A life insurance policy is supposed to provide you with financial security and protection when your loved one passes away, including paying for funeral expenses. We have represented many clients whose spouses or other family members paid premiums for years for life insurance coverage that is then denied after the spouse or family member passes away. If you have lost a loved one and the insurance company is denying your claim and refusing to pay the life insurance proceeds, turn to an experienced life insurance lawyer for help.
At the O'Ryan Law Firm, we can help you fight for your rights under the life insurance policy and the law. You deserve to be paid the benefits that your spouse or family member worked for, and paid for, in the awful event that they passed away prematurely. Employer provided life insurance policies are governed by the Employee Retirement Income Security Act (ERISA) and we are one of the few law firms that focuses on ERISA law.
Common Reasons for Life Insurance Claim Denials
At O’Ryan Law Firm, we have helped numerous clients obtain life insurance benefits after their claims were denied. Some of the most common reasons that an insurance company denies a life insurance claim are:
Employers frequently offer basic term life insurance to their employees at little or no direct cost to the employees. In most cases, this life insurance coverage is issued automatically, without regard to the health or medical history of the insured employee. However, this basic life insurance coverage sometimes isn’t enough for every employee, so some employers offer additional supplemental coverage (commonly referred to as buy-up coverage) that employees can purchase for a modest premium payment that will be deducted from their paychecks.
The insurance companies that issue this supplemental coverage typically require employees to provide evidence of insurability, or EOI, in the form of a short “statement of health” and/or a basic physical exam and blood draw before the coverage is issued. However, insurers or employers oftentimes fail to request this information before enrolling an employee in the supplemental life insurance coverage. In those situations, if the employee passes away, the insurance company may deny the beneficiary’s life insurance claim based on a failure to provide the necessary evidence of insurability, or proof that the employee was in good health when they applied for the supplemental coverage, even though the insurance company never asked for that information while continuing to accept the employee’s premium payments until the employee’s death. The insurance company’s failure to request Evidence of Insurability should not be held against the life insurance beneficiary when the insurance company has happily accepted the premiums for months or years without asking for EOI.
Many employers promise that when an employee becomes disabled, and is awarded short or long term disability benefits under the employer’s disability plan, the employee will continue to receive employer-provided benefits like life and health insurance for as long as that employee continues to receive disability benefits. Sometimes, when an employee’s disability is clearly permanent, the disability insurance company may offer the employee a lump sum buyout that allows the employee to receive a large sum of money immediately in exchange for forfeiting their right to receive monthly benefits over the remaining benefit period under the policy.
While these lump sum buyouts can be very helpful for disabled workers who are struggling to make ends meet, it is important to fully consider the implications of a buyout before agreeing to take one. For example, by accepting the lump sum payment, and forfeiting the right to receive monthly disability benefits, the employee may unintentionally forfeit the right to continue to receive life and health insurance from the employer. Many employees fail to consider this question and unknowingly lose their employer-provided life insurance as a result. However, in some circumstances, the employer may fail to properly notify the employee that the life insurance coverage has terminated and therefore may make the employer responsible for paying life insurance benefits.
If you are a life insurance beneficiary whose claim has been denied for either of these reasons, contact O’Ryan Law Firm for a free consultation.
We Will Fight for Your Life Insurance Benefits
Our attorneys are well-versed in all aspects of life insurance policies, claims governed by ERISA, appeals and litigation. One of our firm's attorneys, Bridget O'Ryan, has worked inside the insurance industry and knows the tricks and tactics an insurer will use to try to keep you from getting the benefits you need and deserve. Other common arguments the insurers put forth include to deny life insurance claims include:
- The coverage lapsed, even though notification was never sent of the lapsed coverage.
- The death was not accidental, in the event a claim was submitted under an accidental death and dismemberment claim
- There was a change in beneficiary that was not proper under the terms of the policy
We have tools at our disposal such as forensic experts, pathologists and private investigators to demonstrate that the insurance company's allegations are false and that you truly are entitled to the life insurance coverage your spouse or family member paid for in order to provide you with financial security and protection. We have successfully represented clients who have had life insurance claims denied by many of the largest insurance companies, including MetLife.
Has your insurance company unfairly denied your insurance claim? Contact an experienced life insurance lawyer online or by phone at 317.255.1000 for a free consultation. Contact Us