasts about 2 years depending on the company and your state laws. During this time your insurance company can look into your policy and if they find a misrepresentation, they can decide the policy is void. If you pass away during this time, your insurer has the right to, and most likely will, investigate your family’s claim. If the company finds any misinformation, the company has two options: one, if the misinformation was small enough, they may look at how much you should have been paying on your premium and deduct that amount from the death benefit before releasing it to your beneficiaries, and two is out right denying the claim.

 

These options depend entirely on the insurance company, how big the misrepresentation was, and your state laws. So, the best thing you can do is just be honest on your application. Even if you have higher risks or health problems there are several life insurance policies that can and will cover you with the correct information.

Things You Should Expect To Disclose

Here are some examples of the kind of important information you have to disclose:

 

  • Medical history – You have to provide information on any current health conditions including your mental health. You also need to provide prescription history and family health history.
  • Dangerous hobbies – If you regularly participate in a dangerous hobby such as racing, mountain climbing, recreational piloting, and scuba diving you must tell your life insurance company.
  • Dangerous behavior – You have to disclose if you’re a smoker, have a criminal record, dangerous driving record such as a DUI conviction, or other traffic violations.
  • Dangerous jobs – Anyone with a dangerous job may have higher rates because of their daily risks at work. This includes construction workers, active military, firefighters, police, and pilots.

Contestable Circumstances

Contestable circumstances depend on how you pass away. Certain types of death can be excluded from coverage, most often linked with the contestability period we mentioned above. For example, if you say you are not a smoker and then pass away due to emphysema. Other contestable circumstances incur dying while performing an illegal act. While newer policies are starting to have less and less exclusions, older policies may exclude death during military service, acts of war, piloting a plane recreationally, scuba diving and mountain climbing. 

 

Another contestable circumstance is suicide. Most life insurance policies come with a suicide clause, which states that benefits will not be paid if the policyholder commits suicide within a certain period of time after buying the policy (typically 2 years). Meaning your insurer may deny your family’s claim if you pass away due to suicide within that time period. If you or someone you know is having suicidal thoughts, please contact the National Suicide Prevention Lifeline at (800)-273-8255.

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Not Providing Documentation

This one is less common, but it can happen so we’re putting it here just in case. When your family contacts the life insurance company to start the claims process, they will most likely be asked for certain documentation, at the very least they need the death certificate. If your beneficiaries don’t provide the documentation in time their claim can be denied.

Policy Term Has Expired

You could outlive the term of your term life insurance policy, which would result in no death benefits payment. If your policy is about to expire and you need coverage for longer you may be able to renew your policy (at a higher cost) at the end of your term. You may also be able to convert your term policy into a permanent life policy, but there is a window of opportunity to do so. If you’re interested in converting, make sure you know the deadline, so you don’t miss it.

No Designated Beneficiary

A life insurance claim may also be denied if the insured failed to name a beneficiary. Every policy stipulates who should receive the proceeds in the absence of a designated beneficiary. In the absence of a designated beneficiary, an insurance company will distribute the proceeds in accordance with the applicable state law or the policy terms. As insurance companies may mistakenly pay benefits to the wrong person, such claims may result in lengthy delays or denial.

 

What To Do If A Claim Is Denied

If you receive a claim denial letter it can be scary, especially if you relied on your loved one’s income and the money would supplement that income. If the insurance company finds that the policy holder died of suicide within their clause’s time frame or find another violation during the contestability period, the claim will not only be denied, it can also be disqualified from an appeal. However, other denials can be appealed, below are the steps you can take if you’ve received a denial letter.

Contact The Company

In the initial denial letter, the insurance company will detail the reason they’ve denied the claim. However, if the reasons are unclear or don’t have sufficient supporting information, the best thing to do is request additional information regarding their specific objections to paying out the death benefits. For example, if the denial just says “violation of terms” you can request what the violation was specifically and any documents that “prove” the violation. You should know if you are dealing with a life insurance policy that came from an employer there is typically only 60 days from the denial letter to file an appeal so don’t put off contacting them. 

Contest The Decision

All insurance companies have an appeals process. You will have to file the appeal and provide evidence that the denial was incorrect. For example, if the denial is due to a lapsed policy, you would provide them with the receipts from payment premiums to prove the policy was in fact up to date. You have the option to represent yourself during this appeal. However, while self-representation is free, it comes with added emotional stress due to going through this complex process on top of grieving. In certain cases, you can contact your state’s insurance department or attorney general for help through the appeals process. Generally, the state departments of insurance and attorney general’s office offer easy and free resources to help get your death benefit as long as the claim was valid. Having state representation carries some serious weight during the appeals process so consider contacting them for help.

