Denied ERISA Life Insurance Claims
Christian Lassen, Esq. | Quoted in The Wall Street Journal | 25 Years Experience
If your employer provided life insurance claim was denied, your case is almost certainly governed by ERISA, the Employee Retirement Income Security Act. ERISA imposes strict federal rules on how group life insurance claims must be handled, appealed, and litigated. These rules are fundamentally different from state law life insurance claims, and a single mistake during the appeal process can permanently destroy an otherwise valid claim.
At Lassen Law Firm, we focus exclusively on helping beneficiaries challenge denied life insurance claims nationwide, including complex ERISA governed group life insurance denials. Christian Lassen, Esq., has 25 years of experience handling ERISA denials and personally manages each case to ensure strict compliance with ERISA’s procedural requirements.
How ERISA Changes Life Insurance Claim Rights
ERISA is a federal law that governs most employer sponsored benefit plans, including group life insurance. When a life insurance claim is denied under an ERISA plan, beneficiaries are required to complete a mandatory administrative appeal before filing a lawsuit.
Unlike non ERISA claims, ERISA cases are usually decided solely on the administrative record created during the appeal process. Courts generally do not allow new evidence, testimony, or documents after the appeal is complete. This makes the appeal stage the most critical phase of an ERISA life insurance claim.
ERISA also limits available damages. In most cases, beneficiaries may recover only the life insurance benefits owed, interest, and potentially attorney’s fees. Punitive damages and emotional distress damages are not available, which makes building a strong appeal record essential.
Why ERISA Life Insurance Claims Are Denied
ERISA life insurance claims are often denied for reasons unrelated to whether coverage should exist. Insurers and employers frequently deny claims based on technical issues, administrative errors, or alleged paperwork failures.
Common ERISA denial scenarios include alleged lapse of coverage after employment termination, failure to convert group coverage to an individual policy, disputes over beneficiary designations after divorce or remarriage, and alleged misrepresentations on enrollment forms. Many claims are denied because employers fail to provide required notices or mishandle premium payments, yet insurers deny benefits anyway.
These denials are frequently challengeable under ERISA when the plan administrator failed to follow federal requirements.
Common Reasons ERISA Life Insurance Claims Are Denied
ERISA life insurance denials commonly involve:
• Failure to convert group coverage after leaving employment
• Alleged lapse caused by employer premium payment errors
• Disputes over beneficiary designations after life events
• Misrepresentation allegations on enrollment or evidence of insurability forms
• Late or disputed proof of loss submissions
• Contestability investigations during early coverage
• Deaths alleged to fall outside policy terms
• Improper application of exclusions
• Employer administrative failures
• Termination related coverage misunderstandings
Many of these denials collapse when plan documents and administrative procedures are closely examined.
How We Handle Denied ERISA Life Insurance Claims
ERISA claims require precision, speed, and procedural discipline. We immediately request the full plan documents, summary plan descriptions, and the complete administrative record. We analyze whether the plan administrator complied with ERISA’s notice, disclosure, and claim handling requirements.
We then prepare a comprehensive administrative appeal designed to fully develop the record for federal court review. This includes submitting legal arguments, documentary evidence, and expert materials where appropriate.
If the appeal is denied, we file suit in federal court and pursue enforcement of the life insurance benefits based on the record created during the appeal.
Behind the Scenes How ERISA Life Insurance Claims Are Actually Won
Most ERISA life insurance cases are decided long before trial. Success often turns on whether the appeal record exposes procedural violations, inconsistent plan interpretations, or unsupported conclusions by the insurer.
ERISA claims are commonly resolved through:
• Administrative appeals exposing notice and procedural violations
• Discovery limited to conflicts of interest and claim handling flaws
• Motions challenging arbitrary and capricious decision making
• Court ordered benefit awards based on record deficiencies
• Settlements after insurers assess litigation risk
The appeal record is everything. Once it closes, opportunities to fix mistakes disappear.
What To Do After a Denied ERISA Life Insurance Claim
If your ERISA governed life insurance claim is denied, immediate action is critical.
You should request the denial letter and full plan documents, calendar the ERISA appeal deadline which is often 180 days, avoid submitting an appeal or statements without legal guidance, and contact an experienced ERISA life insurance attorney promptly.
Submitting an incomplete appeal or missing an ERISA deadline can permanently bar recovery, even when the denial was wrongful.
For a concise overview of ERISA claims and deadlines, see our Denied ERISA Life Insurance Claim Fact Sheet.
See Our Denied ERISA Life Insurance Claim Fact Sheet
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Written & Reviewed by Christian Lassen, Esq., Nationally recognized life insurance lawyer: 25 years experience, hundreds of millions recovered. Quoted in The Wall Street Journal ( May 17, 2025).
Last reviewed: Jan 3, 2026 | Contact 800-330-2274
Frequently Asked Questions About Denied ERISA Life Insurance Claims
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ERISA claims require beneficiaries to exhaust administrative appeals before suing and are governed by federal court procedures and remedies.
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Typically, you have 180 days from the date of denial to submit an administrative appeal under ERISA regulations.
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No. Under ERISA, you must first exhaust the internal appeal process before filing a lawsuit.
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Missing the ERISA appeal deadline usually means you lose your right to sue or recover benefits.
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Typically, you sue the insurance company, not your employer, although in some cases employers can be liable for administrative errors.
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No. Under ERISA, beneficiaries generally cannot recover punitive damages — only plan benefits, interest, attorney’s fees, and possibly equitable relief.
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The administrative record includes all documents the insurer reviewed to make the decision. Courts usually limit review to this record in lawsuits.
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Usually not. New evidence is rarely allowed in ERISA lawsuits unless special exceptions apply, making the appeal stage critical.
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Yes. Skilled attorneys often negotiate settlements while preparing ERISA appeals, leveraging the insurer's risk of losing later in court.
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You can challenge wrongful denials based on employer error, improper notice of conversion, or misapplication of plan terms.
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Yes. Divorce can revoke prior beneficiary designations under some state laws, although ERISA preemption rules complicate these cases.
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Yes. If accidental death coverage is employer-provided, it falls under ERISA's rules and appeal procedures.
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Yes. If the employer fails to forward premiums properly, insurers may deny claims, but legal challenges may still succeed.
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Yes. Insurers may investigate applications during the first two years, but still must act fairly and reasonably.
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You may have legal claims against the employer under ERISA if misinformation caused loss of life insurance benefits.
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Yes. Courts often award reasonable attorney’s fees to successful ERISA plaintiffs.
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Most cases resolve within 6 to 18 months, depending on court schedules and settlement opportunities.
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No. ERISA life insurance lawsuits are typically decided by a judge, not a jury.
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An attorney helps by preparing the appeal correctly, preserving evidence for court, negotiating settlements, and litigating skillfully if necessary.
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