If this is something you worry about, here’s what you should know should you ever have to dispute a denied life insurance claim.

Know your policy’s terms and conditions 

There’s no point in paying a premium for years only for your loved ones to not receive the benefit when they need it the most. This is why it’s important to read your life insurance policy’s terms and conditions carefully and be completely honest during the signup process. If you told your life insurer that you weren’t a smoker but they later found out you smoked a packet a day, that would be reason enough to reject a claim.

You should also know that every life insurance policy will have a list of exclusions – provisions referring to perils, hazards, circumstances and activities not covered by the policy. As an example, MiWayLife won’t provide cover for those who indulge in a list of risky activities that include cave diving and solo mountaineering. Being aware of your policy’s terms and conditions and adhering to them is usually all there is to it when it comes to the difference between a paid and denied claim.

What to do if your claim is denied

Okay, so you weren’t fibbing about your health or climbing Mount Everest on your own – but your life insurance claim has still been denied. What can your loved ones do about it? You’ll be glad to know that, if they feel their insurer has unfairly denied their claim, they can dispute it.

Step 1 – Find out why

The first step in disputing a rejected claim is to understand why it was rejected. Read the denial letter carefully. If the reason is unclear or you don’t agree with it, contact the insurance company to can clear up any confusion.

Step 2 – Gather your evidence and file an appeal

Once you have a good understanding of why the life insurance claim was rejected, if you still want to challenge the denied claim, gather your evidence. As an example, if your insurer rejected the claim citing unpaid premiums, you’ll want copies of the bank statements proving that they were indeed paid. Each insurance company has its own appeals process so contact the company directly for specific instructions on how to proceed.

Step 4 – Approach the ombudsman for long-term insurance

If you’ve done everything you can to negotiate with the life insurance company but haven’t had any success, know that you’re within your rights to approach the ombudsman for long-term insurance and request that they mediate your situation.

Lastly, don’t hesitate to get the ball rolling as most life insurance companies have a deadline. At MiWayLife, if you wish to challenge a rejected claim via legal proceedings, these must be instituted within 6 months after the date on which notice of rejection was received. Failure to institute legal proceedings within this period will result in a loss of all rights to any benefits which the claimant may have had against us.

The bottom line

At the end of the day, if you have a life insurance policy, you’ll find that honesty, adhering to the terms and conditions as well as the exclusions and, of course, paying your premiums, is all it takes to not have to worry about denied claims. However, if you ever do find yourself in this situation, there are things you can do to challenge it.

Did You Know:

You can now take out life cover with us online in a few simple steps. No calls and no agents! Make sure to take care of those you love today by buying MiWayLife cover online.