Working With EZ

It is important to understand why life insurance claims can be denied in order to ensure that your family receives the benefits you want to leave for them. And if you’re in the market for a policy that will safeguard your family’s financial future, be sure to compare policies from different companies and work with a knowledgeable agent. To get started simply enter your zip code into the bar below. Or you can contact one of our licensed agents today at 877-670-3560.

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Do Credit Scores Affect Life Insurance Premiums?

When you apply for a life insurance policy, in most cases the insurer will dive into your background, looking at things like your driving record, your medical records, and even your hobbies. They do this to determine how much of a risk you will be for them to insure you. But how in-depth do they get? For example, will they look at your credit score, and will they consider it when setting your rate? The short answer is yes, your credit history does affect your life insurance premiums. Read on to find out just how it does.

Will Insurers Check Your Credit Score? illustration of a paper with credit report on it

Some insurance companies review credit scores in order to determine if you are likely to repay a loan, while others do not. This is why it is important to compare policies from different companies. Remember, though, even if an insurer does check your credit score, it will just be a tiny part of what they will consider when deciding if they should insure you and how much you should pay. 

Will Your Credit Score Affect Your Premiums?

Your credit score can indeed affect the price of your life insurance policy. Your insurer wants to know your credit attributes and how financially responsible you are, and wants to make sure that you will be able to pay your monthly premiums and won’t lapse on your policy. They will look for:

  • Bankruptcy
  • Carrying large credit card balances
  • High percentage of credit card use
  • Late or missing debt payments
green check mark in a green circle
You can still find a great affordable policy, even with bad credit!

But don’t worry too much – you will generally only be denied a policy or have to pay a lot extra if you have filed for bankruptcy or something similar.

Can You Find a Great Policy?

Absolutely! Life insurance companies are more concerned about your health and your lifestyle than they are about your credit score. And there are many great affordable life insurance options to choose from that will provide enough money for your family, for a low monthly price. 

The best way to find the right life insurance policy for you and your specific needs is by working with an agent who specializes in life insurance. We have provided the top life insurance companies in the nation below; each offers hassle-free assistance and the most competitive rates. Always check multiple sites to make sure you have bargaining power and know the advantages of each company. Make sure a hard time isn’t made harder by a financial burden, check life insurance rates today.

Wait- Why Are My Life Insurance Premiums Higher Than the Rate I Was Quoted?

Have you gotten a quote from an insurance company, only to find that your actual premiums are higher than expected? This can happen especially with life insurance policies because quotes are generated based on the small amount of information you provide while you are looking for a policy. Once the life insurance company looks a little more closely at you and your level of risk, they might find something that changes your rate. 

Quotes Are Only An Estimate

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Your initial life insurance rates provided are only an estimate.

When you start researching life insurance, you will receive many quotes for policies. The quotes provided are only estimates of how much a policy might cost you based on the minimal information the insurance company has about you, or what you might call a “best-guess estimate.” These estimates are given to you before the life insurance company conducts a medical exam and gathers more information from you, so they will often change based on that information. 

Why You Were Approved for Your Actual Rate

Once you provide your agent or insurance company with more information, you will be given a more accurate quote for your premiums: the more information you provide, the more accurate the quote for your premium rate will be. This is especially true after you have undergone a medical exam, because the insurer will then know the whole scope of your health history, as well as have information about your driving record, and any other factors that are used for determining rates. That means your real rates could be different from your initial quote because:

Your Initial Quote Was Not Based On Your Health

As we already mentioned, when you first begin looking at policies, your agent or insurer might not ask you the questions needed for a more accurate quote. For example, they might not ask you about your blood pressure readings, cholesterol levels, BMI, and so forth, and these stats help determine how much you will actually pay. 

The Underwriting Process Reveals More

exam room tools
After you undergo a medical exam, then the life insurance company can provide a more accurate rate.

To follow on the above point, once you undergo a medical exam, your life insurance company will have much more relevant information about you, allowing them to better assess your risk. In other words, the more they find out about your health, the more accurate your quote will be. And if you are afraid of undergoing a medical exam, don’t be! It can work to your advantage, even if you have health issues: as long as you are managing any conditions and taking steps to improve your health, the exam can actually work in your favor.

