Not legal advice. This page summarizes provisions of the D.C. Code as published by the Council of the District of Columbia and one decision of the D.C. Court of Appeals. It does not cover DISB regulations or the full body of District case law.
Quick view
- Suit deadline: three years for a simple contract (12-301(7)); a policy may not cut it shorter (31-4704(1)).
- Bad faith: no independent tort (Choharis, 2008); the claim sounds in contract.
- Killers: conviction of murder or manslaughter is the trigger (19-320).
- Lost policies: insurers run semi-annual death master file checks (31-4731).
What every District life policy must say
Section 31-4703 lists the features an ordinary life policy issued or delivered in the District must have. The ones that matter most in a death claim:
- Grace. At least 30 days or one month to pay any premium after the first year. The company may charge interest of up to 6% a year for the days of grace used, and if the insured dies during grace, unpaid premiums for the current policy year may be deducted (31-4703(a)(2)).
- Two-year contest period. After the policy has been in force for at least two years during the insured’s lifetime, it is incontestable except for nonpayment and for violating policy conditions about naval or military service in wartime. At its option, the company may also except disability and accidental-death benefits (31-4703(a)(3)(A)(i)).
- Statements. Absent fraud, the insured’s statements are representations, not warranties. A statement cannot be used to defend a claim unless it appears in a written application and a copy was endorsed on or attached to the policy at issue (31-4703(a)(3)(A)(ii)–(iii)).
- Reinstatement. A reinstated policy can be contested for fraud or material misrepresentation for as long a period as the original policy allowed (31-4703(a)(3)(C)).
- Age. If the company learns before final settlement that age was misstated, it pays what the premium would have bought at the right age, at its rates on the issue date (31-4703(a)(4)).
What a District life policy may not say
Section 31-4704 forbids, among other things:
- a clause giving less than three years after accrual to bring suit (1);
- after the contest period, any settlement worth less than the face amount (plus dividend additions, less debt and deductible premiums), except under provisions on misstated age, suicide, aviation, and wartime military or naval service (3);
- a clause making the soliciting agent the agent of the insured, or binding the insured by the agent’s acts or statements (5);
- paying funeral benefits in goods or services, or steering them to a particular undertaker (6), (7).
The provisions reviewed here do not state a fixed number of years for a suicide clause. If a denial relies on one, ask a District lawyer how the clause is limited.
Who gets paid, and when the insurer is discharged
Under 31-4716(a), a lawful beneficiary or assignee (other than the insured or the insured’s estate) takes the proceeds ahead of the insured’s creditors, whether or not the beneficiary could be changed. Premiums paid with intent to defraud creditors, with interest, go to those creditors out of the proceeds. The company is discharged by paying under the policy’s terms unless, before payment, it receives written notice from or for a creditor specifying the amount claimed.
Unclaimed policies: death master file checks
Section 31-4731 requires insurers to compare in-force individual policies, annuity contracts and retained asset accounts against a death master file (the Social Security Administration’s file or an equally comprehensive source) at least twice a year. For each match, within 90 days, the insurer must make a documented good-faith effort to confirm the death, decide whether benefits are due, try to locate the beneficiaries, and send claim forms or instructions. Beneficiaries may not be charged for the search. ERISA and federal employee plans, pre-need funeral policies, credit life and accidental-death coverage are outside the definition of “policy.”
Unfair claim settlement practices
D.C. Code 31-2231.17 has two lists, each limited to conduct frequent enough to indicate a general business practice:
- Subsection (a), carrying a penalty of up to $1,000 per violation, includes refusing to pay “for a reason that is arbitrary or capricious based on all available information” and failing on request to promptly explain a denial.
- Subsection (b) includes compelling “insureds or beneficiaries” to sue by offering substantially less than they later recover, failing to affirm or deny coverage within a reasonable time after proof of loss, and delaying claims by requiring both a formal proof of loss and duplicative later verification (b)(7), (b)(5), (b)(12).
Section 31-2231.02 says the chapter permits an administrative remedy only and creates no private cause of action, while not impairing rights that exist independently.
Choharis v. State Farm (D.C. 2008)
A homeowner whose house suffered water damage sued over the handling of his claims. In Choharis v. State Farm Fire & Casualty Co., 961 A.2d 1080 (D.C. 2008), the D.C. Court of Appeals:
- declined to recognize a tort of bad faith for an insurer’s handling of policy claims, reasoning that every contract carries an implied covenant of good faith whose breach is recoverable in contract, and that any extra protection for policyholders is for the legislature;
- recognized that fraud or negligent misrepresentation claims can still proceed where facts separable from the contract support an independent duty; and
- applied the District’s rule that punitive damages are unavailable for breach of contract unless the breach merges with and assumes the character of a willful tort.
The case involved a homeowner’s policy, but its reasoning addresses insurance claims generally. A beneficiary’s remedies for a wrongly denied life claim are therefore mainly contractual unless separate tort facts exist.
Group life conversion notice
If a group policy gives a covered person the right to convert to an individual policy without proof of insurability, and the person is not told of the right at least 15 days before the conversion period ends, the period is extended to 15 days after notice, capped at 60 days beyond the original expiration. Written notice delivered to the person, or mailed to the last known address by the employer or by the insurer, counts (31-4711.01(a)). The section does not extend insurance coverage itself. For employer plans under federal law, see employer group life.
Time to sue
D.C. Code 12-301 sets three years for an action “on a simple contract, express or implied” and 12 years for an instrument under seal. Unless the policy is a sealed instrument, plan around the three-year period, and remember a policy may not shorten it (31-4704(1)).
Homicide: 19-320
- Conviction trigger. A person convicted of the felonious homicide of another, “by way of murder or manslaughter,” takes nothing from the victim by inheritance, will or similar interests. That share passes as if the killer had died first (19-320(a)).
- Insurance. Policies the convicted person procured, directly or indirectly, for his own benefit, or that are payable to him on the victim’s life are void (19-320(b)).
The statute does not itself say who receives the money from a voided policy, and it turns on a conviction. Where a prosecution is pending or never brought, a District lawyer can advise on equitable principles and on whether the insurer should deposit the money with a court.
Example
A beneficiary in Ward 6 learns that her late uncle had a policy she never knew about. Fourteen months after the death, the insurer’s death master file match leads it to mail her a claim form. She files right away. If the claim is denied, the three-year contract period generally runs from when the claim accrued. She should get advice promptly rather than assume the clock started only when she learned of the policy.
Complaints to DISB
The Department of Insurance, Securities and Banking takes consumer complaints: File a Complaint or Report Fraud (DISB). Filing with DISB does not pause the limitation period.
Sources
- Code of the District of Columbia, Council of the District of Columbia: code.dccouncil.gov.
- District of Columbia Department of Insurance, Securities and Banking: disb.dc.gov.
- Choharis v. State Farm Fire & Casualty Co., 961 A.2d 1080 (D.C. 2008) (full opinion, CourtListener): courtlistener.com. Read November 3, 2026.
Not legal advice. This page summarizes general rules and the specific statutes cited. Your policy's wording, the state whose law applies, and whether the coverage came through an employer can all change the result. See the disclaimer and editorial policy.