If you are the beneficiary of a life insurance policy, the benefits you receive could be a significant financial asset. They also represent the wishes of the insured regarding who they want to receive benefits. If a claim has been denied or an insurance company is telling you they are investigating the matter for an unreasonably long period, you need the representation of our Pennsylvania life insurance claim denial attorney.
If you are the named beneficiary on a life insurance policy that has been denied or if you believe that the insurance company is purposefully dragging the process out, contact the Reiff Law Firm. Our experienced attorneys have been representing individuals struggling with insurance companies for decades. To schedule a free, confidential appointment, call the Reiff Law Firm at (215) 709-6940.
Lawyer Handling Denials of Life Insurance Claims in Pennsylvania
Insurance providers employ experienced accountants, actuaries, and attorneys. They are charged with calculating the risk of any policy they issue and ensuring that they are not required to pay more than necessary. Denials of life insurance claims are profitable for insurance companies, and there is an assumption that beneficiaries will not pursue legal action.
If your claim is denied, the insurance provider will typically close the file. Because the insurer is not working for your best interests, they will not readily work with you in solving a dispute or negotiating a compromise. Our experienced Pennsylvania life insurance claim denial attorneys understand the frustration and have several legal strategies we can employ for dealing with insurance companies.
Life Insurance Claim Denials Under Federal and Pennsylvania Law
It is vital to have an experienced attorney working on your behalf if a life insurance claim is denied. The Pennsylvania and federal laws governing individual and group life insurance policies are complicated. If you do not understand the complexities of the controlling law, the chances of overturning a denial are drastically reduced.
Having our Pennsylvania life insurance attorney, who is well-versed in both Pennsylvania and federal law, working for you is vital when appealing a denied claim. Depending on the type of insurance policy that was denied, the governing law will be different. Individual policies are typically governed by Pennsylvania contract law, while group life insurance policies fall under the federal Employee Retirement Income Security Act (ERISA).
Common Reasons Life Insurance Claims Are Denied in Pennsylvania
Under many circumstances, a beneficiary will have no issues dealing with a life insurance company. When a policy has been in force for decades with regularly paid premiums, most insurance providers will pay the required benefits the insured envisioned. This is especially true if the deceased was elderly and died of natural causes.
However, life insurance companies make profits by collecting premium payments and not paying significant claims. If a policy is only a few years old, the value is substantial, or the cause of death is in question, a provider could reject the claim on any of the following grounds
Mistakes or Misrepresentation
A common reason an insurance company will deny a claim is a mistake or a misrepresentation on the insurance application. The information you provide must be accurate – especially your medical history or unusual risk factors. Insurance companies often assume that mistakes are intentional lies and deny claims on those grounds. Our Pennsylvania life insurance attorneys are familiar with these allegations and understand that the majority of misrepresentations are justifiable errors, misunderstandings, or accidental omissions.
Contesting or Investigating a Claim
Every life insurance policy has a period of contestability included in its terms and provisions. Typically, the period is two years from the date the policy starts, but it can vary from policy to policy. Should a policyholder die during this early period, the insurance company is entitled to investigate to determine if misrepresentation or fraud occurred. It is not uncommon for an insurance provider to take advantage of this provision to deny an otherwise valid claim.
If a death is accidental, there could be some questions as to whether the policyholder took their own life. Suicide is a legitimate reason for denying a claim, but the burden of proof rests with the insurer. Our seasoned attorneys are prepared to argue against unfounded allegations of suicide or self-harm.
Additionally, accidental death claims are often denied by insurance providers. An insurer will take the position that the death was not accidental if the insured’s negligence played a direct role in the death. Fighting these rejections is similar to fighting rejections based on claims of suicide; we will prove that someone else caused the accidental death.
Failure to Pay a Premium
If the insurance customer failed to pay the policy premiums, the life insurance coverage could lapse. If this occurs, the policy could be forfeited, prohibiting the beneficiaries from collecting any benefits. Typically, the lapse in payments must be significant and a policy’s coverage should not lapse for a couple of missed payments.
Fighting a Denied Insurance Policy Claim in Pennsylvania
If you are having issues with a life insurance provider, the representation of our Pennsylvania life insurance claim denial attorney will be helpful. If your claim was denied, we will thoroughly review your policy terms and all correspondences and communications with the insurance company to help determine if the denial was inappropriate. Additionally, we will negotiate with the insurance provider to work towards a solution in your favor.
When claims are contested, the insurance company will have a team of lawyers working on their behalf. Our attorneys are prepared to fight for you and to take your case to court if negotiations fail to produce the result you desire.
Call Our Pennsylvania Life Insurance Claim Denial Attorney for a Free Consultation
If someone named you as a beneficiary in their life insurance policy, they wanted to provide you with a sum of money at the time of their death. While this may have been a significant economic boost or just the means to pay for their funeral costs, you are contractually entitled to that benefit. When insurance companies wrongfully deny or delay life insurance claims, you need the assistance of our Pennsylvania life insurance claim denial attorney. Our lawyers and staff understand the state and federal laws that control the insurance industry and have the resources to fight for your rights. Call the Reiff Law Firm at (215) 709-6940 to schedule a free, confidential consultation.