How to Appeal a Denied Life Insurance Claim

May 7, 2025

When No Doesn’t Always Mean No

Did you just open your mail to find a denial of your life insurance claim? If so, your emotions are likely running high. Nothing complicates the mourning process more than a claim’s denial. You are already distraught regarding your loss; now you have to worry about the overwhelming financial impact on your life.

Times like these are trying, but there is some good news.  In the world of insurance decisions, no does not always mean no.  In pursuit of profitability, insurance companies often deny valid claims.

Policyholders have the right to appeal these decisions; a process best pursued with the guidance of a denied life insurance claims attorney.

This professional can review your situation and, if appropriate, assume responsibility for managing the appeal on your behalf.

Embarking on a Denied Life Insurance Claim Appeal

When you work with a seasoned and knowledgeable denied life insurance claims attorney, you can rest assured that the appeals process will be handled efficiently and effectively. These professionals can manage the time-consuming ins and outs of the appeal while you focus on your well-being.

That said, you should understand the steps involved in the appeals process to manage your expectations and provide your attorney with the information they need. These steps are shared below.

Review the Entirety of the Life Insurance Policy

Now is the time to sit down and read your loved one’s life insurance policy, from beginning to end. The information in this document can provide answers to many of your questions.

First, identify the coverage start and end dates. You must ensure that your loved one was covered at the time of death. Additionally, pay close attention to the premium payment requirements. This is a good time to confirm that these payments were made on time and that there was no lapse in coverage. Be advised, insurance companies generally notify policyholders of missed payments and provide them a grace period to become current.

Other areas of the policy to which special attention should be paid include the contestability clause and the exclusions. The contestability clause protects insurance companies from fraud by providing two years during which they can investigate policyholder-provided information to confirm accuracy. Misinformation referring to health (weight, high blood pressure, illness), lifestyle (smoking, drug use), and hobbies (scuba diving, motorcycle riding, skydiving) can invalidate a policy or result in a reassessment of risk.

Exclusions to life insurance policies include:

• Suicide (during the contestability period)
• Hazardous jobs
• Dangerous activities
• Flying planes/helicopters
• Criminal activity
• Travel to specified areas.

Death resulting from the above exclusions may result in a denial of claim.

Determine the Reason for the Claim’s Denial

Insurance companies are required by law to provide a written explanation detailing the reasoning behind denying a life insurance claim. If your letter does not include this, it should be requested from the insurance company.  Some of the most common reasons for denial include:

• Missed premium payments resulting in lapses in coverage
• Death resulting from an excluded activity
• Dying during the contestability period from suicide
• Application misrepresentations (failing to disclose issues like smoking or pre-existing medical conditions, for example).

Bear in mind that there may be circumstances where even these common reasons can be successfully appealed.  Your insurance lawyer can provide guidance on whether or not you have a viable case.

Collect Supporting Evidence

If your denied claims attorney believes you may have a reason for an appeal, they will ask you to gather information to strengthen your case. This may include bank statements or proof of payment for premiums, medical records, copies of all communication between your deceased loved one and the insurance company, as well as you (the beneficiary) and the insurance company, autopsy reports, and death certificates.

When you provide these documents to your attorney, always keep copies for your records.

Draft an Appeals Letter and Submit it Appropriately

The tone, structure, and contents of these letters are critical; you want to do all you can to impact a successful appeal. First, identify the correct individual or department to which the letter should be addressed, because letters sent to the wrong area may never be redirected and considered.

All appeal letters should be polite and as succinct as possible. That said, make sure to share specific details, including these:

• Name of the policyholder
• Policy number
• Your name and contact information and that of your attorney
• Clear explanation of why the denial was in error (referencing policy language where appropriate)
• Copies of all documents that can support your claim.

When you work with a denied claims insurance attorney, they can draft this letter on your behalf. They understand the format and terminology necessary to increase the chances of having a successful appeal.

Finally, submit your appeal as required by the life insurance company; this may vary from organization to organization. Some require using company portals, while others may request a hard copy to be mailed or even emailed. Always send correspondence using certified or express mail that requires a signature upon delivery.  Emails should be sent with a read receipt. You want to have proof that your appeal letter was received.

Stay Attentive

Unfortunately, the process is not complete once the appeal is submitted.  Regular communication, via email, is necessary.  You want to be sure that the appeal is being heard. If you call, always follow up with an email summarizing the conversation.  It is important to maintain accurate communication records.

In those cases where your appeal is denied, you can file an external appeal (with the Oklahoma Department of Insurance) or, if your attorney believes bad faith is involved, move forward with legal action.  Bad faith actions include, but are not limited to, unreasonable delays, improper investigations, intentionally low settlement offers, and the misrepresentation of policy terms.

Bad faith monetary damages for these actions can include payment due on the original claim plus interest, compensation for emotional distress, and attorneys’ fees.  In some cases, where the insurance company’s actions were particularly malicious, punitive damages may be awarded.  Work with your bad faith insurance claims lawyer to identify, calculate, and substantiate all damages.

Doug Terry Law Knows How to Appeal a Denied Life Insurance Claim

Leverage Their Knowledge and Experience in Your Time of Need

Often, life presents us with situations we don’t have the expertise to handle appropriately. In times like these, we reach out to others for assistance. We engage CPAs to file taxes, financial advisors to manage investments, and plumbers to repair leaks. Insurance claims are intentionally complex and technical, and most people don’t know how to appeal a denied claim effectively. That is made more difficult by the fact that you are also in mourning. Engaging professional legal assistance is in your best interests.

Attorney Doug Terry founded his firm decades ago to close the capability gap that exists between insurance companies and their policyholders.

When dealing with ordinary people, these organizations have the upper hand and regularly leverage it to improve profitability. Mr. Terry brings this same competency to his clients, individuals who believe their insurance companies’ decisions are inappropriate.

Recognized throughout the state for its compassionate approach to service, in-depth knowledge, and reputation for success, the firm is a valuable resource for those in need.

Get the Help You Need Today

Responding to life insurance claim denials is time sensitive for two primary reasons.  First, there is a finite period in which an appeal will be heard, so you have to comply with mandated deadlines.  And, second, policyholders need compensation for their losses so they can pay bills and solidify their financial futures. Without question, time is extremely valuable.

Recognizing this, Doug Terry and his team make it a point to be available immediately to meet with those concerned about their life insurance denials. Because they appreciate the importance of connection during emotional times, they offer all potential clients a free consultation. Contact them today at 405-463-6362 to schedule an appointment. This meeting can provide valuable insight regarding the validity of your concerns and will highlight your attorneys’ approach to service.

Unfairly denying life insurance claims is abhorrent.  Doug Terry Law believes insurance companies must uphold the promises they make to their policyholders and will work tirelessly to hold insurers accountable when they fail.  They know how to appeal a denied life insurance claim.