Los Angeles Insurance Claims Denials Lawyer
Jeffrey I. Ehrlich, Certified Appellate Specialist
Civil Appeals Attorney
News and Cases
Life insurance claims denials
Insurance companies who deny life-insurance claims, usually do so for three reasons:
- Because they believe that the policyholder (the person insured) made misstatements on the application for the policy, essentially misleading the insurer about the true nature of the risk presented. Misstatements on insurance applications can form the basis for the insurer rescinding the policy after the insured has died.
- Because the policyholder died in circumstances for which there is no coverage. For example, the insured committed suicide during the first two years of coverage, before the policy became “incontestable” under California law.
- Because they claim that the death occurred before the policy was actually in effect.
If the insurer claims that the insured made misstatements on the application, it is important to review the application to see if the questions asked were clear, and whether or not the application itself was attached to the policy as the law requires. It is also vital to know whether the application was taken by an agent of the insurance company. If so, the company will be deemed to know all information disclosed to the agent, even if the information is not accurately reflected on the application.
Disability insurance claims denials
Insurers frequently deny disability claims because they will dispute that the policyholder is actually “disabled” as that term is defined in the policy. They may also impose additional criteria not included in the policy as a basis to deny coverage — such as insisting that there be “objective” symptoms of any disabling illness, even though the policy does not contain such a requirement.
Southern California civil appeals attorney, Jeffrey Isaac Ehrlich, is an appellate specialist certified by the State Bar of California’s Committee on Legal Specialization.