You’ve recently lost a loved one, you’re overwhelmed with sadness, with the tasks of preparing for the burial service, handling the deceased’s final affairs, and now you have to file a life insurance claim. The last thing you want to worry about is how best to deal with the life insurance company’s claims process. Maybe you even need the life insurance benefit to pay for the funeral. You call the life insurance company and are told that it could take 30-60 days to investigate the claim. Now what?
Fortunately, most funeral services can proceed through an assignment of the life insurance benefit to the funeral home. This is done by signing a document which assigns an amount of the life insurance benefit sufficient to satisfy the funeral home bill, after which the remainder of the proceeds, if any, will be paid to the beneficiary. Unfortunately, though, more than 5,000 life insurance claims are denied every year in the U.S., sometimes leaving the beneficiary responsible for paying the funeral bill.
Many people don’t even know that life insurance companies can deny a life insurance claim. The purpose of having a life insurance policy is to ensure that the designated beneficiary receives a specified amount of money upon the death of the insured. It’s that simple, isn’t it? Not quite. Like with any insurance contract, there are complicated provisions and exclusions in life insurance policies, and applicable state and federal laws that can interfere with an anticipated claim payment. Sadly, life insurance is a business, and life insurers maximize their profits by denying as many claims as possible. A large percentage of denied life insurance claims are wrongful, and many of those claims are never disputed. It’s a win-win for the life insurance company when a beneficiary gives up on a denied life insurance claim.
To protect yourself from the beginning, you should keep a few things in mind. First, contact the life insurance company immediately, and notify it that the insured has passed away. If the life insurance benefit was obtained through the insured’s employment, contact the employer for claim instructions. The employer may instruct you to contact the life insurer directly, or it may submit the claim on your behalf. Either way, you should request that the appropriate claim forms be sent by mail. You can also download the forms from most insurance company websites.
If, for any reason, you are told that you are not entitled to claim the life insurance benefit, submit your request for the claim forms in writing or download the forms from the company’s website, if possible. This could occur for several reasons, but most commonly because the life insurance company claims you are not the designated beneficiary, the policy has allegedly lapsed for nonpayment, or it has not yet taken effect. Do not let the insurance company deter you from filing a claim. Always Always ALWAYS file your claim and get a written explanation of the denial. This will assist a life insurance lawyer in evaluating your denied life insurance claim.
To file your claim, you will need the insured’s death certificate, the claim forms, and a copy of the policy if you have it. If you cannot locate the policy, that’s okay. In certain cases, the life insurer may require that you submit a police report or other accident report, an autopsy report, a medical authorization form, or other supporting documents. You will want to submit the death certificate and claim forms as soon as possible, and the life insurance company will notify you if any other information is required to process the claim.
Once you’ve submitted your life insurance claim, follow-up frequently for status updates. Most life insurance claims should be processed within 30 days. If an insured passes away within two years of the policy’s effective date, or if the policy is an accidental death policy, the life insurance company may request additional time to investigate the claim. Even then, your claim should be paid within 60 days. Life insurance companies benefit from delaying payments, so remember that the squeaky wheel gets the oil. Keep calling, and make sure you know what’s happening with your claim at all times.
The most important thing, and I repeat, the most important thing to know is this: life insurance claims are denied all the time. It is critical that you keep a complete record of all communications with the insurance company until the claim has been paid in full. Keep a file folder of all documents submitted to the life insurance company and also all documents received from the company. You should keep a log of all telephone calls, and include the dates and times of the calls, the names of the agents you spoke with, and notes about what the agent told you during each call. Write down the agent’s direct quotes if possible. Keeping good records can make the difference in whether a life insurance attorney decides to pursue your case, and ultimately whether your life insurance claim is paid.
Finally, if your claim is delayed for more than 60 days, or if it is denied for any reason, contact a life insurance lawyer without delay. This is especially true for life insurance policies obtained through the insured’s employment because these claims are governed by ERISA, a federal statute with strict appeal deadlines. ERISA appeals should always be filed with the assistance of an experienced life insurance attorney, as any future lawsuit will likely be limited to the appeal file, meaning no new evidence can be introduced at trial. In all cases, policy limitations and/or state law will require that a lawsuit be filed within a certain time frame, and missing a filing deadline will forever bar your claim.
The Life & Property Insurance Law Offices of Heather D. Lee is a multi-state law practice offering free consultations and low contingent fees on all delayed and denied life insurance claims. Please visit http://www.life-insurancelawyer.com for more information about how we can help collect your delayed or denied life insurance claim with no up-front costs for you.
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Law Offices of Heather D. Lee, Esquire 