Question 1

Can a life insurer deny a claim over a mistake on the application?

Accepted Answer

Sometimes. Under Section 154, an insurer may rescind for a misstatement that was material to the risk, even an innocent one. The statement must appear in the written application or policy, and once an individual policy has been in force for two years during the insured's lifetime, it generally becomes incontestable.

Question 2

The insurer says the policy lapsed. Is that the end?

Accepted Answer

Not necessarily. Illinois requires a grace period and, for many policies with annual, semiannual, or quarterly premiums, a statutory notice before lapse. Cash value, extended term coverage, or a waiver-of-premium benefit may also keep the policy in force.

Question 3

What if the coverage came through an employer?

Accepted Answer

Group coverage is often governed by ERISA. Federal law then controls, and an internal appeal usually must be filed first, on a short deadline. The appeal record often shapes what a court can later review.

Question 4

How are fees structured?

Accepted Answer

Many life insurance claims suit a contingency fee, because the benefit is a fixed amount and the recovery pays the fee. Some matters, such as appealing a loss of coverage before any death claim, fit a flat or hourly fee. We set the structure out in writing at the start.

Question 5

Should we stop paying or terminate if the tool isn’t working?

Accepted Answer

Not before reviewing the contract. Withholding payment or terminating without following the notice-and-cure process can put you in breach and hand the vendor the stronger claim. Document the failures in writing, follow the contractual notice procedure, and preserve logs, outputs, and correspondence first.

Life Insurance Claim Denials

A Promise Tested After a Death.

Common Disputes

Rescission Over the Application

Contestability Disputes

Lapse & Missed Premiums

Accidental Death Benefits

Employer & Group Coverage

Delayed Payment

Frequently asked questions