How to File a Life Insurance Claim

How long does the life insurance claims process take?

In many cases, life insurance claims can take 14 to 60 days from filing to death benefit payout.1 Insurers must verify the policyholder has passed away, check the policy terms to ensure the death is covered, and verify the beneficiaries are correct. Usually, if it takes longer to receive the payout, there may be delays in the process. In this case, you can contact the insurer and find out why. Several factors can impact the length of the claims process:¹

• Policy type: Term life insurance, which is a simpler type of policy, may process more quickly than permanent life insurance policies.
• Insurer: Insurers may vary in processes and procedures for life insurance payouts, altering the process length.
• Regulations: States and localities may vary in life insurance regulations, potentially changing how long it takes to receive a payout.
• Missing information: Errors or missing information or documents, such as a death certificate, delay the process.
• Cause of death: Certain causes of death may require additional investigation. For example, if homicide is the cause of death, insurers investigate the circumstances further. If the policyholder was involved in criminal activity at the time, or the beneficiary committed the homicide, claims may not be paid out.
• Suspected fraud: Insurers carefully evaluate claims since life insurance fraud is the most common type of insurance fraud.² If insurers suspect fraud, the additional investigation can prolong the claims process.
• Contestability period: The first one to two years of a policy may have a contestability period, during which insurers have the right to evaluate a claim more closely and ensure the death is covered.

Beneficiaries’ rights in life insurance claims

The law extends beneficiaries several rights to protect them and create an even playing field regarding filing life insurance claims and receiving the payout they deserve. Beneficiaries have the right to:³

• Know the policy amount: You have a right to request the insurer to share the policy amount with you, in case the policyholder did not share that information.
• Know how to file a claim: Insurers must offer clear guidance on filing a claim properly and provide a timeline for its processing.
• Know why claims are delayed or denied: If a claim takes longer than a month to pay out or gets denied, you have the right to know this and find out why.
• Know how to file an appeal: Life insurers must provide clear instructions on filing an appeal if they deny your claim, including how and where to file it and the deadline for filing. All of this is typically explained on the insurer’s site and in a claim denial letter.
• Examine documents the insurer uses in reviewing a claim: Understanding the documents insurers use is crucial to knowing if you could successfully file an appeal on a denial. So, you have the right to examine any documents an insurer uses when reviewing a claim.

What to do if your life insurance claim gets denied

Life insurance claims may be denied for several reasons:

• Lapsed policy: If the policy lapsed through unpaid premiums or cash-value-related reasons, the claim may be denied.
• Misrepresentation: Intentionally falsifying or omitting relevant information, such as falsely claiming nonsmoker status or omitting a high-risk hobby on the application, can lead to claims denial.
• Term policy expiration: If the policyholder had a term life insurance policy, claims will be denied if the policy expired.
• Policy exclusions: Deaths under certain circumstances, such as death due to involvement in criminal activity, may result in denial.

If a claim is denied, you can file an appeal. Here’s how:

• Know the reason for denial: Insurers provide a letter detailing the reason for the denial. However, you can request further information if needed.
• Understand the appeals process: Insurers provide detailed appeals instructions, so review those and make sure you understand the process.
• Review the policy: Carefully review the policy terms and conditions to see if you have a legitimate case to appeal.
• Gather evidence: Collect documentation for the appeal relevant to the case, such as premium payment records for lapsed policy denials, medical records, correspondence with the insurer, police reports, and similar documents. The more relevant evidence you have, the stronger your case could be.
• Submit the appeal: Fill out and submit an appeal form to the insurer. Attach a letter laying out your side and provide evidence that they should overturn the denial. Follow the appeals process step by step.
• Get legal advice: Consider speaking with an attorney specializing in insurance law. They can help you identify evidence and documentation to build your case, craft a strong appeal letter, communicate with the insurer, and answer any other questions.

If the appeal is unsuccessful, but you firmly believe you have a valid claim, consider filing a complaint with your state’s insurance department. Legal action can be a last resort if the regular appeals process fails and your relevant state government agency doesn’t succeed. However, the costs and time involved can be significant, so weigh this against the benefits of the payout.

Learn more about life insurance

Filing a claim is more straightforward than it may sound at first. Once you know the policy details and insurer, you’ll need to fill out a claims form and submit it along with a certified copy of the policyholder’s death certificate. In many cases, you’ll receive a payout within a few weeks to a month. If your claim is denied, you may not be out of luck. You have the right to file an appeal and to know how to do so. The effort involved is worth it if you can overturn the denial and receive the financial assistance the death benefit offers.

If you’re interested in getting life insurance to help provide loved ones with financial security in case of the unexpected, consider getting a policy from Aflac. Speak with an agent today to explore your options, ask any questions you may have, or get a quote.