Common reasons why life insurance won’t pay out

Life insurance payout rates are actually quite high, although there are some instances where your policy could be voided and the payout refused...

Parents, grandparents and children sat on log

February 5, 2020

One of the biggest concerns people have about taking out a life insurance policy is the risk of not paying out.

Life insurance is designed to pay out a lump sum when you die, and provides peace of mind that your family and loved ones will not be left in financial trouble when you are gone.

As the policy payout is so important, it makes sense that people may be a bit concerned that their investment (in the form of life insurance premiums) will end up being for nothing.

However, despite these concerns life insurance policies actually have a relatively high payout rate. According to data from the Association of British Insurers (ABI), the payout rate of life insurance policies is actually 98%.

The ABI's data also found that the average life insurance payout is £75,061.78.

Although the stats show there's no need to be worried about your life insurance policy being void and your payout declined, you still shouldn't become complacent when it comes to following the terms of your life insurance policy.

Some of the most common reasons for life insurance not paying out are:

  • Non-disclosure of medical conditions
  • Suicide
  • Outliving your term life insurance policy
  • Diagnosed with a terminal illness (often this results in an early payout less than the full policy value)
  • Moving abroad
  • Concealing information on your application (e.g. smoking, dangerous hobbies/occupation)

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We all might be guilty of telling the odd little porkie, yet we all know proper lies get you nowhere in life, full stop. And what’s more, it REALLY doesn’t help you/your family in your bid to receive life insurance pay-outs, trust us.

So avoid non-disclosure – or good old fashioned fraud – if you’re wanting to provide for your dependents when your number’s up in life. Some cases of non-disclosure are perhaps more complex than others, yet others aren’t. For example if you’re diagnosed with a known life-shortening condition or illness and fail to disclose this on your life insurance application form, any future claim can be justifiably refused by the provider.

Honesty is always best practice so as to ensure that all parties are singing from the same hymn sheet from the off, and by honesty we mean painting an accurate picture of the policyholder’s general health and lifestyle.

Committing suicide

With most life insurance policies, the main exclusion is that suicide is not covered in the first 12 months. Should this tragic event happen to the policyholder after this period, their beneficiaries will be able to claim the payout (subject to their policy terms).

Having said this, it is extremely important to note that some UK insurers cite the non-disclosure of mental health issues as a reason for why a claim might be rejected, so if you have ever suffered with mental health problems, you must disclose this information to your insurer/broker. Failing to disclose this is likely to void the policy and the beneficiaries will not receive a payout if the policyholder passed away due to mental health reasons, such as suicide.

Insurance companies have this precautionary measure in place to effectively safeguard against someone taking out a sizeable life insurance policy with a (somewhat macabre) view of taking their own life to get their families/dependents out of financial difficulty.

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Outliving your policy

Perhaps the most common cause of non-payouts is the policyholder outliving their term life insurance policy.

This type of life insurance protects you for a fixed amount of time - say you’re 30-years of age when you decide to arrange a 40-year fixed term life insurance policy, which means that you’re 70-years of age (if you’re still with us) when it runs out. Die 12 months down the line at 71, and your dependents will not receive a payout.

As long as thought carefully about the length of time you were covered, this shouldn't cause a problem. Fixed term life insurance plans are generally used to cover the length of a mortgage and/or to make sure children have grown up, been educated and are self-sufficient before you pass away.

And as life expectancy continues to grow year on years, courtesy of healthier lifestyles amongst other factors, the chances are you’ll out-see the financial usefulness of the policy. Having said that many of these type of fixed term plans are designed to come to an end (before you do) at 70-years of age (both level life and decreased life plans are geared up for this cut-off point), yet whole life insurance packages will thankfully cover the policyholder until such time as they pass away.

Being diagnosed with a terminal illness

Should a life insurance policyholder be struck down with a terminal then they may not be entitled to a full pay-out. The good news (if there really is any positive news to be had in this hypothetically awful situation) is that dependents will be able to claim an early pay-out lump sum, which financially amounts to a percentage reduction of the full figure, the percentage depending on the time remaining on the uncompleted term.

Also if the policyholder is diagnosed with a terminal illness within 12 months of the plan ending then the insurer isn’t obliged to settle early, but instead only once the insured party has passed. For the record, a terminal illness is one which is defined as ‘a rapidly progressing sickness or condition, where the life expectancy is deemed to be a time no more than 12 months in duration, and which offers no known cure’.

Moving abroad

That’s right, certain policies might well be compromised (or worse still, completely contravened) if the policyholder takes it upon themselves to travel – or indeed, live – outside some pre-determined geographical areas for an enduring amount of time.

Such locations include outside of the European Union as well as more exotic and far flung destinations like America, Canada, Australia, New Zealand and the Isle of Man and the Channel Islands for longer than 12 months consecutively.

Does life insurance pay out if you travel despite UK government warnings?

When it comes to travelling abroad to countries that are experiencing illness outbreaks, epidemics or global pandemics, such as the Corona Virus in China, many people have shown concern over whether or not their life insurance policy would still cover them should anything go seriously wrong – despite them willingly choosing to travel to the affected country.

The truth is that all insurance providers have different terms and conditions with each policy, but generally, your cover is based on the time of application.

When you take out life insurance to protect your loved ones, you’re probably unlikely to know about any potential future travel plans at the time, so unless you knew about it when you took the policy out, you would still be covered.

As long as you are completely truthful when applying for life insurance, and you do not withhold any information, you will be covered by your provider – just be sure to check all the terms within your policy so that you know exactly what you are covered for before agreeing to it.

And remember, before travelling anywhere, it is important to get a comprehensive travel insurance policy to make sure you’re covered for any medical costs or other expenses that occur as a result of an accident.

Concealing Information

We’re not talking about incriminating family stuff, more change of personal details which could affect an existing life insurance plan.

The last thing on our minds when negotiating/fine-tuning a life insurance policy at the beginning of its long term is about our personal situations and circumstances altering in the future, and once the documentation is rubber stamped that's the last we think about it - save for the annual premium payments of course.

But inevitably changes take place in our lives and times, and when they do we should be mindful that we owe it to our life insurance providers (and subsequently our dependents in the long run) to keep them abreast of any amendments as and when they crop up. That way the risk of our policies becoming null and void isn’t posed.

Such examples include when we get married, have children, buy a house, move to a different property, change employer, land an even better job, etc. All of which could necessitate revisions to your life insurance policies for a variety of individual reasons and which result in increasing the sum assured or reviewing and renegotiating the deal from the ground up.

Neglect to do this and you could wind-up under-insured, and should your dependents benefit from a life insurance windfall in the future, the chances are it won’t cover what you had saved for and more pressingly, what they will need.

What should I do if my life insurance claim is dismissed?

The bottom-line is that this is rarely the case, as insurance industry-supported figures habitually reveal.

However if you’re one of the unfortunate stats then there are things you can do to contest the decision. Firstly you should address your life insurance claims provider, following their official disputes/complaints protocol and process. If this doesn’t change their hearts, then you are perfectly entitled to take your case to the independent arbitrator and fiscal regulatory body, the Financial Ombudsman Service (or the FOS). They will sit in judgement on your case and decide which party is right after looking into both sides of the argument/stand-off.

If the FOS concludes that the policyholder’s claim was unlawfully denied and consequently rule in your favour, then it has the power to enforce that the life insurance company either rectifies the outstanding issue or compensates you from a monetary perspective.

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