Someone buys life insurance, names family and/or friends as the beneficiaries, and breathes easier knowing that his or her death at least won’t cause financial harm.
In many cases, the life insurance policy is specifically bought to serve as a replacement for the earnings of the insured.
Yet when the insured dies and the beneficiary presents a claim for the policy proceeds, surprise: the insurer denies the claim.
It’s certainly too late to go find another insurance policy on the deceased. Considerable anxiety is imposed on a family already trying to deal with the death of the insured.
Depending on the reason for the denial and the amount of evidence that the beneficiary can muster, the insurer may be subject to a claim that it breached its duty of good faith.
That could result in the beneficiary recovering damages considerably greater than the value of the policy itself, including punitive damages and attorney fees.
In other words, a court may not look favorably on an insurance company trying to take advantage of grieving family members.
An attorney experienced in bad faith cases involving life insurance gives the beneficiary the best chance of prevailing on that bad faith claim.
Big insurers hire life insurance policy attorneys to try to thwart your claim, and they count on you giving up. If you don’t think that’s fair, you’re not alone. A good life insurance attorney can advocate for you.
If you’re wondering, Is there a life insurance attorney near me? we can answer, yes! At The Johns Law Firm, we fight insurance companies on behalf of the plaintiffs they have wronged.
Contact us for a free consultation with our life insurance policy lawyers or keep reading for more information on life insurance lawsuits.
Common Reasons for Denial
There are limited reasons for the insurance company to deny a life insurance claim. Among the most common are the following:
- The insured lied about or concealed relevant health information when filling out the insurance application, such as falsely saying that there was no history of cancer;
- The insured committed suicide, which is not covered by the policy; or
- The insured died while engaged in a particularly dangerous activity that the policy excluded;
- The premiums weren’t paid.
These are, of course, the reasons that the insurance company may give for denying your claim. That doesn’t mean that they justify the denial of your claim for proceeds from a life insurance policy.
For example, life insurance policies typically provide that they are “incontestable” once the policy has been in force for two years.
Our life insurance attorneys can use this as a defense against insurance companies claiming life insurance misrepresentations.
Any misrepresentations on the application would not prevent the recovery of the proceeds if the death occurred more than two years after the policy was issued.
Even if the death occurs during the two years when the policy can be contested, misrepresentations and concealment don’t automatically justify the denial.
In most states, for example, the fact that an applicant lied about a family history of cancer won’t allow the insurer to deny a claim for the death of someone in a car accident.
Common Bases for Bad Faith Claims
Insurance companies have a duty of good faith and fair dealing with respect to an insurance policy. This means they must be fair and abide by the terms of the contract.
Some insurance companies breach their duty of good faith and fair dealing by trying to cheat their policyholders out of contractual benefits.
One improper practice by some life insurance companies is known as “post-claim underwriting”.
“The insurance company simply waits until the insured dies to do the kind of investigation that it should have done before issuing the policy. If the investigation turns up any evidence that can arguably be used to deny the beneficiary’s claim, the insurer does so.”
An experienced bad faith life insurance lawyer can spot the signs of post-claim underwriting and craft a solid bad faith claim against the insurer.
Another common improper practice by life insurers is to state that a health misrepresentation caused them to issue a policy that they would never have issued if they knew the applicant’s true state of health.
The Contestability Period
The contestability period of a life insurance policy is a window of one to two years that runs from the time your policy takes effect.
During the contestability period, the insurance company can investigate the information you provided on your life insurance application.
If the company finds any misrepresentations, they can deny a death benefit to your loved ones.
Even if your cause of death is unrelated to the misrepresentation on your life insurance application, the company may deny your death benefit.
For instance, imagine you lied about smoking on your application but died in a car accident.
Lawyers for the life insurance company may advise denying the benefit even though the misrepresentation was unrelated to your death.
Insurers have incontestability clauses in place because states enacted legislation placing limits on life insurers’ ability to deny claims for mistakes on applications.
Life insurance companies use incontestibility clauses to protect their profits.
Here are things you should know about the contestability period:
- You should complete your application as truthfully as possible, even if some facts seem negative.
- During the contestability period, the insurance company can investigate your application and void or possibly modify your policy based on misrepresentations.
- Insurers don’t investigate every claim during the contestability period. They usually investigate claims that seem suspicious.
- If the insurer’s investigation reveals that your application was truthful, it must pay your family your death benefit. However, an investigation always delays the benefit payout.
- If you die during the contestability period and the insurer finds misrepresentation, it can reduce or deny your family’s benefit payout.
- Even if the insurer does not contest the policy during the contestability period, the insurer can still deny your life insurance benefit based on other circumstances like the suicide clause. If you commit suicide, the insurer likely will not pay your death benefit.
- When your policy lapses because you forget to pay a premium, the insurer can instate a new contestability period before reinstating your policy.
It is never a good idea to misrepresent yourself on a life insurance policy application. However, people make mistakes, and we don’t think their beneficiaries should lose out on benefits.
