Denied ERISA Life Insurance Claim Fact Sheet
Christian Lassen, Esq. | Quoted in The Wall Street Journal | 25 Years Experience Helping beneficiaries nationwide challenge denied ERISA life insurance claims.
What Is ERISA
The Employee Retirement Income Security Act is a federal law governing employer provided benefit plans, including group life insurance policies. ERISA establishes specific procedures for claim handling, appeals, and lawsuits.
Under ERISA, beneficiaries must complete the administrative appeal process before filing suit in federal court. The appeal stage is critical because courts generally limit review to the evidence submitted during that process.
Why ERISA Life Insurance Claims Are Denied
ERISA life insurance claims are frequently denied for administrative or technical reasons rather than true lack of coverage.
Common reasons include:
• Failure to convert group coverage after employment ends
• Alleged lapse due to employer premium errors
• Beneficiary designation disputes
• Misrepresentation allegations
• Delayed proof of loss
• Contestability reviews
• Improper application of exclusions
• Employer paperwork failures
Immediate Steps After an ERISA Denial
- Request the denial letter and plan documents
- Identify the appeal deadline
- Collect enrollment and employment records
- Avoid submitting an appeal without understanding requirements
- Seek experienced ERISA guidance
Key Legal Principles
• ERISA requires exhaustion of administrative appeals
• Courts review claims based on the administrative record
• Damages are limited to benefits, interest, and fees
• Procedural violations can overturn denials
Frequently Asked Questions
How long do I have to appeal
Often 180 days, but deadlines vary by plan.
Can I sue immediately
No. ERISA requires completion of the appeal process first.
What damages are available
Typically policy benefits, interest, and attorney’s fees.
Is legal representation important
Yes. ERISA appeals are technical and unforgiving.
Key Takeaways
• ERISA governs employer provided life insurance
• Many denials result from administrative errors
• Appeal deadlines are strict
• Proper appeals significantly improve outcomes
For detailed guidance and representation, see our main page on Denied ERISA Life Insurance Claims or contact our office for a free consultation.
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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
Our FAQ
Have questions? We are here to help. Still have questions or can't find the answer you need? Give us a call at 800-330-2274 today!
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A grace period is the time after a missed payment during which the policy remains in force, usually 30 to 60 days depending on state law and policy terms.
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No. In most states, insurers must send a written notice of overdue premiums and warn of pending lapse before terminating coverage.
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The policy may still be enforceable. Beneficiaries can challenge the lapse based on the insurer’s failure to provide required notice.
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Yes. If the insured dies during the grace period, the policy is still considered active, and benefits should be paid.
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Yes. In group life insurance policies, employers sometimes fail to forward premiums properly, leading to wrongful lapse denials.
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Yes. If automatic payment setups fail through no fault of the insured, lapses may be challenged.
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Some policies automatically borrow against cash value to cover missed payments. Failure to apply this correctly can lead to wrongful lapse claims.
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Possibly. Some courts excuse nonpayment if the insured was mentally incapacitated and missed premiums without proper notice.
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No. Reinstatement must occur while the insured is alive, but wrongful lapse denials can still be challenged posthumously.
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Not without following strict notice and grace period rules. Beneficiaries can often challenge technical denials.
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Deadlines vary by state, but it’s critical to act within 1 to 5 years depending on the policy and jurisdiction.
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Not necessarily. Payments mailed within grace periods or accepted by insurers may keep coverage active.
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Bank records, payment receipts, insurer correspondence, and premium notices are key evidence.
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If the insurer used an outdated address despite updated information, lapse denials can often be overturned.
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Possibly. If the insured submitted a reinstatement application before death, it may help challenge a lapse denial.
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In some states, special grace periods and protections applied during COVID-19 emergencies. They can help fight wrongful lapses.
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Only if the insurer followed all legal notice and grace period requirements. Otherwise, beneficiaries may still recover.
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Misapplied premiums can lead to wrongful lapses — and courts often hold insurers accountable for these errors.
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An attorney can obtain records, challenge improper lapses, negotiate settlements, and litigate if necessary to enforce payment.
Our Clients Speak Volumes
The Right Choice for Your Claim
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“Apparently, there were so-called inconsistencies on the application. The insurer used that as an excuse to avoid paying. Thankfully, Lassen Law stepped in and proved everything had been disclosed accurately. Claim paid.”- Rebecca M.
Why The Lassen Law Firm Is Different
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Proven National Results
With over two decades of exclusive focus on life insurance litigation, we’ve helped thousands of families recover wrongfully denied benefits. Our reputation for fast, strategic resolutions has made us a trusted national resource for complex claim disputes.
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