How to Appeal a Life Insurance Claim Denial

Life insurance carriers may reject your insurance claims for several reasons. Failure to pay life insurance premiums can be one of the reasons why an insurer decides to decline a claim for benefits. Aside from this, the insurance carrier may not grant you the proceeds if you are not listed as one of the beneficiaries of the policy. Perhaps, the cause of the policyholder’s death is not covered by the terms and conditions of the policy. However, you should be wary that there are instances of insurance claim denials that are rooted merely on corporate greed and fraud. If you believe that the rejection of your claims is unjust and unreasonable or deem yourself as a victim of potential fraud, you have the right to dispute the denial of your claim.

1. Put all life insurance policy documents in order and acquaint yourself with the terms and conditions of the policy. Tag on any paperwork that attests your communications with the insurance carrier and all proof of payment to the insurance company.

2. Contact the insurance provider and have a word with the supervisor of the adjuster who actually rejected your claim. Tell them that you believe that the denial of your claim is done without good reason and ask for a compelling explanation for the denial. If there are any required documents that you can resend to the company, like notarized copy of the policyholder’s death certificate, then resend it. If you still at odds with the rejection of the policy, then request for the certified copy of the policy.

3. Ask them to review your life insurance claim. Send them a letter stating your reasons why you believe that the rejection was incongruously made. Attach any copies of important papers that could support your claim. Wait for 10 business days and get in touch with the insurance carrier to see if your life insurance claim has been reopened. If not, proceed to the next steps.

4. Call or visit the Department of Insurance or Insurance Commission in your state where your life insurance policy was issued. Rummage around for contact information for the Department of Insurance in the phone directory or by performing a simple internet search.

5. Submit a completed form to have the unseemly insurance claim rejection investigated. You can download the form to dispute an unreasonable insurance decision on most Department of Insurance websites. You can also contact the department and ask for a form. Moreover, do not forget to indicate necessary information such as the type of claim, the claim number, policy number, name of the insurance company, and a brief statement of your problem and recommended workable solutions.