HOW DOES A CONTESTABILITY PERIOD WORK?
A life insurance provider might look into an insured after their death during what is called the contestability period to make sure the data they provided on their application was valid.
It typically lasts for two years following the purchase of a policy, and if the insurer discovers that the information given was false, they may refuse or scale back coverage for the policy's beneficiaries.
Here's how life insurance contestability works.
HOW DOES THE CONTESTABILITY PERIOD WORK?
The purpose of contestability periods is to safeguard insurance companies from fraud. In essence, they provide the insurer with a window of opportunity to confirm the accuracy of information regarding anyone they have just insured.
The objective is not to punish people who committed unintentional errors in their life insurance applications. Contrarily, contestability periods are meant to shield insurers from being required to pay benefits when someone purposefully deceives them and passes away.
This is how it works.
If you pass away during the contestability period, the examiner who was assigned to look into your claim may opt to look into it further. If you passed away due to an unforeseen circumstance, insurance companies are far more inclined to investigate your claim. For instance, if you claimed to have never smoked cigarettes yet passed away from lung cancer, that would very certainly be sufficient to start an investigation.
The claim examiner may ask for your medical records and verify your file with the MIB Group (a database most health and life insurers use to report information about people applying for insurance) during the contestability period. They can reject your claim if they discover that you lied or withheld information on your life insurance application, leaving your beneficiaries with nothing. Let's talk about that.
WHAT IF THE COMPANY FINDS MATERIAL MISREPRESENTATION?
The insurer will distribute the death benefits asap if no material misrepresentation was made. However, if the insurance company discovers material misrepresentation on the application after the investigation is completed, it has many options that depend on the amount of the death benefit and the extent of the misrepresentation.
If the misrepresentation would have resulted in a higher premium, they will pay the proceeds minus the additional premiums that would have been charged had they known the new information. Even if the false information is minimal, such as a check-up that wasn't mentioned, the insurance company will take that course of action.
The insurer would deny the life insurance claim and return to the beneficiaries the premiums that the insured had paid for the policy if the insured purposefully omitted critical information that would have resulted in a denial of coverage. One example would be failing to disclose a chronic illness, a criminal record, or diagnostic tests that revealed a serious illness.
THE SUICIDE CLAUSE
The contestability period, which is the first two to three years of your coverage, overlaps with the "suicide clause" in your life insurance policy, however, it is a different provision of your policy.
If your death was contestable, the life insurance company has the right to look into it. If the cause of death was self-harm, the corporation has the right to deny your beneficiary's claim under the suicide clause.
Suicide clauses are there to stop people from purchasing insurance with the goal to take their own lives and leave money for their beneficiaries. Your insurance will pay the death benefit if you commit suicide within two to three years. The suicide clause period resets if you need to purchase new insurance, just like the contestability period.
CAN MY CLAIM BE DENIED AFTER THE CONTESTABILITY PERIOD?
After the contestability period expires, the life insurance company no longer has the option of opening an investigation. Your beneficiary files the claim, and they can usually expect to receive the benefit within a few weeks.
The primary exception is if the life insurance company believes you intentionally provided false information on your application or that you committed insurance fraud. For instance, it's not necessarily fraud if you were truthful about being a former smoker but remember the day you gave up smoking incorrectly (though it could show up in a contestability investigation during the first two years).
However, even after the contestability time has passed, an insurance company might take action to launch a fraud inquiry if you claim to be a nonsmoker, a computer-employed marathon runner who passes away from miner's lung.
As soon as your life insurance policy takes effect, you are protected. And you can anticipate that your loved ones will benefit from your policy as long as you didn't lie on your application.
Simply put, the contestability period gives insurance companies time to look into claims. Don't lie or withhold information to obtain lower rates and then hope to survive the contestability period. Be truthful and don't make things difficult for your family. You can be confident that your loved ones will receive the benefit you are seeking to provide for them if you have upheld your end of the bargain by submitting complete, correct information when you applied. If you lie and then die during the contestability period, your loved ones may be denied a death benefit payout if the life insurance company discovers you lied.