A letter saying your life insurance claim is "under review" or "under investigation" can be alarming. Insurers do investigate certain claims, and understanding why can help you respond.
Why claims get investigated
Insurers commonly look harder when the insured died within the first two years of the policy, when the cause of death is unclear, when the policy amount is large, or when the application raises questions. They may request medical records, prior applications, and statements from doctors or family members.
What the insurer may be looking for
Whether health information on the application was accurate
Whether premiums were properly paid
Whether an exclusion might apply to the cause of death
Whether the beneficiary designation is valid
How to respond
Answer reasonable requests promptly and in writing. Ask what specific documents are missing and why. Keep a record of every request and response, and be cautious about signing broad authorizations without understanding their scope. If the process stretches on, ask in writing when a decision will be made.
When to get advice
If the insurer asks for a recorded statement, requests unusual records, or the investigation seems to have no end, speaking with an attorney can help you avoid mistakes.
An investigation is not a denial, but it can turn into one. Being organized and responsive, while protecting your rights, puts you in the best position.
Davila Cobos Law Firm, PLLC represents clients in San Antonio and Laredo. Learn more about our life insurance claim denial attorney services, or contact the firm to discuss your situation.
This article is general information, not legal advice, and reading it does not create an attorney-client relationship. Every situation is different, so talk to a Texas attorney about yours.
