Why would a life insurance company deny a beneficiary their benefits?

Asked by: Trenton Shanahan V  |  Last update: November 8, 2025
Score: 4.2/5 (55 votes)

Some policies exclude coverage for deaths that result from underlying conditions that existed at the time the policy was entered. Policies may also exclude payment to a beneficiary who intentionally killed the insured party.

What would cause a life insurance claim to be denied?

Life insurance may not pay out if the policy expires, premiums aren't paid, or there are false statements on the application. Other reasons include death from illegal activities, suicide, or homicide, with insurers investigating claims thoroughly.

What is considered a valid reason for an insurer's refusal to pay death benefits directly to a minor?

A valid reason for an insurer's refusal to pay policy proceeds directly to a minor would be if there is a concern regarding the minor's capacity to manage the funds or if the minor does not have a legal guardian or trustee appointed to manage the funds on their behalf.

Can a life insurance beneficiary refuse payment?

However, a person must contact the life insurance company and make it aware of their desire not to receive the proceeds. Some insurance companies may want to see a letter from the primary beneficiary, while others will request that the primary beneficiary fill out their own form.

Which case is likely to be declined by a life insurer?

9 Reasons Why You Were Declined For Life Insurance
  • Medical issues.
  • Hazardous occupation.
  • Financial reasons.
  • Lifestyle choices.
  • Lab results.
  • Driving record.
  • Criminal record.
  • Foreign travel.

Life insurance benefits often denied

38 related questions found

What makes a person uninsurable for life insurance?

They can include engaging in risky hobbies and behaviors like skydiving; having a history of DUIs or speeding tickets; having a dangerous job like roofing; having a criminal record or a less than ideal financial history; being a smoker; and failing a drug test.

What is one of the most common reasons for a claim being rejected by an insurance company?

9 top reasons your claim is denied
  • Incomplete information. Claims often get denied due to incomplete information. ...
  • Service not covered. ...
  • Claim filed too late. ...
  • Coding or billing error. ...
  • Insurer believes the procedure wasn't necessary. ...
  • Duplicate claim filed. ...
  • Pre-existing condition not covered. ...
  • Lack of pre-authorization.

Can a beneficiary be denied?

They can refuse (renounce) the inheritance after you die, but they can't “legally refuse” to be a beneficiary in your will. You get to write your own will, leave your assets to anyone you choose and don't need permission to name who is a beneficiary in your own will.

What are the rules for beneficiaries of life insurance?

As a standard life insurance beneficiary rule, you must explicitly identify each beneficiary with their full name and Social Security number. Pro tip: Do you live in a community property state? If so, you'll need your spouse's consent to designate a primary beneficiary other than them.

What can override a life insurance beneficiary?

A will cannot override a beneficiary designation because the policy is a contract between the person who purchases it and the issuer. The only way anyone can override a beneficiary other than the policyholder is if a court determines there's a conflict between named beneficiaries and state laws.

Why would a death benefit be denied?

4. Exclusions Specified in the Policy. Most life insurance policies have exclusions that specify circumstances under which a death benefit will not be paid. Common exclusions include death from a risky activity, certain natural disasters, or acts of war.

Can a life insurance company refuse to pay?

Life insurance companies look for any reason they can find to deny coverage. They regularly deny coverage based on policy lapse, which occurs when a policy is terminated due to missed premiums. Insurers cannot simply cancel a policy right after a missed payment and without letting interested parties know.

Why do life insurance companies deny coverage?

Underwriters review the application itself and may also examine additional records, including prescription history, medical records from the past few years, motor vehicle records, and financial and criminal history. The insurer may decline their application if the applicant is considered too risky.

How long does it take for a beneficiary to receive money from life insurance?

In many cases, it takes anywhere from 14 to 60 days for beneficiaries to receive a life insurance payout. But many factors impact this time frame. These include the insurance company's procedures, when the claim is filed, how long the policy was active, the cause of death, and state laws regarding insurance payouts.

What will disqualify me from life insurance?

Due to the added risk health problems create for insurers, some pre-existing conditions can raise your premium or even disqualify you entirely from certain types of life insurance. A few common examples of pre-existing conditions include high blood pressure, diabetes, cancer, and asthma.

How often do life insurance companies deny claims?

Almost 1 in 5, or 20%, of life insurance claims are denied by insurance companies, often due to material misrepresentation or incomplete medical history in the life insurance application. This high denial rate emphasizes the importance of working with a skilled life insurance lawyer to get the payout you deserve.

Who cannot be a life insurance beneficiary?

Ineligible Beneficiaries: Minors: Generally, minors (individuals under the age of 18 or 21, depending on the jurisdiction) cannot be named as direct beneficiaries of a life insurance policy. In such cases, a trust or custodian may be designated to manage the proceeds until the minor reaches the age of majority.

How do life insurance companies verify beneficiaries?

Many states require insurance companies to check the Social Security “Master Death File” for deceased policy holders and to try to notify their beneficiaries when they find a policyholder on that list.

What is the beneficiary rule?

A beneficiary is generally any person or entity the account owner chooses to receive the benefits of a retirement account or an IRA after they die. The owner must designate the beneficiary under procedures established by the plan.

Can a beneficiary decline?

In that case, you might be wondering if it's possible to decline an inheritance and the responsibilities that go with it. This process is called “disclaiming” an inheritance, which means you're turning down the rights to the assets you were supposed to inherit.

What overrides beneficiaries?

This means that an executor can override a beneficiary's wishes if those wishes contradict the expressed terms of the will, do not comply with applicable laws, and the executor acts in the best interest of the estate and its beneficiaries.

What to do when a beneficiary does not respond?

Dealing with a problem beneficiary

California executors can overrule beneficiary wishes based on the decedent's will or court orders, and align actions with legal requirements. Before making such decisions, it's wise to consult a probate attorney in order to comply with regulations and avoid potential disputes.

Which insurance company denies most claims?

Other insurance companies with the highest claim denial rates included Sendero Health Plans (28%), Molina Healthcare (26%) and Community First Health Plans (26%). Additionally, the analysis found the denial rates for other major insurance companies, including Anthem (23%), Medica (23%) and Aetna (22%).

What is a dirty claim?

Dirty Claim: The term dirty claim refers to the “claim submitted with errors or one that requires manual processing to resolve problems or is rejected for payment”.

What are the 3 most common mistakes on a claim that will cause denials?

Here, we discuss the first five most common medical coding and billing mistakes that cause claim denials so you can avoid them in your business:
  • Claim is not specific enough. ...
  • Claim is missing information. ...
  • Claim not filed on time (aka: Timely Filing)