Not all life insurance claim denials stem from misrepresentation, suicide clauses, or excluded activities. A growing number of claims are denied because of administrative breakdowns—errors made by the insurer, the employer, or even third-party administrators that cause policies to lapse, beneficiaries to be misfiled, or coverage to be wrongfully terminated. These mistakes often go unnoticed until it’s too late, leaving grieving families without the financial support they were promised.
Our law firm routinely recovers life insurance benefits that were denied because of clerical failures, communication gaps, or bureaucratic mismanagement. If you've been told the policy wasn’t in force, the wrong person was named as beneficiary, or the application was never “completed,” there’s a good chance the denial can be challenged and reversed. If you have North Dakota life insurance claim issues call us.
Real Examples of Administrative Errors That Led to Denied Claims
Payroll Deduction Failure After Leave of Absence
An employee went on short-term disability and assumed life insurance premiums were still being deducted from their paycheck. They weren’t. The insurer later denied the $250,000 claim, saying the policy had lapsed. We showed that the employer failed to notify the employee of their obligation to self-pay, violating ERISA notice rules. The claim was paid.Group Coverage Canceled Without Notice
A client’s spouse died unexpectedly. When she filed for the $100,000 benefit, she was told the group policy had been canceled six months earlier due to a company-wide change in providers. Neither the employee nor his family was informed. We proved the insurer had breached its duty of disclosure and secured the payout.Failure to Process Beneficiary Change Form
In a $300,000 claim, the policyholder had submitted a new beneficiary form after a divorce, naming his daughter instead of his ex-spouse. The form was lost internally and never recorded. After the insured’s death, the ex-spouse made a claim and was paid. We filed an interpleader challenge on behalf of the daughter and won the case.Late Enrollment in Supplemental Coverage Ignored by HR
A newly eligible employee submitted paperwork for supplemental life insurance but HR failed to process it. The insurer denied the $150,000 claim, saying the employee was never enrolled. We demonstrated that the employer accepted premiums and the employee had complied in good faith. The insurer paid under the doctrine of waiver.Wrong Policy Canceled During Carrier Transition
A client had both basic and optional life insurance through work. During a carrier transition, only the basic policy was transferred, and the optional $200,000 policy was accidentally terminated. The insured died several months later. The insurer blamed the employer, and the employer blamed the insurer. We forced a joint settlement and recovered the full benefit.
Common Administrative Failures That Lead to Denial
Unprocessed Applications or Enrollment Forms
Failure to Notify Employee of Conversion Rights After Termination
Incorrect Effective Dates Entered Into Systems
Coverage Terminated Due to Mislabeled Employment Status (e.g., full-time vs. part-time)
Outdated Beneficiary Information Due to HR Negligence
Premium Payment Errors During Leave, Disability, or Job Changes
Missing Evidence of Insurability or Lost Medical Records
Miscommunication Between Employer and Insurer During Open Enrollment
These problems are not just technicalities. They can cost families hundreds of thousands of dollars and leave them with no financial safety net after a death. Worse, insurers often present these denials as final when in reality, the law provides strong protections against administrative error—especially under ERISA.
We Know How to Challenge Administrative Denials—and Win
When policies are denied due to paperwork issues, system failures, or employer mistakes, it takes aggressive legal intervention to sort out who’s at fault and force payment. We review everything: payroll records, correspondence, enrollment files, and internal communications between insurers and employers. We track down lost documentation and uncover where the failure occurred.