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Coping with the loss of a loved one, whether a parent or spouse, is an emotionally difficult time. While coping with grief, the last thing you need is to contend with an insurance company over a life insurance claim. When an insurer adds to this burden by denying or delaying a claim, it can feel like a betrayal. That’s where we come in. At Kantor & Kantor, we’re more than just attorneys—we are people helping people.

Life insurance is an essential safety net, covering expenses like funerals, mortgages, and educational needs following the insured’s passing. We understand that life insurance policies are meant to provide peace of mind and financial security for your loved ones.

Our mission is simple: to provide compassionate legal support and fight to ensure you receive the benefits you deserve from your life insurance policy. Our experienced San Jose life insurance lawyers are here to help you get the benefits you are entitled to. Call us today at 408-539-0081 to schedule a free consultation.

We offer a free case evaluation to discuss how our attorneys can assist you. Contact us now at 408-539-0081 for a free consultation.

Common Reasons Life Insurance Claims Are Denied

When grieving a loved one, the last thing you want to deal with is a denied life insurance claim. Unfortunately, this happens more often than many people realize. Here are common reasons why life insurance claims get denied in San Jose:

Accusations of Misrepresentation or Non-Disclosure

Insurance companies often scrutinize the policyholder’s application for inaccuracies or omissions. To justify a denial, they may claim that the policyholder provided false information or failed to disclose relevant facts, such as pre-existing medical conditions. Insurance companies may claim that the policyholder provided false information or failed to disclose relevant facts when there is a reasonable explanation for such facts. Similarly, the type of question asked may be ambiguous, which leads to the claimant’s not understanding what was being asked.

Allegation of Policy Lapse or Non-Payment of Premiums

Another common reason for denial is the unlawful allegation that the policy lapsed due to non-payment of premiums. There are laws in place and stipulated requirements that outline the time frame that insurance companies have in which to provide notice that a policy is lapsing. If insurance companies do not comply with these notice periods, they are obligated to reinstate that policy. Insurance companies may argue that the policy was not in force at the time of death, thus invalidating the claim.

Accusations of Failure to Provide Required Documentation

Insurance companies require various documents to process a claim, including the death certificate, proof of identity, and, often, medical records. Denials can occur if the insurer claims the provided documentation is insufficient or incomplete. This most frequently occurs when the death occurs in a foreign country and a death certificate is difficult to interpret or impossible to obtain.

Tactics Used by Insurance Companies to Deny Life Insurance Claims

Insurance companies often resort to various tactics to avoid paying out life insurance claims. Here are ten common strategies they employ:

  • Demanding Excessive Documentation: By requesting an overwhelming amount of paperwork, insurers can make it difficult for claimants to comply, thereby justifying a denial based on incomplete documentation.
  • Interpreting Policy Language Narrowly: Insurers may use vague or ambiguous policy terms to their advantage, interpreting them in the narrowest way possible to deny coverage.
  • Accusing Material Misrepresentation: They might allege that the policyholder provided false or misleading information on the application, even if the discrepancies are minor, caused by ambiguity, or unrelated to the cause of death.
  • Citing Policy Exclusions: Insurance companies often rely on specific exclusions, such as suicide, acts of war, or dangerous activities, to deny claims, even in cases where the exclusion might not apply.
  • Relying on Medical Underwriting Issues: If the policyholder had a pre-existing condition not disclosed at the time of application, the insurer might deny the claim based on non-disclosure or misrepresentation, regardless of whether the condition contributed to the death.

What to Do if Your Life Insurance Claim Has Been Denied

Discovering that your life insurance claim has been denied can be devastating. It is important not to lose hope.

Your first step is to understand the reasons behind your claim denial. Carefully review the denial letter from the insurance company. Understand their specific reasons for denying your claim. This will help you identify any misunderstandings or discrepancies that must be addressed.

Then, gather your documents. Collect all relevant documents related to the life insurance policy and the claim. This includes policy documents, medical records, correspondence with the insurer, and other paperwork supporting your claim.

Once you have done this, it is time to seek legal advice. Life insurance policies are complex legal documents, and claim denials often involve intricate legal and factual issues. Contact our experienced life insurance lawyer. We will analyze your case, assess the validity of the denial, and guide you on the best course of action.

The next step is to file an appeal. If we determine that the denial is unjustified, we will assist you in filing an appeal with the insurance company. This involves presenting additional evidence, addressing any concerns the insurer raises, and making a compelling case for why your claim should be approved.

