Types of Cases
In an effort to maximize profits and minimize expenses, life insurance companies will seek out almost any available reason to deny payment. Most often, life insurance denials fall into two categories:
Material misrepresentations - when an insured has allegedly omitted or misrepresented the true facts concerning health, income, or other personal information in the application.
Lapsed premiums - when the premium payments have not been timely paid at the time of death.
Life insurance denials also occur when there is a suicide or other alleged dispute about the death of the insured. Denials can occur in other contexts, too. Since a life insurance policy is a contract between the policyholder and the insurance company, if the insurance company believes that the policyholder breached the contract, it may deny a claim for the policy.
In New Jersey and New York, like in many other states, the insurance company has a two-year contestability period in which to rescind coverage on the grounds that a material misrepresentation was made in the application. After two years have passed since the life insurance policy was issued, the insurance company cannot disclaim coverage on this basis. But if the insured dies within those two years, the insurance company may investigate the truthfulness of the application and, if warranted, deny coverage based on a material misrepresentation. Denials routinely occur within this two-year contestability period.
Many policyholders and beneficiaries believe that if their claim is denied, they have no recourse and must accept the decision as final. However, if your insurance claim is denied, you have a right to challenge it in court.
If a policyholder or beneficiary who has experienced a life insurance denial resides in New Jersey or New York, or if the insurance company has its headquarters in New Jersey or New York, Attorney Eric Dinnocenzo may be able to provide legal representation to help them recover the policy.