Life Insurance Claim Denied for Anemia

Here are the facts about a life insurance claim denied for anemia.

There are very specific guidelines that life insurers evaluate when they offer a policy to anyone with a history of anemia. Those guidelines are the basis for both underwriting a life insurance policy and, during the Contestability period of a death claim, the determining factor whether a claim is paid or denied.

The guidance for anemia considers the type of anemia, the severity of the anemia, any treatment for anemia and whether there were complications that resulted for the anemia.

Even if the insured person did NOT disclose Anemia on their life insurance application the guidance still applies and the claim can still be paid.

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Life Insurance Claims and Anemia

Anemia can be of several different types such as Low Iron, Sickle Cell, Aplastic and Hemolytic, just to name a few. Some forms are much more dangerous than others and insurers treat them differently.

Being anemic does NOT mean a death claim is automatically denied. If the insurance company denies a death claim without having blood test results, then they’ve improperly denied the claim.

The measurement of anemia is the amount of hemoglobin in a person’s blood. The national guideline for normal hemoglobin differs between men and women. For men, “normal” rages from 13.5 to 17.5 grams per deciliter. And for women, normal ranges between 12.0 to 15.5 grams per deciliter. See Mayo Clinic

People can go from being anemic to not being anemic. This has direct relevance to life insurance claims. If a blood test demonstrates a person was anemic, and they took another blood test that showed they weren’t anemic, then the most recent test prevails.

How someone would stop being anemic would be if their type of anemia was Low Iron or Vitamin Deficiency Anemia. With these types of anemia either iron supplementation or vitamin supplementation can increase the amount of hemoglobin. In some instances the person simply needs to eat more iron-rich foods. In other cases, a doctor may recommend an iron transfusion.

When these treatments are successful anemia is no longer present. This is like removing a cancer. Once the cancer is removed, and the person has a clean bill of health, cancer no longer exists in the body. Anemia, likewise, can end. Therefore, before an insurer can deny a life insurance claim for anemia, they have to know if there was treatment, the type of treatment and the result.

As stated above, a life insurance claim cannot be denied for anemia unless all of the facts are known and support such a denial.

Get Help with a Life Insurance Claim Denied for Anemia

More severe forms of anemia, such as Sickle Cell and Anemias associated with bone marrow disease need to be disclosed on a life insurance application to avoid conflicts. But again, if the anemia wasn’t disclosed the death benefit may still be payable.

When a person has a permanent anemia condition such as Sickle Cell the severity has to be looked at. Life insurers categorize Sickle Cell Anemia as being Mild, Moderate or Severe.

Some people live their entire lives without any major complication from Sickle Cell Anemia. For this person their anemia would be categorized as Mild. A life insurer shouldn’t deny a claim for Mild anemia because there’s no significant impact to the person’s mortality.

If a person suffers from severe fatigue or an enlarged heart, for example, then they may be categorized as having Severe anemia. Severe anemia is the most likely category to be denied in the event of a death claim investigation.

We see insurers simply review medical records and look for the word “anemia”. When they find it they deny the claim. This is NOT a valid basis for denying a life insurance claim for anemia. Contact us for help:

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We first do our own medical review, then we demonstrate to the insurer why their denial decision is wrong. We’re experts in death claims where anemia is the basis for denial. By doing a thorough examination of the person’s medical history, applying underwriting guidance, and using our medical experts, we get denied claims over-turned and paid to our clients.

If your life insurance claim was denied for anemia, of any type, contact us for our representation.