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What We Offer to New Yorkers

Vargas Gonzalez Delombard, LLP represents life insurance beneficiaries throughout New York City who are struggling to secure the benefits they’re owed. With experience litigating in state and federal courts across all five boroughs, we provide the insight and advocacy clients need when insurers attempt to delay, deny, or dispute coverage.

We handle:

  • Claims denied without valid justification or are subjected to unreasonable delays
  • Conflicts between beneficiaries or multi-claimant interpleader actions
  • Disputes involving policy rescission or alleged lapse in coverage
  • Denials based on fraud allegations or contested suicide exclusions
  • Employer-sponsored group policy claims governed by ERISA

What Is Life Insurance? How Do Life Insurance Policies Work?

Life insurance is a legally binding contract between a policyholder and an insurance company, designed to provide financial protection to the policyholder’s beneficiaries after their death. In exchange for regular premium payments, the insurer agrees to pay a lump-sum death benefit to the named beneficiaries upon the insured’s passing. This benefit can:

  • Help cover funeral costs
  • Pay off outstanding debts
  • Replace lost income
  • Fund long-term expenses such as education or housing.

In New York, individuals may obtain life insurance through private individual policies or as part of an employer-sponsored group plan, often governed by federal ERISA regulations. The most common types of coverage include:

  • Term life insurance, which offers coverage for a fixed period (such as 10, 20, or 30 years) and is typically more affordable
  • Whole life insurance, which is a form of permanent coverage that lasts a lifetime and may include a cash value component that accrues over time

Once a claim is submitted after the insured’s death, New York law requires insurers to act promptly and fairly. Under New York Insurance Law § 3213, insurers must begin an investigation and pay valid claims without undue delay.

In most cases, insurers are required to pay interest on death benefits if payment is not made within a specified timeframe. Policies are also subject to a two-year contestability period, during which insurers may investigate for misrepresentations on the application. After that window closes, the policy generally becomes incontestable—unless fraud is proven.

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Why Can a Life Insurance Claim Be Denied?

Common reasons for denials in New York include:

  • Material misrepresentations in the application
  • Policy lapse due to missed payments
  • Disputes about named beneficiaries
  • Allegations of suicide within the contestability window
  • ERISA procedural issues (for employer policies)

What Laws Cover Life Insurance in New York?

New York Insurance Law § 2601 – Unfair Claims Settlement Practices

This statute prohibits insurers from engaging in deceptive, unfair, or abusive claims handling. Specifically, § 2601 makes it unlawful for an insurance company to:

  • Fail to acknowledge or act promptly on claim communications
  • Refuse to pay claims without conducting a reasonable investigation
  • Misrepresent policy provisions or deny coverage without justification

If an insurer violates this law, it may be subject to regulatory penalties, and its actions may serve as evidence in a bad faith or breach of contract lawsuit. The New York Department of Financial Services (DFS) enforces this statute, which also provides oversight and complaint resolution.

New York Insurance Law § 3203(a)(3) – Incontestability Clause

Under § 3203(a)(3), all life insurance policies issued in New York must become incontestable after two years from the date of issue, except in cases of intentional fraud.

This means that, after the two-year mark, insurers cannot void or deny a claim based on misstatements or omissions in the application—even if they later discover inaccuracies—unless they can prove the insured intended to deceive.

This statute protects beneficiaries from post-claim investigations designed to invalidate coverage on technicalities or good-faith mistakes.

ERISA – Employer-Sponsored Group Life Insurance Plans

If the life insurance policy was provided through an employer, it is likely governed by the Employee Retirement Income Security Act of 1974 (ERISA). This federal law preempts most state insurance rules and imposes strict deadlines and administrative procedures for appealing denied group claims.

Beneficiaries must follow specific steps before filing suit in federal court, and courts generally review ERISA cases under a deferential standard unless misconduct is proven.

At VGD, we are well-versed in handling ERISA-based claims and appeals for New York employees and their families, including union members, public workers, and private-sector employees.

NY General Obligations Law § 5-101 – Six-Year Statute of Limitations

This statute gives beneficiaries six years from the date of breach (typically, the date of denial) to file a lawsuit for breach of contract in connection with a life insurance policy.