The best way to get an accurate quote and not be surprised by your actual premium rates is to provide as much information as possible when comparing plans from different life insurance companies. There are many different kinds of life insurance policies to choose from, including whole life insurance, term life insurance, and final expense insurance, so if you’re not sure where to begin, consider using online tools, or speaking with an agent. The right policy for you is out there! We have provided the top insurance companies that offer life insurance policies below; each can give you hassle-free assistance and the most competitive rates in the nation. Always check multiple sites to make sure you have bargaining power and know the advantages of each company. Make sure a hard time isn’t made harder by a financial burden, check life insurance rates today.

Questions To Ask Before Buying Life insurance

When it comes to life insurance, there are two things that you can be sure of: you need it in order to ensure your family’s financial stability in the future, and you have a lot of decisions to make when choosing a policy. It takes a lot of thought – and it should: it’s a big, important commitment. So if you’re unsure how to narrow down your choices, and how to decide which policy is right for you, you should first ask yourself the following questions; having the answers in your mind can make the process of comparing life insurance policies and buying the right plan much easier.

How Much Coverage Do I Want?

suitcase full of money stacks
Before buying life insurance, you will need to determine how much money will be enough for your family when you are gone.

When determining how much coverage you will need, you  have to ask yourself who depends on you and what kinds of debts you have. Typically, the death benefit on your policy should equal up to 10 times your current annual income, but it is important that you take the time to write down all of your current financial obligations, such as your mortgage, childcare expenses, car payments, and any other future obligations. Will you want to leave an inheritance when you pass away? Help your children pay for college? Buy a house? All of these things will need to be taken into account when choosing your benefit amount, and the best way to calculate your life insurance needs is to get help from a trained agent who can help you determine how much coverage you will need. 

How Long Should I Have Coverage For?

Once you choose the amount of coverage you need, you will have two basic types of life insurance coverage options to choose from: term and permanent.

The difference between the two is that a term life insurance policy will cover you for a specific amount of time (typically 10, 20, or 30 years), while a permanent life insurance policy will cover you for your whole life. The advantage to term life insurance? It’s cheaper, and can be a great, affordable option if you want to provide income for your family to cover short-term debts and needs. For example, do you have a 30-year mortgage that your spouse would have difficulty paying off if you die? Then a 30-year term life insurance policy is perfect to cover those 30 years until the mortgage is paid off. 

If you are unsure if a term life insurance plan will provide enough coverage, look into a permanent life insurance policy, which would allow your family to live comfortably, even after your debts are paid. These policies have a cash value growth potential and can replace income, assist with your retirement planning, and more. Comparing all of your different options will give you a better understanding of which policy is better for you and your family, and how much you can afford.

How Healthy Am I?

african american woman stretching touching her foot with one hand and the other hand backwards in the air
Ask yourself how healthy you are to get a better understanding of how much premiums will be; the healthier you are, the cheaper it will be.

This question is important in determining which type of policy is better for you. Life insurance rates are based on multiple factors, and your health history is one of them: the healthier you are, the cheaper your premiums will be, and vice versa. But even if you do have health conditions, there is no need to worry! With a guaranteed issue life insurance policy, such as simplified issue life insurance, you will not be turned down because of your health; you will not have to answer medical questions, or undergo a medical exam

Will Premiums Change Over Time?

This depends on which kind of coverage you go with. With term life insurance, your premiums start out lower than with permanent coverage and stay at a fixed rate for the term, but if you choose to extend your policy, your rates will go up. With whole life insurance, as long as you don’t let your policy lapse, your premiums are guaranteed not to increase for the rest of your life. If you choose to go with a universal life insurance policy, your premiums will increase with age, but if you have accumulated cash value, this can cover the increases. These are all things you will have to consider and compare when researching life insurance policies. 

What Happens If I Don’t Die During A Policy’s Term?

If you opt to get a term life insurance policy, there is a good chance that you will survive the specific term, and if you do not pass away during the term, no one receives the death benefit. You do have the option to keep your policy and convert it into a whole life insurance policy, but you need to be aware that your rates could go up, especially if you develop health conditions. This is why it is important to consider from the start if a term life insurance policy is your best option, or if a permanent life insurance policy is better for your circumstances. 

Choosing the right life insurance policy is necessary in order to ensure that your family gets the benefits they need. It might seem complicated and frustrating to find the right one, but it can be done, with some help. The best way to find the right life insurance policy for you and your specific needs is by working with an agent who specializes in life insurance. We have provided the top life insurance companies in the nation below; each offers hassle-free assistance and the most competitive rates. Always check multiple sites to make sure you have bargaining power and know the advantages of each company. Make sure a hard time isn’t made harder by a financial burden, check life insurance rates today.