A burial insurance contestability period is the first two years in which the insurance companies can investigate and deny claims if they find evidence of misrepresentation from the person who is insured. Your burial insurance contestability period begins on the first day your policy is in for.
If you die within the contestability period, the company has the right to question or contest your claim. The company could deny paying the death benefit to your beneficiary if you lied or misrepresented information, even if the cause of your death is not related with the misrepresentation of your application.
They can investigate whether you gave accurate information on your life insurance application. They can check your medical history details to make sure there are no misrepresentations on any information you provided. For example, you state that you don’t have diabetes, when in fact you do.
Material misrepresentation happens when you mislead an insurance company by giving inaccurate information on your application to be able to get approval or better rates.
If there is evidence of material misrepresentation, the company may cancel your insurance coverage or deny a claim. In some cases, they may reduce the insurance payout to your beneficiary.
Your policy contestability period is nothing to worry about unless you lie on your life insurance application. There are very few policyholders that need to deal with the contestability, but if you do, keep reading to understand what it is, and the rights of the life insurance company.
WHAT IS A BURIAL INSURANCE CONTESTABILITY PERIOD?
The contestability period is a two-year window that starts from the day you purchase your burial insurance plan. During this time, the life insurance company is allowed to review your coverage for:
- Misrepresentation made during the application
- Suicide or intentional acts of self-harm
- Homicide involving the beneficiary
The purpose is to ensure that you didn’t lie or withhold any facts about yourself during the application process.
During the burial insurance contestability period, the insurance company can conduct an investigation to determine if your family will get the insurance payout or they will be denied. In most cases, there will only be an investigation if the company assumes that there was false information on your application or if there was some fraud.
The contestability clause comes into play after you’ve died, and the life insurance company feels they need to investigate if your death was suspicious.
However, if the company finds any misrepresentation in your application during the contestability period while you’re still alive, they can cancel your policy and return all the premiums you’ve paid, or ask you to pay higher premiums.
Material misrepresentation means incorrectly answering questions on the application form in order to get a lower rate on the life insurance policy. Often, applicants would answer questions to make them seem healthier or less of a risk.
There are times when applicants answer questions without verifying their information. Sometimes, insurance brokers inaccurately fill out application forms for their clients. All of these things may cause a future denial of a claim.
The material misrepresentations don’t even have to be related to the cause of your death. If you die from choking on a doughnut, but you also have alcohol or drug problem, or you failed to disclose that you have some polyps removed from your ovary, or claimed to be much younger when you’re really 68 years old, your policy can be canceled.
If the insurance company finds out that you lied on the application about your health or about any pre-existing conditions you have, they have the right to dispute the claim and not release the payout from your policy. That’s why it’s very important to be entirely honest with your application and disclose any relevant information about your health or past.
You should be transparent about your medical history when applying for life insurance coverage. When you die, you won’t be able to explain any inconsistencies and the time spent paying premiums will be for nothing.
The only way to ensure that your beneficiary receives the insurance payout is, to be honest on your application.
The life insurance suicide clause determines when the policy will begin to pay for suicide or intentional acts of self-harm. Each state has different regulations regarding suicide exclusion periods but, most states have a two-year limit.
Life insurance companies generally do not pay if the insured dies from suicide or self-harm within the first two years of the policy. They will only refund the premiums paid without interest.
The claims department usually orders the coroner’s report, police report, and medical records before denying the claim.
The suicide clause only applies during the first two years of the policy. If the insured commits suicide after the contestability period, the life insurance company will pay the death benefit to the beneficiary.
Life insurance often contains a homicide clause relating to accidental death.
The claims department will ask for a police report to verify that the beneficiary was not directly or indirectly involved in the incident. A report implicating the beneficiary involvement will cause the claim to be denied.
The homicide clause protects both the insured and the insurance company. Nobody wants a situation where the beneficiary will benefit from the insureds death due to criminal reasons.
After the contestability period, your life insurance policy cannot be contested by the company for any reason other than non-payment.
The contestability period is different from a guaranteed acceptance policy where there is a two-year waiting period until the full death benefit is available.
WHAT IS THE PURPOSE OF CONTESTABILITY PERIOD?
The contestability period begins on the first day of the coverage.
It exists to make sure the information you provide on your application is accurate. It also protects insurance companies from financial losses due to fraudulent claims.
The cost of the premium is based on the applicant’s age and medical history. Some applicants may try to minimize their premium by intentionally misrepresenting their health and lifestyle, such as hiding facts about their medical condition, risky hobbies or a hazardous occupation.
WHAT IS THE EFFECT OF CONTESTABILITY PERIOD TO DEATH BENEFIT PAYOUT?
A contestability period is the insurance company’s protection against fraud.
The insurance provider may still give the death benefit payout even if your information contains some flaws. This will happen if the mistake is something minor, but bigger errors may cause the claim to be denied or reduced.
Be meticulous when you apply for insurance coverage, you don’t want to risk your beneficiary losing out on your death benefit.
