Failure to pay a life insurance claim or delays in processing a claim

In many cases, a life insurance payout will occur within a few weeks of the life insurance company being notified of the death and receiving a death certificate. However, in some cases, payment will not be forthcoming, or the life insurance claim will be denied. Reasons for delays or denial of a life insurance claim include lapse of premium, misrepresentation or non-disclosure of facts in the insurance application, death caused while engaging in illegal or dangerous activities, death by suicide, or death within two years of the life insurance policy being issued.

First step to take if your life insurance claim has been denied

You have rights and options if a life insurance claim has been wrongfully delayed or denied. The first important step is to understand the reason for the denial. Our Oshawa life insurance claims lawyers provide a free initial case assessment (contact us today to schedule your consultation) at which we can review your claim, evaluate the basis for the denial, and discuss your options. Each claim is unique, and the outcome will depend on a thorough analysis of the facts, the grounds for the denial, and the wording of the insurance policy terms, coverages, and exclusions. Our lawyers are skilled at assessing a claim in detail to provide you with strategic advice based on the circumstances of your case.

Next steps if your life insurance claim has been denied

If your life insurance claim has been wrongfully delayed or denied, options to dispute the decision include:

  • Internal appeal of the decision. It may be possible to file an internal appeal to have the insurance company reconsider the claim. If an internal appeal is advisable in your situation, an experienced life insurance claim lawyer can assist with the paperwork and investigate your case to gather valid evidence to support your claim. Each insurer has its own appeals process and there are strict deadlines to follow for internal appeals. It is also important to ensure that you do not miss the limitation period to file a lawsuit while waiting for an appeal decision.
  • Filing a lawsuit. In some cases, filing a lawsuit is the best option. If an internal appeal is not recommended in your case (or if the internal appeal is unsuccessful), a lawyer with experience handling insurance disputes can file a lawsuit on your behalf, setting out the legal basis for your claim and seeking payment of proceeds to which you are entitled, plus pre- and post-judgment interest on the amounts claimed and your legal fees. Depending on the facts of your case, you may also have a claim for additional damages for “bad faith” (e.g., that the insurance company acted in bad faith in the manner in which it investigated or handled your claim). What amounts to bad faith varies from case to case and will require the court to look at the conduct of the insurer throughout the claims process.
  • Negotiating a settlement. At any stage of the process – even after a lawsuit has been filed – it is possible for the parties to come to an agreement to settle the claim by way of negotiation or mediation. In fact, most insurance disputes are resolved without the need for a trial. A knowledgeable insurance claims lawyer can evaluate the fairness of any settlement offers from the insurance company and argue strenuously on your behalf to secure the best possible settlement of your claim.

The best course of action to consult with one of our Oshawa life insurance claim lawyers as soon as your insurance company denies the claim, as there are strict limitation periods and procedures to be followed to protect your rights and interests regardless of the option you choose.

If your claim has been denied, get advice from a top life insurance claims lawyer

Oshawa’s Kitchen Simeson Belliveau LLP has been providing reliable legal services for over 35 years. We understand your concerns and the financial implications caused by denial of a life insurance claim. We do not charge for the initial consultation, and we often represent clients with insurance disputes on a contingency fee basis, which means that you do not have to pay anything unless and until you recover money from the insurance company through negotiated settlement or litigation. Call us today at 905-579-5302 to schedule your free consultation.