Life Insurance Claims Expectations
Life Insurance Claims – How to collect and What Can Go Wrong
When a loved one dies – there’s not a standard process for submitting life insurance claims to the insurance company and then receiving the death benefit. In fact, no two life insurance claims are ever the same. It’s an unfortunate reality that the majority of life insurance companies are looking for reasons to deny death benefit claims. Yes, there are times when certain claims should be denied due to fraud, but more often than not, death benefit claims are denied for the wrong reasons.
Examples of initial death claim that were denied:
- A woman was denied because the she paid her premiums from her life savings. The insurance company claimed that she didn’t have enough earned income for them to issue a policy and therefore were not liable to pay the benefit.
- A man was initially denied because there was no named beneficiary… despite the fact that he lived with his disabled mother and had no wife or children and the intent was obvious.
- And another one where the autopsy report was misread by the claim underwriter who accused the insured of being a drug abuser. Later, statements from the man’s doctor disputed this accusation and the claim was paid.
These are just some examples of why you need to prepare your life insurance death benefit claim before you submit. It’s important that you know what you need and what to expect from the insurance company.
Make sure you:
- Read through the policy to determine and restrictions or stipulations for receiving the death benefit.
- Check the date of the application. Is it the same as the policy issue date? Benefits don’t actually start until the date the policy was issued.
- Know that if the insured person dies within two years of the policy date – the insurance company will almost certainly challenge the claim.
- Review the death certificate for the cause of death. If you’re submitting a claim under an accidental death policy, the cause of death will be extremely important in collecting your claim.
Know that the insurance company will do several things when they receive a life insurance claim. First, they’ll ask the beneficiary to meet with a claims underwriter for an interview. You’ll be asked about the insured’s personal life, their medical history, work history, and the cause of death… They’re looking to uncover anything that might have been hidden from the insurance company. In this case – it’s important that you bring someone along to support you, but also as a witness to the questions and answers. Then they’ll perform an investigation. They’ll look at autopsy reports, toxicology reports, old doctor visits, tax returns, social security records, and financial aide applications. It can be a lengthy process so stay in tune and record any conversations and meetings that take place.
If your claim is denied you must be notified – in writing – as to the reason why. From this information, and from the information you’ve collected throughout the process, you can make an appeal. It’s best to have good representation if this happens… someone who knows the laws pertaining to insurance benefits so that you can complete the process quickly and correctly and collect the death benefit that your loved one intended you to have.
