Declined life insurance claims
How does life insurance work?
Life insurance is designed to provide peace of mind, ensuring your loved ones are financially supported if you pass away during the policy term.
It usually pays out a one-off, tax-free lump sum to your chosen beneficiary—this might be your partner, child, or another family member. Some people take out life insurance to make sure their mortgage would be paid off, others want to cover childcare costs, funeral expenses, or simply ensure their family’s lifestyle could be maintained if they weren’t around to provide.
Different types of life insurance
There are several types of life insurance, and it’s important to understand the differences between them:
- Level term life insurance – Pays out a fixed lump sum if you die during the term of the policy. The payout amount stays the same (or ‘level’) throughout.
- Decreasing term life insurance – Often used to cover a repayment mortgage. The amount the policy pays out reduces over time in line with the mortgage balance.
- Joint life insurance – A policy taken out with a partner. Usually pays out after the first person dies, although some policies can be set up to pay out on the second death.
- Family Income Benefit – Instead of a lump sum, this type of policy pays a regular income for a set number of years. It can be helpful if your family would struggle with monthly living costs.
- Whole of life insurance – Offers a guaranteed payout when you die, no matter when that is, as long as you keep paying the premiums. These policies can be more expensive.
- Over 50s Plans – Guaranteed acceptance for those aged 50+, sometimes with no medical questions asked. These plans tend to have lower payouts and a waiting period before full cover begins. Many people take them out to help cover funeral costs.
Some life insurance policies can also be combined with critical illness insurance, so they may pay out early if you are diagnosed with a serious condition defined in the policy terms.
We’ve created a separate guide ‘Declined Critical Illness Claims’ that explains how critical illness claims work, and what to do if the claim is declined.
What does life insurance cover?
Life insurance generally pays out on death, regardless of the cause, unless an exclusion applies. Most life insurance policies cover:
- Death from illness (e.g. cancer, heart disease)
- Accidental death (e.g. car accident)
- Death from natural causes
- Suicide (usually after an initial exclusion period, such as 12–24 months)
It’s important to check the policy exclusions, as insurers may not pay out in certain situations—such as deaths linked to high-risk sports or hobbies, substance misuse, or travel to restricted areas.
What extra benefits might be included?
Life insurance policies often come with a few optional or built-in extras:
- Terminal illness benefit – If you’re diagnosed with a condition that means you’re expected to die within 12 months, your insurer may pay the life insurance amount early. Not all policies include this, so check your terms. For more details, see our guide on ‘Declined Terminal Illness Claims’ and what to do next.
- Waiver of premium – If you’re unable to work due to illness or injury, your insurer may cover your premiums so your policy doesn’t lapse.
- Bereavement support – Some policies offer access to grief counselling or practical support for loved ones after a claim.
- Buy back option – If a joint life insurance policy pays out upon one policyholder’s passing, this feature may allow the surviving partner to reinstate cover without needing a new application.
How do I make a claim on a life insurance policy?
Let Appeal Avenue handle the claim process for you
Losing someone you love is one of the hardest experiences in life, and we understand how overwhelming everything can feel—practical arrangements, grief, finances, and uncertainty about the future. If your loved one had a life insurance policy, making a claim is a key step toward getting some financial stability during a difficult time.
Most insurers aim to make the claims process as straightforward and compassionate as possible—but if you need support with a life insurance claim, book an appointment with us.
We’ll talk through what’s happened and explore your options—including our advocacy service if needed. Check the fees section of our website for more details on costs.
Or, make your own life insurance claim following our guide below
Alternatively you can make your own life insurance claim by following process below. We are here to help if this process seems overwhelming.
1. Contact the insurance company as soon as possible
Most insurers will need to be notified quickly after the policyholder’s death. You’ll usually find contact details on the policy documents.
2. Have key documents ready
You’ll need the original death certificate, the policy number, and sometimes proof of your identity or entitlement (e.g. if you’re the named beneficiary or next of kin).
3. Complete a claim form
The insurer will usually ask you to fill in a short form confirming the details of the person who has died and the cause of death.
4. Submit supporting paperwork
Depending on the cause of death, the insurer might request medical records or a coroner’s report. If the death happened abroad, additional documents like a translated death certificate may be needed.
5. Wait for the insurer’s decision
Once the insurer has the necessary documents, they will assess the claim. This can take a few weeks, especially if they need to clarify anything with medical professionals.
6. Payout or explanation
If the claim is successful, the insurer will issue payment and confirm how and when the funds will be transferred. If a claim is declined, the insurer should provide a clear reason—and we can help you review their decision if needed.
If a life insurance claim is declined
A declined life insurance claim can be devastating — emotionally and financially — especially when you’re grieving a loved one and depending on that money. But a rejected claim doesn’t necessarily mean the decision is final.
Insurers refuse to pay out on life insurance claims for a number of reasons — they may say the policyholder didn’t disclose something about their health or lifestyle when they took the policy out (this is referred to as non-disclosure or misrepresentation; you can find out more about this on our ‘non-disclosure and misrepresentation page’).
Claims can also be declined if the cause of death is excluded under the terms of the policy, or if the policy had lapsed or was never formally accepted.
The insurer should tell you the reason why they have declined to pay out on the life insurance claim. If you don’t agree with their decision, you can make a complaint or appeal; visit our ‘tips on making a complaint or appeal’ page for more information.
To get started, request a copy of the decision letter from the insurer. This should explain why the claim was refused — look out for mentions of exclusions, non-disclosure, or unclear medical definitions. Many declined claims can be successfully challenged, especially if there’s been a misunderstanding or a procedural error.
If you would like our support with making a complaint or appeal, make an appointment with us today and we will chat through what has happened and what your options are — take a look at the fees section of our website for an idea of the costs involved.
Ready to start you life insurance claim?
Start a new claim or get help with your appeal for life insurance today.