After the death of a spouse or loved one who is providing you financial support, one of the first questions that arises is whether the decedent had life insurance. But even if there is a policy in effect, the insurance company may be telling you that payment is being delayed or possibly even denied because your loved one died within the period of contestability.

Another problem occurs if the policy inadvertently lapses, but is reinstated on condition of the insured completing a new application — that triggers a new contestability period.

But once two years elapses from the date the policy is taken out, the policy is deemed “incontestable.” That means the insurance company may not deny a claim based on statements made in the application — unless the insurance company can show that misstatements or deliberate omissions were made with an intent to defraud.

What an investigation seeks to uncover

The contestability period is the first two years after a life insurance policy takes effect. If someone dies within the first two years of the policy’s effective date, the insurance company reserves the right to deny payment in the event statements made in the application for insurance were untrue, even if any misstated information had nothing to do with death; i.e., a history of tobacco use is denied but the insured died in a car accident.

The results of the investigation

If the investigation concludes that the insured misrepresented or omitted important information on the insurance application, coverage may be denied.

If the insurance company denies the claim, you will likely receive a refund of your premiums, but, if the company approves your claim, the payment should include interest for the time the claim was delayed. While insurance companies reportedly dispute only about 1 percent of all claims, this may be of little comfort if your claim is one that has been denied.

If you believe the insurance company has wrongfully denied benefits, you should immediately contact a lawyer for assistance. At DeBofsky, Sherman & Casciari, P.C., we have the experience to help you. We will examine your policy and surrounding facts; and if we determine that the denial was erroneous, with any appeals or litigation that may be warranted.

Related Articles

What Personal Injury Lawyers Need to Know About ERISA Liens

What Personal Injury Lawyers Need to Know About ERISA Liens

Personal injury lawyers are frequently faced with lien claims against their clients’ recoveries brought by health insurers, union welfare funds, and other health benefit plans. Those plans fall within ERISA’s scope as “welfare plans” which are defined […]

Mark DeBofsky Recognized by Best Lawyers®

DeBofsky Law is pleased to announce that the Mark DeBofsky was recognized in the 29th edition of The Best Lawyers in America® for high caliber work in Employee Benefits (ERISA) Law, Litigation – ERISA and Litigation – Insurance […]

What Employment Lawyers Should Know About ERISA

What Employment Lawyers Should Know About ERISA

The Employee Retirement Income Security Act of 1974, or ERISA, is a complex federal statute that applies to nearly all employee benefit plans, subject to a few narrow exceptions. Combining aspects of contract law, trust law, administrative law, and common law, ERISA is famously complex, earning it the moniker: “Everything Ridiculous Imagined Since Adam […]