Finally, prepare for litigation by gathering all relevant documentation, including your policy, denial letters, medical records, and any communication with the insurance company. Consult with an experienced life insurance attorney at Kantor & Kantor who will represent your interests and pursue the benefits you’re entitled to.

Our attorneys at Kantor & Kantor will help you gather all medical records and other documentation.

Why Choose Kantor & Kantor?

We understand the financial and emotional strain that accompanies the loss of a loved one. Our attorneys will provide a personalized and effective legal representation tailored to your needs.

Here’s why clients in San Jose trust Kantor & Kantor:

A Wealth of Relevant Experience

With decades of dedicated practice in life insurance law, we bring a wealth of experience to every case we handle. Our firm has successfully navigated many insurance claim disputes, securing rightful benefits for our clients.

An Approach Focused on You

We prioritize your concerns and needs above all else. Each case is approached with personalized attention, tailoring our strategies to your unique circumstances. Your goals become our goals, and we are committed to achieving a favorable resolution that meets your expectations.

Long History of Success

Our firm’s reputation is built on results. We have a strong record of achieving favorable outcomes through negotiation, mediation, and litigation when necessary. We leverage our understanding of insurance policies and laws to strategize effectively for your case.

Accessible and Responsive Service

Communication is key. We ensure that you are informed throughout the legal process. You can expect clear, timely updates and prompt responses to your questions and concerns.

Local Presence, National Insight

Based in California, we have a deep-rooted connection to our community and a broad perspective on insurance issues that extend nationally. This local presence and national insight allow us to offer comprehensive and effective legal solutions.

Readiness to Fight for You

When you choose Kantor & Kantor, you choose a team that is prepared to go the distance. Whether through negotiation or litigation, we pursue the justice and compensation you deserve.

How We Can Help With Your Life Insurance Claim

Our San Jose life insurance attorneys are committed to providing comprehensive support to clients at every stage of the life insurance claims process. Here’s a closer look at how we can help you:

  • Understanding Your Situation: We start by reviewing your life insurance policy and the reasons provided for the denial. Our experienced team analyzes the details to develop a clear strategy tailored to your situation.
  • Strategic Legal Guidance: With decades of experience in insurance law, our firm provides strategic guidance tailored to your unique circumstances. We explain your rights under the policy and state laws, ensuring you understand all available options moving forward.
  • Advocating on Your Behalf: Insurance companies may use complex tactics to minimize payouts or deny claims outright. We have decades of experience negotiating with insurers, ensuring your voice is heard and your rights are protected.
  • Litigation Support: In cases where the insurer refuses to pay its fair share, our skilled litigators are prepared to take your case to court. We successfully litigate against insurance companies, fighting to secure the benefits you deserve.

What if My Life Insurance Claim Is Denied Due to a Beneficiary Dispute?

Life insurance claim denials from beneficiary disputes often trigger legal proceedings called ‘interpleader actions.’ The insurer initiates this when multiple claimants contest the rightful beneficiary designation. The aim is to settle disputes and ensure an equitable distribution of the life insurance proceeds. This process may entail legal disputes, with the funds potentially held in escrow until the court decides.

Such conflicts commonly arise from scenarios such as neglected beneficiary updates post-divorce, the absence of a designated beneficiary, or suspicions regarding the validity of beneficiary alterations, particularly if done hastily or under dubious circumstances. Interpleader actions are governed by state and federal laws, providing a structured approach to resolving complicated beneficiary disputes.

Contact Our Life Insurance Attorney in San Jose Today

Don’t let life insurance claim issues add to your burden during an already difficult time. Contact our San Jose life insurance attorneys today to schedule a free consultation. During this initial meeting, we will review the details of your case, answer any questions you may have, and outline the best course of action for moving forward.

Take the first step toward securing the benefits you deserve. Contact Kantor & Kantor at 408-539-0081, and let us be your trusted advocate in resolving your life insurance claim.
Attorney Glenn Kantor, California

Attorney Glenn R. Kantor

Glenn Kantor is a founding partner of Kantor & Kantor LLP. As a young attorney, Glenn saw the injustice of wrongful insurance denials and created a law firm to represent individuals seeking to obtain their rightful benefits. Glenn is committed to ensure that clients receive the benefits they are entitled to under their insurance policies or group health plans. [Attorney Bio]