This relatively generous time frame provides more flexibility than in many other states, but waiting too long to act can still harm your case, especially when evidence or witnesses become harder to access.

What Should I Do if My Life Insurance Claim Is Denied in Miami?

A denied life insurance claim can feel like an overwhelming setback, especially when you’re already dealing with the emotional loss of a loved one. But a denial is not the end of the road. If your claim has been rejected in Miami, here’s what to do next:

  1. Review the denial letter carefully. Insurers are required to state the reason for the denial. Common reasons include missed premium payments, alleged misrepresentations, or beneficiary disputes.
  2. Collect all documentation. Gather the insurance policy, payment records, application forms, correspondence with the insurer, and the denial notice.
  3. Avoid giving recorded statements. Insurers may try to use your words to justify the denial. Don’t engage further without legal guidance.
  4. Know your rights under Florida law. In many cases, a denial can be challenged, especially if the policy is past the contestability period or the insurer failed to give proper cancellation notice.
  5. Talk to a qualified life insurance attorney. An experienced lawyer can review your case, identify errors in the insurer’s decision, and take action to overturn the denial or file a bad faith claim.
  6. Act quickly. Florida law sets strict deadlines for contesting denied claims. Waiting too long could affect your ability to recover the benefits.
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Why Choose VGD in New York City?

We bring deep fluency in New York insurance law and decades of combined experience handling both individual policies and complex employer-sponsored group plans governed by ERISA. Our attorneys are seasoned litigators who regularly represent clients in state and federal courts throughout all five boroughs, and we are well-equipped to navigate the procedural and legal challenges unique to New York’s highly regulated insurance landscape. When major insurers deny what you’re rightfully owed, we have the resources, knowledge, and courtroom strength to fight back.

What Compensation Can You Recover?

In New York, you may be eligible for:

  • Full life insurance policy benefits
  • Pre-judgment interest (9% annually per CPLR §5001)
  • Attorneys’ fees (in some bad-faith cases or under federal ERISA law)
  • Emotional distress and punitive damages (where applicable)
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FAQ's

How long do I have to file suit in New York?

What happens if the policy was obtained through work?

Can an insurer deny a claim due to suicide?

Are life insurance proceeds taxable in New York?

What if multiple people claim to be beneficiaries?

Can insurers deny based on alleged fraud after two years?

What if I can’t locate the original policy?

Do NYC courts award interest on late claims?

Can VGD handle appeals for denied group policies?

Do you offer bilingual services in New York?

How long do I have to file suit in New York?

New York allows six years for breach-of-contract claims. Federal timelines for ERISA claims are shorter, typically three years.

What happens if the policy was obtained through work?

Employer-sponsored life insurance is governed by ERISA, which has strict procedural rules. We handle administrative appeals and litigation.

Can an insurer deny a claim due to suicide?

Only if it occurred within two years of the policy start date and the policy contains a clear exclusion.

Are life insurance proceeds taxable in New York?

They are not subject to state or federal income tax, but may impact estate tax calculations.

What if multiple people claim to be beneficiaries?

The insurer may file an interpleader action in court. We help rightful beneficiaries protect their claims.

Can insurers deny based on alleged fraud after two years?

Only if the fraud is willful and material. After the incontestability period, denials are challenging to sustain.

What if I can’t locate the original policy?

We can help using tools like the NAIC Life Insurance Policy Locator.

Do NYC courts award interest on late claims?

Yes. 9% annual interest is available on overdue payments from the date the claim was due.

Can VGD handle appeals for denied group policies?

Yes. We are experienced in ERISA appeals and federal litigation in the Southern and Eastern Districts of New York.

Do you offer bilingual services in New York?

Yes. Our team is fluent in Spanish and serves diverse communities across NYC.

The Insurance Company Has Lawyers. So Should You.

Don't navigate the legal system alone if your life insurance claim has been denied, delayed, or mishandled. Contact Vargas Gonzalez Delombard, LLP today to schedule your free case evaluation and let us fight for the benefits your loved one intended you to receive. We operate on a contingency fee basis—meaning you pay nothing unless we recover for you—and our bilingual team provides accessible, culturally attuned legal support to Spanish-speaking families across the city.

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