Interpleader Lawyer

Life Insurance Lawyer New Hampshire

Our life insurance lawyers in New Hampshire handle delayed and denied life insurance claims, AD&D claims, beneficiary disputes and New Hampshire interpleader lawsuits.

A denied chronic illness claim and a denied life insurance claim due to a sickness exclusion are distinct situations, each with its own set of circumstances and implications:

  1. Denied Chronic Illness Claim:

    A denied chronic illness claim typically involves a type of insurance policy known as long-term care insurance or chronic illness insurance. These policies are designed to provide coverage for expenses associated with chronic illnesses or long-term care needs, such as nursing home care, assisted living, or home healthcare services. Here’s how a denied chronic illness claim differs:

    • Nature of the Policy: Chronic illness insurance policies are specifically designed to cover the costs of care and treatment for chronic conditions and long-term illnesses. They are not life insurance policies in the traditional sense.

    • Denial Reasons: A chronic illness claim may be denied for reasons such as:

      • Failure to meet the policy’s criteria for a qualifying chronic illness or long-term care need.
      • Failure to provide the required documentation or proof of the chronic illness.
      • Attempting to claim benefits for a condition that is not covered by the policy.
      • Policy lapsing or non-payment of premiums.
    • Outcome: When a chronic illness claim is denied, the insured typically does not receive the benefits needed to cover the costs of chronic care. The denial does not result in a payout to beneficiaries upon the insured’s death since it is not a life insurance policy.

  2. Denied Life Insurance Claim Due to Sickness Exclusion:

    A denied life insurance claim due to a sickness exclusion typically relates to a traditional life insurance policy where the primary purpose is to provide a death benefit to beneficiaries upon the insured’s death. Here’s how it differs from a denied chronic illness claim:

    • Nature of the Policy: Life insurance policies provide a death benefit to beneficiaries when the insured person passes away, regardless of the cause of death. Sickness exclusions in life insurance policies usually pertain to specific circumstances related to the insured’s health.

    • Denial Reasons: A life insurance claim may be denied due to a sickness exclusion if the policy contains provisions that exclude coverage under certain circumstances. For example:

      • If the insured’s death is a direct result of alcohol or drug abuse and such exclusions are specified in the policy.
      • If the insured dies by suicide during the policy’s suicide exclusion period (typically within the first one or two years of the policy).
      • If the insured’s death is related to a pre-existing medical condition that was not disclosed or was explicitly excluded in the policy.
    • Outcome: When a life insurance claim is denied due to a sickness exclusion, the beneficiaries do not receive the death benefit, and the policy does not pay out. However, it may be possible to challenge the denial if there are grounds to dispute the insurer’s decision.

In summary, a denied chronic illness claim and a denied life insurance claim due to a sickness exclusion involve different types of insurance policies, denial reasons, and outcomes. Chronic illness insurance is designed to cover long-term care expenses, while life insurance is intended to provide a death benefit to beneficiaries. The reasons for denial and the consequences of denial are specific to the type of policy and the circumstances surrounding the claim.

Contact us

FREE CONSULTATION