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 (ERISA) is a federal law that governs employer‑provided benefits, including group life insurance policies. When a claim is denied under ERISA, beneficiaries must follow strict administrative appeal procedures before filing a lawsuit in federal court.
ERISA limits recoverable damages to policy benefits, attorney’s fees, and interest, making the appeal process critical.
Why ERISA Life Insurance Claims Get Denied
- Common reasons insurers and employers deny ERISA claims include:
- Failure to convert group coverage after leaving employment
- Alleged lapse due to employer error or late premium payments
- Misrepresentation on insurance applications
- Beneficiary disputes after divorce, marriage, or employment changes
- Delay in submitting proof of loss
- Failure to update beneficiary designations
- Contestability investigations during the first two years of coverage
- Deaths ruled outside policy terms
- Improper application of exclusions for certain causes of death
Many denials stem from employer paperwork errors or administrative mistakes — not actual policy violations.
What To Do After a Denied ERISA Claim
- Request the denial letter and plan documents immediately.
- Review the insurer’s stated reasons carefully.
- Do not appeal alone ERISA appeals are complex and favor insurers.
- Contact an experienced ERISA attorney to prepare your appeal.
- File within the ERISA deadline (usually 180 days). Missing deadlines can end your claim.
Your Legal Rights
Insurers must prove valid grounds for denial.
Beneficiaries can appeal and, if necessary, file suit in federal court.
Courts often overturn denials caused by employer errors or improper exclusions.
Case Example
We helped a spouse recover $300,000 after an employer failed to provide proper notice of conversion rights at termination. The insurer denied the claim, but we successfully appealed under ERISA and obtained full benefits.
Frequently Asked Questions
Q: How long do I have to appeal an ERISA denial?
A: Typically 180 days, but deadlines vary. Missing them can destroy your claim.
Q: Can I sue immediately after a denial?
A: No ERISA requires you to exhaust the administrative appeal process first.
Q: What damages can I recover under ERISA?
A: Usually policy benefits, attorney’s fees, and interest. Punitive damages are not available.
Q: Do I need an attorney?
A: Yes ERISA appeals are technical, and experienced counsel is essential.
How We Help
- Obtain and analyze the full administrative record.
- Prepare detailed appeals within strict ERISA deadlines.
- Identify employer or insurer violations of ERISA duties.
- File federal lawsuits when appeals fail.
- Secure rightful payouts for families nationwide.
Contact Us
If your ERISA life insurance claim has been denied, don’t wait. Deadlines are strict, and insurers count on families missing them. Call 800‑330‑2274 for a free consultation. No fees unless we win.
Key Takeaways
- ERISA governs employer‑provided life insurance claims.
- Denials often result from employer errors or administrative mistakes.
- Appeals must be filed within strict deadlines (usually 180 days).
- Experienced attorneys dramatically improve the chances of success.
Free Case Evaluation Contact Us!
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: Dec 7, 2025 | 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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“My husband died overseas, and the insurer stalled the claim citing lack of documentation. The Lassen team got official death records from abroad, translated and authenticated them, and made the insurer pay. They truly handled everything.”- Patricia W.
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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Recognized ExpertisePerfect 10.0 Avvo rating endorsed by over 1,700 attorneys; life member of the Multi-Million Dollar Advocates Forum; ranked among the top 1 percent of lawyers nationally for life insurance litigation.
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Client-First AdvocacyNo upfront fees: our contingency fee guarantee aligns our interests with yours; we provide personalized, compassionate representation from your initial consultation through resolution.
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Media & Community LeadershipQuoted in The Wall Street Journal and featured in leading legal publications; frequent speaker at national conferences; dedicated to charitable efforts supporting pediatric cancer care.
