Life Insurance Claim Denied Attorney
If your life insurance claim has been denied, that denial is not necessarily final — and it may not be legally valid. Insurance companies deny thousands of life insurance claims every year. Some denials are legitimate. Many are not. Insurers deny valid claims based on overstated misrepresentation allegations, improperly applied exclusions, procedurally defective lapse declarations, and technical arguments that do not hold up under legal scrutiny. They deny claims knowing that most beneficiaries will not fight back — and they are right, most of the time. We are the exception.
At Kadetskaya Law Firm LLC, we represent life insurance beneficiaries whose claims have been denied — by every major insurer, for every type of denial reason. We have recovered millions of dollars in denied claims through administrative appeals, demand letters, and litigation. We work on a contingency fee basis — you pay nothing unless we win.
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A Denial Is Not the Final Word
The most important thing to understand after receiving a denial letter is this: the insurer's decision is its legal position — not a final legal determination. You have the right to challenge it. And a significant percentage of denied claims that reach our firm are recoverable. The denial letter is the beginning of a legal process, not the end of one. But the process has strict deadlines — and missing them can permanently forfeit your right to recover. Act quickly.
The Most Common Reasons Life Insurance Claims Are Denied
Misrepresentation on the Application
The most common denial reason — particularly during the first two years of a policy, known as the contestability period. The insurer claims the insured failed to disclose a medical condition, medication, or other information on the application, and uses this to rescind the policy and refund only the premiums paid.
What most beneficiaries do not know: misrepresentation must be both material and intentional to legally justify a denial in most states. Material means the insurer would not have issued the policy — or would have issued it on different terms — had it known the true information. If the alleged omission did not contribute to the insured's death, or if the insurer accepted premiums with knowledge of the condition, the denial is vulnerable to challenge.
Many misrepresentation denials are successfully overturned on appeal or in court. See our detailed guide to misrepresentation denials →
Policy Lapse for Non-Payment of Premiums
The insurer claims the policy lapsed before the insured's death because a premium was not paid. Lapse denials are among the most frequently overturned in life insurance law — because state law imposes strict procedural requirements on insurers before coverage can be legally terminated.
Before declaring a policy lapsed, insurers must send required premium notices, observe a grace period of at least 30 to 31 days, send a lapse notice that complies with state law, and mail all notices to the correct address. When they cut corners — sending notices to old addresses, miscalculating grace periods, or failing to apply automatic premium loan provisions — the lapse may be legally invalid.
Our firm recovered $1,000,000 for four beneficiaries after demonstrating that the insurer failed to comply with state lapse notice requirements. We recovered another $1,000,000 from John Hancock in a lapsed policy case. [Learn more about policy lapse denials →](/life-insurance-policy-lapse-denial/)
Exclusions Applied to the Cause of Death
Accidental death policies and accidental death riders contain exclusions — for sickness, intoxication, drug use, illegal activity, and other circumstances. Insurers apply these exclusions aggressively and often beyond what the policy language actually supports.
The central legal principle in exclusion denials: the insurer must prove that the excluded cause — not the accident — was the proximate cause of death. The presence of alcohol, drugs, or a pre-existing condition in a toxicology report or medical record does not establish causation. Courts have repeatedly held that the insurer bears the burden of proving causation, and many exclusion denials cannot meet that standard.
Our firm has recovered accidental death benefits in cases involving the sickness exclusion, the narcotic exclusion, the intoxication exclusion, and the illegal activity exclusion — from Prudential, Broadspire, CUNA, Guardian, and Lincoln National. Learn more about accidental death denials →
Contestability Investigation
The insured died within the first two years of the policy. The insurer launches a contestability investigation — reviewing the application, obtaining medical records, and looking for anything it can characterize as a misrepresentation. Many families receive dense denial letters full of medical terminology and policy citations that make the denial seem unassailable. Often it is not.
