Delayed or Denied Non ERISA and Private Life Insurance Claims

When the family breadwinner passes away, life insurance benefits can keep the family in “home and hearth.” After all, that is why your family member purchased the policy to begin with. The mortgage payment, the car payment, the gas, electric and food bills don’t stop coming.

The life insurance policy is there is make sure there is money to pay the bills.

Life insurance companies will typically pay death benefits within weeks of getting a death certificate. However, it is not uncommon for life insurance companies to deny claims for coverage or exclusion reasons.

A claims denial compounds the tragedy, grief and fear that comes with the loss and leads the family no choice but to hire  expert life insurance attorney, such as the name of our firm. We represent families and beneficiaries against life insurance companies like, list name, by litigating claims in state or federal court.

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The Delay Game Played In Non-ERISA or Private Individual Life Insurance Policy Claims. 

There are several delay games played in both non-ERISA and private individual life policy claims. The first is to ask for the death certificate multiple times and the second, and most widely used, it the multiple and staged request for medical records. The life insurance carrier will ask for medical records from Dr. A one month,   Dr. B the second month, Dr. C the third month, and so on, and so on.

Sometimes, they escalate the game and “lose” what you sent or worse, yet want more information, and delay making a decision on the claim.

They want to frustrate you while you are grieving. If the really wanted to deny your claim, they would have quickly done so. They just want you to give up, go away and let them bank the life insurance proceeds.  

Don’t be the Victim of The Delay Game! Get help NOW!

If your claim is delayed, the first question is what law applies to the claim.  Is this a state law or an ERISA claim? The answer can make all the difference!

One easy way to figure this out is to ask the following questions:

  1. Did your loved one buy the life insurance policy through a private insurance agent? If so, state law applies. That is fantastic! State law varies state to state but you have the right to file for bad faith and punitive damages, take the deposition of the liar for hire doctors used by the life insurance company and have a jury trial. 
  2. Did your loved one buy the life insurance policy through their employer who was not a governmental agency or church based? If so, most likely state law applies. That is just as good because life insurance companies don’t like having the expense of a state lawsuit and explain why the denied a legitimate claim.
  3. Did your loved one buy the life insurance policy through their employer as part of a benefit package? If so, the Employee Retirement Income Security Act of 1974 (ERISA) applies.

Better yet, call us at name of firm phone number and we will figure out what law applies and what needs to be done immediately to get your benefits. Don’t let the life insurance company steal your loved one’s financial legacy and your peace of mind. 

What are the Reasons a Non-ERISA or Private Insurance Life Insurance Denial?

There are three primary reasons for the denial of a non-ERISA or private life insurance claims denial.

Coverage Defenses. The life insurance carrier may argue there is no coverage by saying:

  • The policy holder was not eligible for coverage,
  • The policy holder did not timely elect coverage,
  • The policy holder made a misrepresentation on the application,
  • The policy holder did not complete the application,
  • The policy holder didn’t pay the premium so coverage lapsed,
  • The policy holder’s employer did not forward the application to the life insurance company.

The Life Insurance Company’s Interpretation of the Policy Terms and Provisions

The life insurance carrier will justify a denial based on their self-interested interpretation of the life insurance policies. Many times, life insurance carriers will interpret the terms of the policy in their favor and deny a claim on the basis that the death was caused by an act or event that was excluded under the terms of the policy:

  • The policy holder’s death was suicide,
  • The policy holder’s was caused by the use of alcohol or drugs and a reasonable person would expect that death would result in death,
  • The policy holder’s death is excluded under the sickness exclusion.

Our Experts Say

Life insurance companies commonly use “liar for hire” pathologists, toxicologists and other physicians to create “medical” reasons to justify a claims denial. For example, a claim might be denied on the medical basis that:

  • The policy holder’s death was not an accident,
  • The medical examiner listed the cause of death as a heart attack, stroke, embolism, or some other medical condition that resulted in death,
  • The cause of death is excluded under the terms of the policy.

You need an attorney who understands how and why life insurance carriers deny claims, can attack the reasons for the claims denial, develop the factual, legal and medical evidence needed to win a claim, write a shock and awe appeal and delivered it to the life insurance company in a box that hits their desk with a resounding thud and sue the life insurance company if they don’t pay.     

Call today at 727-   –      for a complimentary 30 minute consultation.  No recovery, no fee.     

Filing a Law Suit to Get the Policy Benefits the Life Insurance Company Promised

We take on life insurance companies like, name , every day.

Why?  Insurance companies are in the business of collecting premium dollars and not paying benefits, if they can get away with it.

The reality is that insurance companies are counting on your overwhelming grief and hope that you will just give up and go away. They have only the policy limits to lose while you and your family have a way of life to lose. Don’t let the life insurance company rob you of the life insurance benefits you need.  Contact us immediately for a free consultation and get all of your questions answered.

We know it can be difficult to make the decision to take on a huge nationwide life insurance company. You are afraid that it will costs lots of money and you may think you just don’t have the emotional energy to take them on. Insurance companies are counting on you giving up or hiring a lawyer who doesn’t know what they are doing or you have never tried a case.

At our firm name, we take cases on an affordable contingent fee basis which means that if we don’t recover benefits, we don’t get paid. It is a simple as that! We can handle your case from application, to appeal, to filing a lawsuit, going to court or getting payment of your benefits. 

We take the stress out of litigation. It is our job to get you the benefits quickly.

If your life insurance claim has been delayed for more than 30 days or denied, call us for help at phone number immediately. Delay is your enemy. Phone number.

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