A denied life insurance claim can add significant stress to an already emotionally challenging time. When you're grieving the loss of a loved one, the last thing you want to deal with is a life insurance company telling you that the claim won't be paid. Fortunately, a denied claim doesn’t always mean the end of the road. In many cases, beneficiaries may have strong grounds to contest the denial—and even win in court if necessary.
At the Law Offices of Jason Turchin, we help beneficiaries nationwide understand their rights and pursue the benefits they are rightfully owed. Here’s what you should consider about how to win a life insurance claim denial lawsuit.
Understanding Why Life Insurance Claims Are Denied
Before taking legal action, it’s often important to understand the reason behind the denial. Insurance companies may send denial letters that list one or more of the following justifications:
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Material misrepresentation on the application (e.g., failure to disclose a medical condition)
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Non-payment of premiums
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Policy exclusions (such as death during a contestability period or death due to suicide)
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Lapse in coverage
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Beneficiary disputes or competing claims
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Alleged fraud or suspicious circumstances surrounding the death
Some reasons may be valid under the law, while others may be weak or used as tactics to delay or deny payment.
Step 1: Request and Review the Denial Letter
The first step in any claim denial case is to carefully review the denial letter issued by the life insurance company. This document should specify why the claim was denied and may cite specific policy language.
Request a copy of the policy, application, and any supporting documents used in making the decision. These records can be essential in evaluating whether the insurer had a legitimate reason to deny the claim.
Step 2: Identify Legal Grounds for a Lawsuit
Once you know the basis for denial, you can start evaluating whether legal action is appropriate. Common legal arguments include:
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Breach of contract: If the insurance company wrongfully denied a valid claim, they may be liable for the full death benefit and possibly additional damages.
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Bad faith: If the insurer denied the claim without a reasonable investigation or misrepresented the terms of the policy, a court may award punitive damages under bad faith laws in certain states.
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Violation of ERISA: If the policy is governed by the Employee Retirement Income Security Act (ERISA), there are specific rules and procedures for appealing a denial and filing a lawsuit in federal court.
If you're unsure what type of policy you’re dealing with—private or employer-sponsored—an experienced life insurance attorney can help you determine which laws apply.
Step 3: Appeal the Denial (If Applicable)
Many insurance policies allow for (or require) an administrative appeal before a lawsuit can be filed. This is especially true with employer-provided life insurance policies governed by ERISA. The appeal is your opportunity to submit additional evidence and legal arguments supporting your claim.
Make sure to file the appeal within the deadline listed in the denial letter—often 60 to 180 days. Missing this deadline could bar you from taking further legal action.
Step 4: File a Life Insurance Lawsuit
If the appeal is denied or if the claim was denied outright without an appeal process, you may need to file a lawsuit. Here’s what that might involve:
a. Choosing the Right Jurisdiction
Depending on the policy type, your lawsuit may need to be filed in state court or federal court. ERISA-governed policies usually go to federal court, while privately purchased policies typically remain in state court.
b. Building Your Case
To win a life insurance lawsuit, you’ll generally need to prove:
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The policy was in force at the time of death
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The premiums were paid and up to date (unless waived)
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The cause of death is not excluded by the policy
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The claim was filed correctly and timely
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The insurer wrongfully denied the claim
Attorneys often gather medical records, payment histories, policy documents, and sworn statements from relevant parties to support the case.
c. Possible Outcomes
Winning the case may result in:
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Payment of the full death benefit
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Interest on delayed benefits
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Attorneys’ fees and court costs
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In rare cases, punitive damages if the denial was in bad faith
Step 5: Consider Settlement
Many life insurance lawsuits settle out of court, particularly if the insurance company realizes the denial may not hold up in front of a judge. Settlement negotiations can result in a faster resolution and guaranteed payment without the uncertainty of a trial.
A seasoned life insurance claim attorney can help you weigh the pros and cons of settlement versus continuing the litigation.
How an Attorney Can Help
Legal representation may significantly increase your chance of success. At the Law Offices of Jason Turchin, we have handled hundreds of life insurance disputes, including:
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Denials based on alleged misrepresentation of health conditions
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Disputes over last-minute beneficiary changes
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Claims denied due to suicide exclusions
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Delays due to missing documents or internal review
We understand how to challenge insurance companies, gather persuasive evidence, and guide clients through complex legal processes.
Tips for Strengthening Your Case
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Keep detailed records. Save copies of all correspondence with the insurer, including emails, letters, and claim submissions.
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Do not give up after the first denial. Many legitimate claims are initially denied, only to be paid later with proper legal action.
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Avoid speaking to the insurer without representation. Statements you make can be used to justify a denial.
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Act quickly. Life insurance lawsuits are often subject to statutes of limitations. Waiting too long could forfeit your right to sue.
Common Questions
Can I sue if the life insurance company claims there was a lapse in coverage?
Yes, especially if there’s evidence of wrongful lapse, such as a missed premium notice or confusing payment procedures.
Is it possible to recover attorneys’ fees in a life insurance lawsuit?
In some cases, yes. Courts may award legal fees if the insurer acted in bad faith or if laws like ERISA allow it.
Can I file a lawsuit if I’m not the primary beneficiary but believe I was supposed to be?
This may lead to a competing claims or interpleader lawsuit, where the court determines who is entitled to the benefit.
Final Thoughts
Winning a life insurance claim denial lawsuit isn’t always easy—but it’s far from impossible. With the right strategy, evidence, and legal support, many beneficiaries recover the benefits their loved one intended for them to receive.
If you’re facing a denied claim, don’t go it alone. Get the legal guidance you deserve. Visit LifeClaims.com for more information, or reach out to The Law Offices of Jason Turchin for a free consultation.