A contestability investigation does not automatically produce a valid denial. The insurer must prove the alleged misrepresentation was material and that it affected its underwriting decision. Many contestability denials are successfully challenged when the omission was innocent, unrelated to the cause of death, or when the insurer would have issued the policy regardless. Learn more about contestability denials →
Beneficiary Disputes and Interpleader
Multiple people claim the same death benefit — an ex-spouse and a current spouse, family members contesting a last-minute beneficiary change, or competing claims involving fraud or undue influence. The insurer may freeze the claim or file an interpleader action — a federal or state lawsuit asking a court to decide who is entitled to the proceeds.
If you have received an interpleader summons, you must respond within 21 to 30 days or risk a default judgment permanently forfeiting your right to the benefit. Our firm recovered $1.1 million in a Minnesota Life interpleader involving three competing claimants. Learn more about beneficiary disputes →
ERISA Group Life Insurance Denials
If the life insurance was provided through an employer, it is almost certainly governed by ERISA — the federal law that controls employer-provided benefits. ERISA denials follow different procedural rules than individual policy denials. Appeal deadlines are strict — typically 60 to 180 days from the denial. The administrative record built during the appeal is the record a federal court will review — meaning evidence not included in the appeal generally cannot be introduced later. ERISA cases require experienced legal guidance from the start. Learn more about ERISA denials →
Group Life Insurance Conversion and Portability Denials
An employee leaves a job and loses group life insurance coverage — because no one told them about their right to convert or port the coverage. When the employee dies uninsured, the family files a claim and is told coverage ended. In many of these cases, the employer's failure to provide required conversion or portability notices creates direct legal liability. Our firm recovered $840,000 from an employer that failed to send a required conversion notice to a terminated employee. Learn more about conversion denials →
Evidence of Insurability Not Approved
The employee elected supplemental group life insurance that required EOI approval but the approval was never obtained — often because the employer failed to submit the form, the insurer lost it, or neither party notified the employee that coverage was conditional. Learn more about EOI denials →
Delayed Claims That Become Denials
Many denials are preceded by months of delay. If your claim has been under review for more than 60 days without clear explanation, act before the denial letter arrives — it is often easier to force payment during the delay than after the denial. Learn more about delayed claims →
What to Do Immediately After Receiving a Denial
Read the denial letter carefully. The insurer must explain specifically why the claim was denied and cite the specific policy provisions it is relying on. If the explanation is vague, that vagueness is itself a legal argument.
Note the appeal deadline. For ERISA plans, the window is typically 60 to 180 days from the denial letter. For individual policies, deadlines vary by policy and state. Missing the deadline can permanently forfeit your right to benefits.
Request the complete claim file. Under ERISA you are legally entitled to it free of charge. For individual policies, send a written request. The file often contains information that directly undermines the denial.
Do not provide recorded statements or sign documents without legal advice. Anything you say or submit to the insurer can be used to support its denial.
Contact a life insurance attorney immediately. The sooner an attorney reviews your case, the more options you have. Most denied claims that reach our firm before the appeal deadline are recoverable to some degree.
How We Challenge Denied Claims
Our process begins with a thorough review of the denial letter, the claim file, and the policy. We identify the specific legal weaknesses in the insurer's position — whether that is a failure to meet the materiality standard for misrepresentation, a procedural defect in the lapse notice, a causation failure in an exclusion denial, or an ERISA procedural violation.
We prepare a comprehensive administrative appeal that addresses every basis for the denial, presents the evidence supporting coverage, cites applicable case law, and builds the record for federal court if necessary. If the appeal is denied, we file suit — in state or federal court depending on whether the policy is governed by ERISA or state law. Most denied claims resolve without litigation once an attorney is involved. Insurers know the cost of defending a bad denial in court and respond differently when they understand the case is being handled seriously.
Insurers We Have Successfully Challenged
We have recovered denied life insurance benefits from virtually every major life insurance company, including:
MetLife · Prudential · Unum · The Guardian · Lincoln National · John Hancock · Genworth · American General · Protective · Transamerica · MassMutual · Nationwide · Principal · Mutual of Omaha · Sun Life · Voya Financial · Cigna · Aetna · Reliance Standard · Standard Insurance · Minnesota Life · CUNA · Broadspire · Colonial Life · Foresters · Hartford Life · United of Omaha · Globe Life · North American Company · RiverSource · Symetra · and many others
If your claim was denied by any insurer — whether listed here or not — contact us for a free evaluation.
