Exploring the Different Types of Life Insurance Denials
One common question we hear at Life Insurance Law, is why it is important to have a policy reviewed when deciding a course of action to deal with a denied claim. Ultimately there is a huge range of policies and so the type of denial for life insurance can depend on the type of policy, specific exclusions in the specific policy, and the insurer. While there may be some similarities, different types of life insurance policies and insurance companies may have varying criteria and exclusions that can result in denial. Here are some examples of the range of differences:
- Pre-Existing Medical Conditions: Certain types of life insurance policies may have stricter underwriting guidelines regarding pre-existing medical conditions. For instance, a term life insurance policy might have more lenient acceptance criteria for certain conditions compared to a whole life insurance policy.
- Risky Occupations and Hobbies: Insurers may have different thresholds for what they consider to be high-risk occupations or hobbies. For example, one insurance company might view scuba diving as a high-risk activity and deny coverage, while another company might cover it with certain exclusions or higher premiums.
- Underwriting Guidelines: Each insurance company establishes its own underwriting guidelines to assess risk and determine eligibility. These guidelines can vary in terms of the health conditions, lifestyle factors, and other criteria they consider. Some insurers might have more lenient guidelines and be more inclusive, while others might have stricter criteria and deny coverage to certain individuals.
- Policy Exclusions: Life insurance policies can have specific exclusions that limit or deny coverage for certain events or circumstances. For example, a policy may exclude coverage for deaths resulting from acts of war, certain hazardous activities, or specific medical conditions. The extent and nature of these exclusions can differ between policies and insurers.
- Policy Riders and Options: Additional policy riders or options can impact the coverage and exclusions. For instance, an accelerated death benefit rider may allow the policyholder to receive a portion of the death benefit if they have a terminal illness, while another policy might not offer such a rider.
It’s essential to have the policy term carefully review, including the exclusions and riders, and understand the specific criteria of the insurer you’re considering when purchasing the policy. If you are experiencing a claim denial after a loss of a loved one, consulting with an attorney can be a great option to get guidance on your specific policy, if the denial is correct for your situation and policy. Additional information may allow you to make an informed decision about how to proceed with a dispute for your situation.
