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Your Information Source for Insurance Coverage Denials & Disputes

Navigating insurance claims is complicated, and dealing with denials is frustrating to say the least. Learn what you need to know here to be successful on your claim.

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Life Insurance Company Denies Claim Based on Policyholder’s Alleged Misrepresentation of Drinking History

Posted by: Insurance | News Desk February 25, 2025
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On July 9, 2024, the United States District Court for the Middle District of Georgia issued a pivotal ruling in the case of Blalock v. Pacific Life Insurance Company. The dispute centered on two life insurance policies, each valued at $1 million, issued by Pacific Life on the life of Jimmie Long. Following Long's death in a collision with a drunk driver on May 24, 2022—within the policies' two-year contestability period—Pacific Life denied the claim, alleging material misrepresentations in Long's application regarding his alcohol consumption history. Read More

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Unum Life Insurance Company Told to Reform Company Practice on Evidence of Insurability

Posted by: Insurance | News Desk October 31, 2024
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Requiring proof of good health, also known as evidence of insurability, is a long-held standard practice across the life insurance industry. Uncontroversial on its face, the practice has fallen under scrutiny in recent years as it has come to light that insurance companies have routinely accepted applications without verifying insurability and only later – after the death of the insured – refusing to pay the claim on the grounds that it did not receive proof of insurability during the application process. These denials could come after years of accepting premium payments and are considered to be unfair, unlawful, or even a bad faith insurance practice. Read More

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The More You Need Preventive Care Coverage, the More Likely Your Claim Will Be Denied, Study Finds

Posted by: Insurance | News Desk September 30, 2024
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This September, the Journal of the American Medical Association (JAMA) published its findings based on a large cohort study of more than a million and a half patients seeking preventive care. The results, published in JAMA Network Open on September 18, reveal that at-risk patients experience claim denials at higher rates than other groups. At-risk populations were defined in the study to include patients with low incomes, those without a high school degree or education beyond high school, and racial and ethnic minority groups. Ironically, preventive care is often free to more affluent groups with better health plans, while at-risk populations experience barriers in the form of cost-sharing requirements, administrative obstacles, and the denial of claims. Read More

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What to Do if Your Life Insurance Claim Is Denied?

Posted by: Insurance | News Desk September 5, 2024
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Life insurance is a critical safety net for many families, providing financial stability during difficult times. While the majority of claims submitted are ultimately paid, a small number of claims get turned down every year. If this happens to you, it’s crucial to understand your rights and the steps you can take to contest the denial.

Understanding the Reason for Denial

The first step in addressing a denied life insurance claim is to understand why the claim was rejected. Insurance companies are required to provide a detailed explanation of the denial, usually in the form of a denial letter. Common reasons for life insurance claim denials include... Read More

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