Our Results in Denied Claim Cases
- $1.1 million recovered in an interpleader action involving three competing claimants and Minnesota Life Insurance Company
- $1,000,000 recovered for four beneficiaries after a policy lapse denial
- $1,000,000 recovered from John Hancock after a lapsed policy denial
- $840,000 recovered from an employer that failed to send a conversion notice to a terminated employee
- Recovery from Prudential — accidental death claim denied under the narcotic exclusion after the insured died in a motorcycle accident with marijuana in his system
- Recovery from Broadspire/Federal Insurance Company — accidental death claim denied under both the intoxication and narcotic exclusions after the insured drowned in a hot tub
- Recovery from Lincoln National — two separate accidental death denials based on the misdemeanor exclusion, both reversed on appeal
- Recovery from The Guardian — life insurance claim delayed for months during a contestability investigation; full benefit recovered
- Recovery from Unum — misrepresentation denial on a portability application reversed on appeal
- Recovery from MetLife — delayed claim involving a misrepresentation investigation; full benefit recovered
- Recovery from Standard Insurance — beneficiary dispute involving an ex-spouse; full benefit recovered for our client
- Recovery from North American Company — lapsed policy denial; full benefit recovered after identifying notice deficiencies
***Prior results do not guarantee a similar outcome.
Frequently Asked Questions
Can a denied life insurance claim be overturned?
Yes — frequently. Many life insurance denials are legally flawed. Misrepresentation denials often fail the materiality standard. Lapse denials often rest on procedural deficiencies. Exclusion denials often fail the causation requirement. Beneficiary disputes often turn on technical legal issues that favor the named beneficiary. Every denial is worth a legal review.
How long do I have to appeal a denied life insurance claim?
For ERISA employer-provided policies, typically 60 to 180 days from the denial letter — depending on the plan. For individual policies, the deadline is set by the policy and applicable state law. Do not wait — contact an attorney immediately after receiving a denial.
What if I already missed the appeal deadline?
Contact an attorney anyway. In some circumstances — if the insurer failed to properly notify you of the deadline, or if the denial itself was procedurally defective — the deadline may be extended or the denial may be challengeable on other grounds.
Does it matter what the denial reason is?
Yes — different denial reasons require different legal strategies. But almost no denial reason is automatically fatal to recovery. Even denials that appear airtight often contain legal weaknesses that an experienced attorney can identify and exploit.
What if the insurer says the policy is void?
An insurer that declares a policy void — typically in a misrepresentation or contestability case — must still prove all elements required by state law to rescind. In most states, that means proving the misrepresentation was material and intentional. A declaration that a policy is void is the insurer's position — not a legal conclusion.
Do I need to go to court to recover a denied claim?
Not necessarily. Many denied claims resolve through the administrative appeal process without litigation. When litigation is necessary, we handle it. We do not stop at the appeal if the insurer upholds a flawed denial.
How much does it cost to hire a life insurance attorney for a denied claim?
Contact Kadetskaya Law Firm, LLC
Kadetskaya Law Firm, LLC handles all denied claim cases on a contingency fee basis. You pay no attorney fees unless we recover your benefits. There are no upfront costs and no hourly charges.
If your life insurance claim has been delayed for weeks or months with no payment and no clear explanation, do not wait for the denial letter. The time to act is now.
(888) 510-2212
Free Consultation
No fees unless we win.
Kadetskaya Law Firm, LLC
630 Freedom Business Center Dr, 3rd Floor
King of Prussia, PA 19406
(888) 510-2212
info@life-insurance-lawyer.com
No fees unless we win.
This page is for general informational purposes only and does not constitute legal advice. Contact our firm directly for advice specific to your situation.