Life Insurance Attorneys
We Can Help You Get the Life Insurance Benefits You Deserve
Losing a loved one should not come with burden of fighting with a life insurance company for life insurance benefits. But that is often the case.
At Dabdoub Law Firm, we help people recover life insurance benefits. Ideally, it is best to have an experienced life insurance attorney represent you with the initial claim. However, if you have a life insurance claim that was denied our experienced life insurance attorneys will be able to help you.
The most common reasons for a life insurance denial include:
- Denial based on non-disclosure of medical history when applying for coverage.
- Denial based on not completing a Evidence of Insurability (“EOI”) form.
- Dispute over who should get paid the life insurance benefits.
With life insurance denials, you may be required to appeal the denial before you can file a lawsuit. It is important to know your next step and to understand what law governs your case.
Our experienced life insurance attorneys can assist you with an initial claim, submitting an appeal of a denied claim or filing a lawsuit.
Understanding Your Options
If the policy was obtained through the insured’s employer, then it
is likely governed by a federal law called ERISA. In that situation, you
will be required to submit an appeal to the insurance company.
If the policy was obtained by the individual on their own, then it is likely
governed by state law.
Whether an appeal is required in that situation will depend on whether the policy requires an appeal before you can take legal action. It is important to review the life insurance policy to know what your obligations are.
If you have to submit an appeal, it is crucial you obtain evidence that refutes the basis for the claim denial. This could be medical evidence or some other kind of evidence pertaining to the death, the application for life insurance and what was provided during the application and underwriting process.
Life Insurance Claim Denial Based on Non-Disclosure of Medical History in Application
Important Takeaways
What to look for in a denial due to non-disclosure of medical history in a life insurance claim:
- Request a copy of the claim file to review the application completed by the insured.
- Review the death certificate and medical records from leading up to death.
A life insurance company may deny a life insurance claim if the insured (the deceased) did not fully disclose their medical history when applying for the life insurance coverage. In this case, the insurer may rescind the life insurance policy and return premium payments. However, it does not mean you have to give up on the life insurance benefits you are entitled to.
It is important in this situation to understand everything that happens during the application process. This includes looking at what was requested from the insurance company, who filled out the paperwork, and what information was disclosed and not disclosed. We also must look at the policy language.
If the condition or injury that caused the death is unrelated to the information that was not disclosed, you may have a good argument that the non-disclosure is irrelevant.
For example, if someone dies in a car accident from injuries sustained from the collision but did not disclose on their application for life insurance a skin biopsy they had 20 years ago, those two things have no bearing on one another. Thus, a denial of the life insurance claim due to a car accident, for failure to disclose an old skin biopsy is refutable.
The attorneys at Dabdoub Law Firm have successfully represented claimants dealing with non-disclosure issues by the deceased on their application for coverage.
Life Insurance Claim Denial Due to Missing Evidence of Insurability Form
What You Need to Know
- An EOI is required when new or increased coverage is applied for
- It is the responsibility of the employer to advise the employee the form needs to be completed
- If premiums were paid and accepted despite never completing the EOI, you may have a strong case
A life insurance company may deny a life insurance claim by saying a specific form was not completed when new or increased coverage was elected. This form is called the Evidence of Insurability (“EOI”) form. The EOI is typically a one-page questionnaire asking about the applicant’s medical history. It is completed and used for underwriting purposes.
During employment, when an employee elect’s coverage for the first-time, or requests an increase in coverage at some point, the employer is required to give the employee an EOI to complete. The employer is then to return the completed form to the insurance company.
In this scenario, what often happens after the employee elects the new or increased coverage, the employer says all is good and deducts premiums from the employee’s paycheck. No EOI was given to the employee or requested to be filled out. To the employee, there is no issue with coverage and premiums are being paid.
Then, years later, the employee dies. The beneficiary files a life insurance claim. The claim is denied by the life insurance company because an EOI was not provided to the insurer. But how could that be if the policy holder was not asked to fill one out, or even made aware that such a form existed?
At Dabdoub Law Firm, we help people overcome the unfair life insurance denials made by insurance companies. We have a track record for getting claims approved and winning cases in federal court.
Is Your Life Insurance Claim Delayed or Denied Over a Beneficiary Dispute?
What You Need to Know
- If the insurance company does not know who the correct beneficiary is, they will delay or deny the claim.
- The insurance company may file an interpleader complaint to get the court’s help in determining who is the proper beneficiary.
- It is important to gather any documents confirming who is the beneficiary.
In some cases, the insurance company may deny or delay a life insurance claim because there is more than one potential beneficiary. They could also deny or delay because it is unsure who the correct beneficiary is.
When this happens, the insurance company has an obligation to determine who the proper beneficiary is and pay the benefits to that person or persons. It is even possible the insurance company files an interpleader complaint to get the courts assistance in determining who the proper beneficiary is. In other instances, they may deny your claim because they have already paid the benefits to another claimant.
Either way, it does not mean you cannot pursue your claim if you are the rightful beneficiary. Our first step is to determine who the correct beneficiary is. We use policy language and any relevant outside documents such as a marital settlement agreement or divorce decree to determine who the right beneficiary is. Then we apply the law to ensure the right person is paid.
The experienced attorneys at Dabdoub Law Firm have handled numerous claims when a life insurance company is delaying or denying benefits based on a beneficiary dispute.
Get Help With Your Life Insurance Claim
If you have to submit a life insurance claim or pursue a life insurance claim denial through appeal or litigation, contact the experienced attorneys at Dabdoub Law Firm. We can help you fight for the life insurance benefits you are entitled to receive.
Because we specialize in life insurance claims, our clients get the benefit of:
- Having an attorney who is an expert in ERISA and individual insurance claims, appeals and litigation.
- Being backed by a law firm with a proven track record of winning tough life insurance lawsuits.
Choose Dabdoub Law Firm to get experienced lawyers on your side. We can help with:
- Submitting life insurance claims.
- Appealing life insurance claim denials and lower court decisions.
- Negotiating settlements and life insurance payouts.
- Filing a lawsuit against your employer and/or life insurance company.
