Sunday, February 22, 2009

San Diego Life Insurance Attorney and Life Insurance Lawyer for Orange County Analyzes Claims Denials And CA ERISA Appeals

Life Insurance Claim Denials

Sadly, it is common for life insurance companies to deny valid claims of beneficiaries under policies insuring the lives of policy holders. When that occurs, family members in Orange County and San Diego can turn to the Law Offices of Sebastian Gibson for assistance.

At the Sebastian Gibson law firm, we don't represent life insurance companies. We only represent policy holders and their family members and beneficiaries. We have a long history of standing up to insurance companies both in personal injury matters and in insurance bad faith cases.

While large insurance companies hope a grieving widow or small children will feel powerless against a company worth billions, with the Law Offices of Sebastian Gibson fighting for your rights, the insurance companies are the ones who have something to be concerned about.

If your claim for life insurance benefits or the policy limits has been denied by a life insurance company in San Diego, Orange County or anywhere in Southern California, or if you need a California ERISA attorney, visit our website at and call us at any of the numbers easily found on our website.

Unfortunately, life insurance companies know that they can take advantage of an unrepresented person who doesn't know the law. And in this area of law, perhaps more than most, the law favors the life insurance company over the unwary and the unrepresented claimant.


Many, if not most life insurance claims are subject to ERISA, the Employee Retirement Income Security Act which by its name alone, causes most attorneys to want nothing to do with it, for fear it will make such claims unduly complicated and unimaginably complex. Some attorneys even have it mixed up in their minds with RESPA, which deals with real estate and mortgage rules, something altogether different.

The most important aspect of ERISA, however, is that most insurance policy claims allow only one appeal of the denial of a claim. That appeal must be handled by the claimant or the claimant's attorney as if it were the claimant's one and only shot at winning the claim. Unless an appeal is made, the claimant will have no right to bring a lawsuit and many grieving family members have made the mistake of failing to make the appeal altogether.

If the appeal is made and denied, the claimant must go to federal court with the lawsuit based solely on the administrative record of the appeal. In most cases, the claimant may not submit any new evidence or call any witnesses after the denial of the first appeal. The case will turn of the record of the earlier appeal alone. And if the claimant has attempted to represent themself without an attorney, it is more than likely that their case may already have been lost by the time it is filed in federal court.

Without the proper preparation of the appeal by an attorney, and without the proper evidence, an appeal of a claim will likely result in a denial which cannot then be appealed with much probability of success. What is even more astounding to the claimant, in most cases, is that it is the same insurer who reviews an appeal. And an insurer that denied the claim in the first place is unlikely to decide the claim differently when the claimant appeals the denial based on the same arguments that failed to persuade the insurance company the first time around.

Insurance Company Claim Denial Excuses

Denials commonly are based on a number of excuses by insurance companies who hide behind them in order to increase their profitability under the pretense, in many cases, of preventing fraud. The insurance companies claim either that there was some misrepresentation or non-disclosure in the life insurance policy application, a pre-existing condition, or that, in the case of an accidental death, that the injury was self-inflicted by being the result of drunk driving, or some other dangerous behavior.

Visit our website at and call us if you have had a claim for life insurance benefits denied by a life insurance company in San Diego, Orange County or anywhere in Southern California or if you need a California ERISA lawyer to prepare an appeal.

If a life insurance company has denied your claim for death benefits, don't let your overwhelming grief for your loved one play right into the hands of the life insurance company. As soon as your claim has been denied is the time to meet with an experienced life insurance and bad faith insurance attorney from our law firm who can properly prepare an appeal and seek to compel the insurer to pay the policy amount to the proper beneficiaries.

About the Author
Visit our website at if you have had your claim for life insurance benefits denied in San Diego, in Orange County or need a California ERISA attorney appeal in Southern California. We have the knowledge and resources to be your San Diego Life Insurance Lawyer and Orange County Life Insurance Attorney anywhere in Southern California.

1 comment:

  1. Life is fragile today! Since death itself is inevitable, the next best thing to do is insure your life for a sum of money that you believe is recompense.


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