Why do life insurance claims get denied?

Whilst life insurance provides peace of mind, you might wonder how often life insurance claims get denied and leave beneficiaries empty-handed. As harrowing as this seems, you should know that very few life insurance claims are denied. According to figures released by the ABI (Association of British Insurers) 98.3% of protection claims were paid out in 2019. 

Whilst there’s very few incidences of life insurance companies declining life insurance claims, it’s certainly worth knowing what can put a claim into dispute. In this article we have outlined some of the main reasons claims may, sadly, be refused. 

Not Disclosing Medical Conditions and Lifestyle Information

When you purchase a life insurance policy, you need to disclose medical conditions and other potential risk factors. If you fail to give accurate information during the application process, any claim on your life insurance policy could be denied in future. 

Any failure to disclose information when taking out a life insurance policy could be considered a misrepresentation. These could be false or misleading statement(s) or a withholding of information. In some cases, a misrepresentation could mean a policy is issued which would have otherwise been denied. 

Most policies include a contestability clause (usually between 1-2 years) where the insurer may request further information regarding the death. This might be through the form of post-mortem notes/medical records to allow the insurer to determine whether any information was withheld during the application process. If your insurer finds evidence of misrepresentation, the policy could be voided and your beneficiary may not receive a death benefit. Just bear in mind that insurance companies have many different ways to verify the data you provide on an application.

What kind of information will insurance providers require me to disclose on a life insurance application?

REMEMBER: You should receive a copy of any application you submit for life insurance directly from your chosen provider (or providers). It’s really important to review your application summary and contact the insurer immediately if you notice any of the information disclosed is incorrect or incomplete. Take time to double check your application questions and answers, as this will help you to catch any errors before it’s potentially too late!

If you’re struggling with debts generally, then please know you are not alone and charities such as Step Change may be able to help.

Outliving a ‘Term’ Life Insurance Policy

If you have term life insurance, you could potentially outlive the policy’s term, meaning there would be no death benefit payout.

If you need longer coverage, the insurer may allow you to renew the policy (at an increased premium) when you reach the end of the term. You may also be able to convert a term life policy to a whole-of-life insurance policy, but there’s a time window to do it. Make sure you know your policy’s dates and terms if you’re interested in changing it.

For more information on this topic, check out our article 'What Happens if you outlice term insurance?'

Death by Suicide

Life insurance policies usually have what’s known as a ‘suicide clause’ that usually lasts for between 12 and 24 months, depending on the insurer. If a suicide occurs during this time, the insurance company will typically not a make a payout (please check the Key Features Document of your chosen insurer for more details about this).

Making a Life Insurance Claim

To ensure a smooth claims process, be sure to tell your family that you have a life insurance policy and where to find it when the time comes. It’s usually best to keep the policy with other paperwork that your beneficiaries are likely to need and look for when managing your estate. Being organised goes a long way.

Being In The Know

It’s worth understanding the differences between the 2 main types of life insurance, being 'term' life insurance and 'whole-of-life' insurance.

‘Term’ life insurance policies run for a fixed period of time (known as the ‘term’ of your policy) eg. 10, 15 or 25 years - but only pay out if you were to die during the term of the policy. There’s no lump sum payable at the end of the term.

‘Whole-of-life’ insurance policies pay out regardless of when you die, as long as you keep up with your premium payments.

Naturally, these policies are typically more expensive than term insurance policies since as long as you keep paying your premiums, the insurer will always have to pay out, whereas you may outlive a term insurance policy.

TIP: Whole-of-life insurance is also known as life assurance by many insurers.

One of the main benefits of whole-of-life insurance is that it can help your family deal with any bills associated with inheritance tax. It also may appeal to you if you’re determined to leave some form of inheritance to your loved ones, or if you want to help with your funeral costs.