Millions of people have died due to the COVID-19 pandemic worldwide leaving grieving families, many of them under financial stress. For those of them whose loved ones owned a life insurance policy, a new question arose – does life insurance cover pandemic related deaths? Do life insurance companies deny COVID-19 death benefits?
In the past year, we dealt with many cases where our clients were denied claims due to COVID-19 deaths and helped them recover the payout. If you or someone you know is in a similar situation, we have the experience you need to help you with your claim, from filing the claim to appealing the denial. Call us at 888-510-2212 to speak to one of our lawyers.
Below is the information we have gathered and you should know if you are the beneficiary of a life insurance policy that was denied due to coronavirus.
When Do Life Insurance Companies Deny Claims Due to Coronavirus?
If your life insurance policy is active and the premiums are paid, the cause of the insured’s death is usually irrelevant. This means that if their death is a result of coronavirus, the policy will pay out. There are a few exceptions, however, that insurers may use as reasons to deny the claim for a coronavirus death:
1. Lapsed Life Insurance Policy
If the policyowner failed to pay premiums on the due date, during the grace period and before the policy is reinstated, the policy will lapse. Since there is no coverage at the time of death, no claim can be filed and life insurance companies are not legally obligated to pay out the benefits. Life insurance policies offer a grace period of 30 to 61 days during which the policyowner can pay a missed premium and still have active coverage. Most companies extended the grace period during the coronavirus pandemic. If a payment is not made during the extended grace period, insurers will deny the benefits claim due to policy lapse.
2. Accidental Death Policy
While standard life insurance policies cover most causes of death, accidental death and dismemberment policies, or AD&D, only cover deaths due to accidents and do not provide benefits for the diagnosis or treatment of COVID-19. Companies will deny ADD claims if the insured died of illness or disease. COVID-19 related deaths are considered due to natural causes, not accidents, and are not covered by most accidental death policies. If you purchased a life insurance policy with an accidental death rider, the life insurance coverage will cover a COVID-19 related claim and you will receive a payout on it, but the accidental death rider amount will be denied.
3. Critical Illness Policy
Critical illness policies allow the policyholder to receive payments in case they are diagnosed with certain diseases or conditions such as a heart attack, kidney failure, organ transplant, stroke, or cancer. Most life insurance companies do not include COVID-19 as a covered condition under their critical illness policies. Unless your critical illness policy includes the newly discovered coronavirus, your critical illness claim will be denied. However, there is an exception for cases when COVID-19 leads to covered conditions, such as organ failure.
4. Misrepresentations or Omissions on the Life Insurance Application
Many claims get denied due to material misrepresentations or omissions on the application for life insurance. This means that the policyowner provided inaccurate or incomplete information when applying for the policy. Inaccurate information that can lead to a claim denial can range from an innocent mistake about a doctor visit to intentionally misrepresenting weight or age or not disclosing dangerous hobbies. A life insurance claim can be denied for material misrepresentations only if the insured died during the two-year contestability period when the insurance company launches a thorough investigation of the claim and initial application to make sure no the applicant provided correct information.
5. COVID-19 Related Claims Under Accelerated Death Benefit Rider
Accelerated death benefit riders pay a percentage of the total death benefit if the insured is terminally ill. To receive an accelerated death benefit the insured must prove he/she is terminally ill by supplying a statement from the treating doctor. In addition, accelerated death benefit policies require that the insured person have a certain life expectancy (for example, six months or a year). Life insurance companies have been reluctant to pay accelerated death benefits in COVID-19 related claims unless there is a terminal illness that is exacerbated by coronavirus.
What to Do if Your COVID-19 Related Death Claim Has Been Denied
If your claim was denied due to coronavirus death for any of the reasons above, we recommend a consultation with our life insurance attorneys. We have a high success rate in handling such cases and can help you recover the payout.
Our lawyers work on a contingent fee basis and will only get paid after you win. There is no legal fee if there is no recovery. We take pride in offering competitive contingent fee structures and will work with you to ensure you are comfortable with the fee.
If you find yourself in one of the situations described above or you simply need advice, a free consultation to help you assess your case will always be available to you at our firm. Call us at 888-510-2212 to consult with one of our lawyers.