Life Insurance Claim Denials in South Carolina

Making a life insurance claim in Lancaster, South Carolina, should be the same as in any other city and state, but it’s not. Laws vary from one state to another. In fact the process is not even the same among different insurance companies.  This lack of uniformity adds complexity and frustration, and it is usually the person making the claim who ends up on the losing end.

The typical life insurance claim involves contacting the insurance company, filling out forms, and providing a certified copy of the death certificate (and sometimes medical records). Most life insurance claims are honored and paid, but some are not.  Some of the most common reasons for denial are:

1. Material misrepresentation in the policy – in other words, the insurance company thinks that the deceased lied about or omitted a medical condition, addiction, risky behavior, or something in the deceased’s background that would have kept the policy from ever being issued.

2. The policy lapsed, either because of non-payment or expiration of the policy term. This is especially harsh when the policy holder was hospitalized, incapacitated or under hospice care for a long time before death and the premium did not get paid. Some insurance companies will stop an automatic bank draft for premiums when they suspect that an insured is near death, hoping that no one will notice.

3. Claim is not made in a timely manner.

4. Policy exclusion – such as death from a dangerous activity mentioned in the policy or suicide within a set time after the policy is issued.

* Although not a reason in itself for denial, insurance companies look more closely at “high dollar” policies and those issued a short time before death.

Keep in mind that insurance companies are in the business of making money and they don’t like to pay it out. Some insurance companies take advantage of people who are grieving and are not aware of the law. Those insurance companies play the odds that you will just give up. But you don’t have to take the insurance company’s word for it! Yes, some denials are proper, but many are because of bad faith business practices by the insurance company.

When filing a life insurance claim, do these things:

♦   After the first telephone conversation with the insurance representative, insist that all communication be in writing. Respond to requests in a timely manner, and document every communication with the insurance company in writing, and keep copies of every letter and record.

♦   If you are asked to provide medical records, or give a recorded statement, or meet with a claims investigator, speak to an attorney first. The attorneys at Norrell & Powers Norrell, LLC have experience in these cases. Remember: the insurance carrier should be able to make its determination based upon the death certificate and the information provided by the deceased in his or her application. Since you weren’t part of making the insurance contract, then the most likely reason that the insurance company wants a statement from you is to justify their denial, not help your claim.

________________

Mitch Norrell and Mandy Powers Norrell are Lancaster SC insurance claim lawyers with over 45 years combined experience in handling wrongfully denied life insurance claim cases. This post is provided free of charge for general information only, and not as legal advice for your particular circumstances. To schedule a free consultation, please contact us.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s