How can I deal with a life insurance company that is refusing to pay or is creating delays and confusion about benefits? – North Carolina

Short Answer

In North Carolina, the fastest way to cut through life-insurance delays is to (1) confirm who has legal authority to claim the benefits, (2) submit a complete claim package in writing, and (3) force the insurer to state—clearly and in writing—what is missing or why payment is being refused. If the insurer still delays or gives shifting explanations, the next steps often include escalating to a supervisor, filing a complaint with the North Carolina Department of Insurance, and (when appropriate) having a probate attorney evaluate a lawsuit to enforce the policy.

Understanding the Problem

In North Carolina probate and estate work, a common issue is whether a life insurance company must pay benefits now or can delay because it claims the wrong person is requesting payment, the paperwork is incomplete, or the beneficiary status is unclear. The decision point is whether the person communicating with the insurer has the right legal role to demand payment (named beneficiary, personal representative of an estate, or another legally recognized representative) and has provided the documents the insurer can reasonably require before issuing the check.

Apply the Law

Under North Carolina law, life insurance proceeds usually pay directly to the named beneficiary and do not automatically go through probate. If the estate is the beneficiary (or there is no living beneficiary under the policy terms), the personal representative typically must qualify through the Clerk of Superior Court (Estates) and provide Letters Testamentary or Letters of Administration. When a dispute exists about who should receive the proceeds, insurers often pause payment until they receive sufficient proof or a court order resolving the competing claims.

Key Requirements

Proper claimant authority: The claimant must be the named beneficiary under the policy, or (if the estate is entitled) the duly appointed personal representative with current Letters from the Clerk of Superior Court.
Complete claim submission: Insurers commonly require a certified death certificate and their claim form; they may also request the original policy or a lost-policy affidavit, and Letters if the estate is the payee.
A clear written record: Delays and “confusion” often continue when communications stay informal. A written timeline, written requests for missing items, and written responses help force clarity and preserve options if escalation becomes necessary.

What the Statutes Say

N.C. Gen. Stat. § 75-1.1 (Unfair or deceptive acts or practices) – Declares unfair or deceptive acts in commerce unlawful; it can be relevant when an insurer’s conduct goes beyond a simple paperwork dispute.
N.C. Gen. Stat. § 31A-11 (Insurance benefits; slayer rule) – Provides that if a beneficiary is disqualified under the slayer rule, proceeds are paid as if that person predeceased the insured (often to an alternate beneficiary or the estate).
N.C. Gen. Stat. § 7A-111 (Insurance money for minors/incapacitated adults) – Allows certain insurance proceeds to be paid to the clerk of superior court or public guardian in limited situations involving minors or incapacitated adults, which can affect how an insurer issues payment.

Analysis

Apply the Rule to the Facts: The facts describe a person acting under a power of attorney for a living relative while also dealing with a separate life insurance dispute involving deceased family members. A power of attorney for a living person may help with that living person’s own claim as a beneficiary, but it usually does not replace the need for a personal representative when the estate is the claimant. If the insurer is delaying, the practical focus is to (1) identify whether the claim should be made by a named beneficiary or by an estate, and (2) deliver the insurer’s required documents in one complete written package so the insurer cannot keep changing the “missing items” list.

Process & Timing

Who files: The named beneficiary (or the personal representative if the estate is entitled). Where: The claim is submitted to the life insurance company’s claims department; if estate authority is needed, qualification happens with the Clerk of Superior Court (Estates) in the county where the decedent was domiciled. What: The insurer’s claim form, a certified death certificate, and (when applicable) the original policy or lost-policy affidavit and the PR’s Letters.
Force a written “missing items” list: If the insurer says the claim is incomplete, request a single written list of every document or fact it needs, plus the exact reason for any refusal to pay. Keep all communications in writing and track dates, names, and reference numbers.
Escalate if the file stalls: Ask for a supervisor review and submit a complaint to the North Carolina Department of Insurance if the insurer will not give a clear written explanation or keeps moving the goalposts. If the dispute is about who is entitled to the proceeds, a probate attorney can evaluate whether a court filing is needed to resolve entitlement and compel payment.

Exceptions & Pitfalls

Power of attorney limits: A power of attorney for a living relative does not automatically give authority to act for a deceased person’s estate. If the estate must claim the proceeds, the clerk’s appointment of a personal representative (and issuance of Letters) is often required.
Beneficiary disputes: If multiple people claim to be the beneficiary (or the insurer’s records differ from family expectations), the insurer may delay while it investigates or until a court resolves entitlement.
Incomplete claim packages: Sending documents piecemeal often leads to repeated “confusion.” A single transmittal letter with a checklist of enclosures, plus copies kept for the file, usually reduces back-and-forth.
Policy not located: If the original policy cannot be found, insurers commonly require a lost-policy affidavit or other proof. Request a complete copy of the policy and any beneficiary/ownership records from the insurer to confirm what it shows.
Special payee situations: If a minor or an incapacitated adult is the beneficiary, payment may need to be made through the clerk of superior court or another authorized channel under North Carolina law.

For more on challenging a denial and getting the policy paperwork, see how to get the policy and challenge the decision and how to challenge a payout when paperwork was ignored.

Conclusion

In North Carolina, the practical way to deal with a life insurance company that is refusing to pay or creating delays is to confirm the correct claimant (beneficiary versus estate), submit a complete written claim package (death certificate, claim form, and Letters if the estate is involved), and require the insurer to state in writing what is missing or why it is refusing payment. The most important next step is to send a single, dated written demand for a written decision or a complete “missing items” list and keep a clean paper trail for escalation.

Talk to a Probate Attorney

If a life insurance company is delaying, refusing to pay, or giving shifting explanations about benefits, our firm has experienced attorneys who can help clarify who has authority to claim the proceeds, assemble the right documents, and press for a clear decision and timeline. Call us today at [919-341-7055].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.