If you are the beneficiary of a denied life insurance claim, contact our experienced life insurance lawyers.
We will advocate for your rights with the insurance company.
Categories of Contestability Period Denials
A high-value insurance policy or a policy that has been in place for only a short time is likely to trigger an investigation.
If the insurance company denies your claim during the contestability period, it’s usually for one of the following reasons.
You lied or made a mistake of fact on your life insurance application. Perhaps you put the wrong birth date or stated that you never smoke or drink. If the insurance company finds this information to be false, they can deny your claim.
If the contestability period has passed, your claim cannot be denied for innocent misrepresentation.
But if the misrepresentation was fraudulent—intended to deceive the insurer—then the insurer may be able to deny the claim even after the contestability period ends.
You leave off relevant information that might help your insurance company decide whether to offer you a policy. Maybe you forgot to mention a surgery you had several years ago.
Even if you die in an automobile accident that is unrelated to the health concern, the insurance company could use this omission to deny your claim.
Beware the Exclusion Clause
When life insurance companies write policies, they keep their profits in mind. Therefore, the lawyers for life insurance policies include exclusion clauses to limit the amount of money they have to pay to beneficiaries.
An exclusion clause names cause of death for which the life insurance company is exempt from paying beneficiaries.
If your death is caused by one of the following reasons, it may fall under the life insurance policy’s exclusion clause:
- Dying in combat or an act of war,
- Private aircraft crash,
- Alcohol or drug abuse,
- Illegal activity such as committing a felony,
- Risky activity such as skydiving, and
If you need help understanding your loved one’s life insurance policy, call one of our experienced attorneys. We know that someone cared for you enough to name you as the beneficiary on a life insurance policy, and we want your loved one’s wishes honored.
We will help you understand the details of the life insurance policy and advocate for the money you deserve.
How a Bad Faith Lawyer Can Help
You may wonder if a lawyer for life insurance claims can help you. A bad faith lawyer can help in many ways, including investigating the bad faith practice and advocating for fair practice. Again, an experienced bad faith lawyer knows how to investigate that basis for denying the beneficiary’s claim. The life insurance lawyer should ask these questions:
- Are there other people with the same health problem insured by the same company?
- If so, are their policies issued on terms similar to those in the policy the insurer is denying?
- Did the applicant even make the misrepresentation, or was it made by the agent who took the application, in order to get the application approved?
- Did the insurer sloppily investigate the health condition and make a wrong conclusion?
A bad faith lawyer seeks the truth behind why your claim was denied. If the attorney discovers any bad faith practice by the insurance company, it can bolster your claim.
Bad Faith FAQs
Are you wondering if your insurance company is acting in bad faith?
Even if your insurance company has breached its duty to you, what can you do about it? Here, we answer some common questions on bad faith insurance companies.
How Does Louisiana Define Bad Faith Insurance Practice?
In Louisiana, an insurer has a duty to do two things:
- Adjust claims fairly and promptly, and
- Make a reasonable effort to settle claims with the insured or the claimant or both.
If the insurer breaches either of these duties, the insurer acts in bad faith.
What Is a Breach of an Insurer’s Duty to Act in Good Faith?
Insurers can breach their duty to act in good faith in many ways. Here are a few instances when an insurer breaches its duty, according to Louisiana law:
- Misrepresenting pertinent facts or insurance policy provisions relating to any coverages at issue;
- Failing to pay a settlement within thirty days after an agreement is put into writing;
- Denying coverage on an application that was altered without the notice or consent of the insured;
- Attempting to settle a claim on the basis of an application altered without the notice or consent of the insured;
- Misleading a claimant as to the applicable prescriptive period (statute of limitations); and
- Failing to pay the amount of any claim within sixty days, if the failure is arbitrary, capricious, or without probable cause.
In other words, the insurer is required to abide by the contract that is formed with the insured.
If the insurer breaches that contract without a good reason, the insurer may be acting in bad faith.
What Must an Insurance Company Do to Notify Beneficiaries?
In Louisiana, an insurance company is not required to notify life insurance beneficiaries of their policy benefit. Louisiana failed to pass the Unclaimed Life Insurance Benefits Law, which would require payment of life insurance to beneficiaries.
This means that if a person dies without notifying named beneficiaries of a life insurance policy, the beneficiaries may never know that they are owed money.
Getting Legal Help Is the First Step
If your life insurance claim has been denied for any of the reasons discussed here, and you have any doubt that the denial is justified, give our life insurance attorneys a call. You can google “life insurance lawyers near me” to compare us to the competition, but you won’t find anyone better qualified to fight an insurance company for you.
We have decades of bad faith experience in life insurance cases. Contact us and tell us what has happened so far, and we will advise you of your options. Our life insurance claims lawyers want to help you get the money you’re owed.
We have fee arrangements for every need, and sometimes can accept cases on contingency. Your initial consultation with our life insurance law firm is free.