Losing a loved one is painful enough—but discovering that their employer-provided life insurance claim has been denied can turn a time of grief into a financial crisis. Many employees trust that the group life insurance offered through work will protect their families. But when a claim is denied, survivors are often left without the benefits they were counting on.
If your life insurance claim through a company-sponsored plan has been denied, you need to understand why it happened and what steps to take immediately to protect your rights. Most importantly, you need to act quickly—especially if the claim falls under ERISA, where strict deadlines and rules apply.
How Employer-Provided Life Insurance Works
Most group life insurance policies are offered as part of an employee benefits package. These policies are typically low-cost or free, and the premiums are automatically deducted from the employee’s paycheck. Coverage amounts are often tied to the employee’s salary, such as 1x or 2x their annual income.
One key feature is that employer-provided life insurance doesn’t usually require a medical exam. It’s considered guaranteed issue, meaning nearly all full-time employees qualify. But even with these advantages, claims are frequently denied due to administrative errors, eligibility misunderstandings, or failures in the transition process when employment ends.
Common Reasons Life Insurance Claims Are Denied Under Employer Plans
Many employer-sponsored life insurance claims are denied for avoidable or procedural reasons. Here are the most common ones we see:
1. Ineligibility at Time of Death
The insurer may claim the employee was no longer eligible due to a job status change—such as moving from full-time to part-time, going on unpaid leave, or being terminated before death.
2. Lack of Conversion to an Individual Policy
If the employee left the company or retired and did not convert the group policy to an individual one within the required time frame, the insurer may argue there was no valid coverage at the time of death.
3. Employer Administrative Errors
Sometimes the claim is denied because the employer failed to submit proper enrollment forms, incorrectly recorded the employee’s status, or neglected to deduct premiums from the paycheck.
4. Employment Duration Requirements Not Met
Some plans require a minimum number of weeks or months of employment before coverage begins. If death occurred shortly after hire, the claim may be denied for failing to meet the eligibility window.
5. Premium Payment Gaps
If the employer failed to submit premium payments to the insurer—even if the employee had them deducted—the claim can be denied. This is a failure on the employer’s part, but the insurer may still try to deny benefits.
6. Paperwork Discrepancies or Misrepresentation
Incorrect data entered during enrollment—such as listing the wrong job title, misclassifying the employee, or errors in designating beneficiaries—can lead to a rejection.
Why You Shouldn’t Handle an Employer Life Insurance Denial Alone
If your claim was denied, you're probably overwhelmed, confused, and uncertain about your next steps. Unfortunately, many families try to navigate the appeals process alone—only to miss critical deadlines or submit incomplete appeals.
Most group life policies fall under ERISA (Employee Retirement Income Security Act), a federal law that imposes strict procedures and limits. Under ERISA, you usually have only one chance to appeal, and once that opportunity is gone, your legal options are significantly reduced.
This is why you need to work with a life insurance lawyer who has extensive experience handling employer-sponsored and ERISA-governed denials.
How Our Law Firm Fights and Wins Denied Employer Life Insurance Claims
Our firm focuses exclusively on life insurance litigation. We’ve successfully reversed denials for group policies issued through major employers, unions, and government agencies. We’ve helped clients recover payouts from insurers like MetLife, Prudential, Cigna, Lincoln Financial, Unum, and others—even when the claim was initially denied due to eligibility disputes or conversion issues.
Here’s how we do it:
We obtain the full claim file from the insurer
We gather employment records and policy documentation
We identify legal errors in the denial
We prepare and submit a comprehensive legal appeal—typically 100–200 pages—that forces the insurer to reconsider the decision
Example: A family in New Jersey was denied a $250,000 claim because the employee had been on unpaid leave at the time of death. We proved that premiums had continued and that the employer failed to notify the insured of his right to convert coverage. The insurer reversed its decision and paid the claim in full.
What You Should Do If Your Employer Life Insurance Claim Was Denied
If you’ve received a denial letter, here’s what to do immediately:
Do not accept the denial as final—you may still have time to appeal.
Gather all documents—the policy, denial letter, pay stubs, HR communication, and any notices about coverage.
Request a copy of the claim file from the insurer (you’re entitled to it under ERISA).
Consult a life insurance attorney who regularly handles ERISA-based denials.
Don’t Wait—Time Limits May Affect Your Right to Appeal
Under ERISA, the deadline to appeal a denial is often just 60 or 180 days. Miss it, and you may permanently lose the right to challenge the decision. Even if your claim involves a private employer not governed by ERISA, deadlines still apply—and insurers may delay or deny claims while stalling for time.
We’re Here to Help You Get the Life Insurance Benefits You Deserve
If your employer-sponsored life insurance claim has been denied or delayed, we’re here to help. Our legal team has decades of experience recovering benefits for families in your exact situation. Whether the denial involves eligibility, paperwork errors, or a failed conversion, we know how to challenge insurers and win. When you need legal help for life insurance disputes in South Dakota we are here.
Contact us today for a free consultation. There are no fees unless we recover compensation for you. Let us fight to secure the benefits your loved one worked for—and your family deserves.