If the company decides to investigate you to look at your cause of death versus the information on the application, it will slow down the claiming process.
If you’re the beneficiary, you won’t receive the money as quickly, because the company wants to ensure that you’re not scamming them in some way.
Once they completed the investigation, then you will be able to receive the insurance payout.
If the insurance company looks into your application to ensure that your information wasn’t falsified or omitted, and they discover some error, but the error doesn’t directly deal with your cause of death, the company is required to pay the death benefit to your beneficiary.
Just because you died within the contestability period, doesn’t mean that your beneficiary won’t automatically get the payout from your policy.
If the company investigates the claim, and learn that everything is honest, they must give your beneficiary the death benefit, even if you die a day after you bought the plan.
HOW DOES INSURANCE COMPANY CONTEST A CLAIM?
Before the insurance company contests a claim, they will request to evaluate the medical records and other documents.
They will look for information that will reveal evidence of material misrepresentation or dishonesty in the initial insurance coverage application.
WHAT HAPPENS IF THE INSURANCE COMPANY FINDS MISREPRESENTATION?
If an insurance company discovers you have misrepresented something on your application, they will generally do one of two things:
FIRST – Pay the death benefit, minus the premiums they would have charged in the first place. For example, they would deduct the additional amount a smoker would have paid, if he pays a nonsmoking rate.
For example, if the company found out that you are 60 instead of 55 as you claimed to be, the company will charge the difference in premium and subtract if from the death benefit amount.
SECOND – If there is a mistake that could lead to a coverage denial, they will return all the premiums to your beneficiary but deny the claim.
For example, if you didn’t disclose your cancer in the application, and you died one year after buying the policy.
RESETTING THE CONTESTABILITY PERIOD
If you fall behind on the premiums, your policy may lapse. When that happens, you’ll need to reapply in order to get insurance coverage. You will need to undertake the life insurance application process again.
You will also be subject to an additional contestability period like you were getting life insurance coverage for the first time because the contestability period resets.
If you die within the two years after your policy was reinstated and in force, your beneficiary could lose out on the payout just as they would during the first contestability period.
Remember, if your coverage lapses, a new contestability period will take effect when you reinstate your policy. If a lot of time passed, you could pay higher premiums based on your current age.
The premium will even be higher if the company determines your health declined during the time.
WHAT HAPPENS AFTER THE CONTESTABILITY PERIOD?
Once you’re out of the contestability period, your policy won’t be subject to contestability if you pass away. As long as you keep paying your premiums on time, you will remain covered, and your beneficiary will receive the full death benefit.
After the contestability period, your coverage enters the incontestable period which prevents the insurance companies from denying claims because of a misstatement by the insured.
However, it’s still possible for the company to discover fraud and withhold a death benefit, reduce the amount or return the total paid premiums instead of the death benefit.
For the insurance companies, the two years contestability period is satisfactory to discover fraud or material misrepresentations. They will investigate claims based on your answers on the application, prescription database, medical records and recorded phone interview.
Post-claims underwriting is performed to look for ways to deny claims if death happens during the contestability period. When they suspect there is a fraud, they will spend time and resources to check every detail to look for any inconsistencies.
Post-claims underwriting is done if:
- You declare you don’t smoke, but you died from lung cancer after you purchased the policy.
- You said you don’t have angina but died from a heart attack after a year.
- You didn’t mention that you are an extreme rock climber and you died from a mountain climbing accident.
Post-claim investigation is done to determine your cause of death. If you pass away from a vehicular accident, the company won’t have a reason to check your medical history and find a way to deny a claim.
WHAT HAPPENS IF THE INSURANCE COMPANY APPROVES A CLAIM?
If there is an investigation that proved the insured’s honesty on the application, the beneficiaries will get 100% death benefit plus interest to cover any delay it caused.
The interest rate will begin to accrue after the death of the insured. The length of an insurance investigation varies depending on the circumstances, but they are not too long and they rarely deny a claim.
Depending on how long it takes to process a claim, the company will pay out a death benefit within just a few days. Sometimes it can take as long as 30 to 60 days.
The insurance company wants to pay out as quickly as they can to avoid interest charges on unpaid death benefits.
The insurance companies will exercise their rights to investigate the cause of death during the contestability period. If not, they will all be lining up for bankruptcy.
You put your family at risk if you lie on your life insurance application. Be honest when applying for coverage. Don’t lie or withhold your health information to get lower rates in the hope that you will live through the contestability period.
If you die during the first two years of the policy, the insurance company will pay your claim because you’ve been honest. Lying, or material misrepresentations will cause the claims to be denied.
If you’re a beneficiary dealing with a contested death benefit, please consult a lawyer and understand that the information on this article is not intended to replace a legal counsel.
We encourage you to seek legal advice from a lawyer specializing in contract law before answering any questions from the insurance company.
Also note that while an investigation may be daunting, life insurance companies generally do not contest death benefits unless there is a material misrepresentation. It is better to be prepared and understand your available options when facing life insurance contestability.
HOW CAN FUNERAL FUNDS HELP ME?
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