HomeDisability InsuranceWhat an Incontestability Clause Means for Your Disability Insurance Claim

What an Incontestability Clause Means for Your Disability Insurance Claim

An incontestability clause prevents insurance companies from canceling your disability insurance policy after a certain period unless you’ve committed fraud. Understanding this clause can save you from future headaches and give you peace of mind. In the following sections, we’ll explain how this clause works, why it’s important, and what you need to look for. Stick around to learn how this small but powerful feature works.

Understanding Incontestability Clauses in Disability Insurance Policies

The incontestability clause in disability insurance policies is crucial in providing protection and security to policyholders. This clause essentially states that the insurance company cannot contest the policy’s validity for any reason other than non-payment of premiums after a certain period of time from the policy’s effective date.

Definition of the Incontestability Clause

The incontestability clause protects policyholders by ensuring that, once the specified time period has passed, the insurance company cannot deny a claim or cancel the policy based on discrepancies or omissions in the original application. This clause gives policyholders a sense of stability, knowing that their coverage will remain intact as long as they pay their premiums.

Importance of the Incontestability Clause

The incontestability clause protects policyholders by ensuring that once a disability insurance policy has been in force for a certain period of time, typically two years, the insurance company cannot deny a claim based on inaccuracies or omissions in the application. This protection gives individuals peace of mind that their coverage will remain intact when they need it most.

Most states require the inclusion of such clauses in insurance policies. For example, Florida has Statute § 627.455, which states:

“Every insurance contract shall provide that the policy shall be incontestable after it has been in force during the lifetime of the insured for a period of 2 years from its date of issue except for nonpayment of premiums and except, at the option of the insurer, as to provisions relative to benefits in event of disability and as to provisions which grant additional insurance specifically against death by accident or accidental means.”

Limits and Exceptions of the Incontestability Clause

While the incontestability clause provides valuable protection, there are limitations and exceptions to be aware of. One common exception is when the policyholder commits fraud or provides false information during the application process. In such cases, the insurance company reserves the right to dispute the validity of the policy, even after the incontestability period has expired. In addition, the insurance company may contest the claim if there is clear evidence of intentional misrepresentation or withholding of material information that could have influenced the policy’s issuance.

For example, in a case by the name of Dormer v. Northwestern Mutual Life Insurance Company, the court concluded that the disability claimant’s failure to fully disclose her history of chronic fatigue syndrome, Bell’s palsy, and back pain when applying for disability insurance constituted an intentional and material misrepresentation and permitted the insurance company to rescind her disability policies and not pay her any disability benefits. Policyholders must be transparent and truthful when applying for disability insurance to avoid any potential future disputes related to the incontestability clause.

Benefits of an Incontestability Clause

Imagine the peace of mind that comes from knowing that your disability insurance coverage is secure and that your insurer cannot arbitrarily challenge it. This sense of security is one of the primary benefits of an incontestability clause for policyholders. By including this clause in your policy, you protect yourself from unexpected challenges to the validity of your coverage, providing you with a layer of protection that ensures your policy remains intact when you need it most.

Protection for Policyholders

The incontestability clause protects policyholders by assuring them that their coverage cannot be challenged based on undisclosed information or technicalities after a certain period of time. This provision provides a level of security and reliability that gives policyholders confidence that their coverage will remain in effect as long as they pay their premiums. It acts as a safety net and fosters trust between the insurer and the insured.

An incontestability clause can significantly benefit policyholders in the event of a dispute or claim denial. This clause provides a clear legal basis, reinforcing the validity of the policy and protecting the policyholder’s rights. In the event of a disagreement between the insurer and the insured regarding the terms of the policy, the incontestability clause can serve as a critical measure to prevent unjustified claim denials or unilateral changes in coverage. It puts the policyholder on firmer ground when coverage is challenged and provides an invaluable level of protection when navigating complex insurance issues.

By including an incontestability clause in your disability insurance policy, you secure coverage and establish a foundation of trust and reliability to protect your interests in the face of unforeseen challenges or disputes.

If you are facing a long-term disability claim denial, contact the experienced legal team at the Ortiz Law Firm. Our dedicated professionals are here to help you secure the benefits and protection you deserve. Call (888) 321-8131 for a free case review.