MetLife is one of the largest providers of group life insurance in the United States, especially through employer sponsored plans. While many families expect a smooth claims process, MetLife frequently denies or delays payment for reasons that are confusing, technical, or based on incomplete information. Beneficiaries often assume these decisions are final, but many MetLife denials can be overturned with a targeted legal strategy and a full review of the claim file.
This page explains the most common reasons MetLife denies claims, how these denials can be challenged, and what steps beneficiaries should take immediately.
Why MetLife Denies Life Insurance Claims
MetLife administers a wide range of policies, including basic group life, supplemental life, voluntary life, and accidental death benefits. Because most MetLife policies are tied to employment, many denials stem from administrative mistakes rather than anything the insured did wrong.
Enrollment and Eligibility Problems
One of the most common MetLife denial categories involves eligibility. MetLife may claim that the employee was not properly enrolled, did not meet the plan’s requirements, or was not actively at work. These denials often arise from employer mistakes, such as failing to submit enrollment forms, failing to request evidence of insurability, or deducting premiums without securing coverage. Beneficiaries can challenge these denials by obtaining payroll records, HR communications, and plan documents.
Evidence of Insurability Issues
MetLife frequently denies supplemental life insurance claims by stating that the employee never completed the required evidence of insurability. In many cases, the employer failed to notify the employee, failed to submit the form, or deducted premiums for years without confirming approval. Courts often hold employers and insurers responsible when the employee reasonably believed they had coverage.
Alleged Policy Lapse
MetLife may deny a claim by asserting that the policy lapsed due to nonpayment. These denials often involve payroll errors, billing problems, or confusion during medical leave. Beneficiaries should not assume the lapse is valid. A review of payment history and employer records often reveals that the insured did everything required to maintain coverage.
Misrepresentation on the Application
MetLife may claim that the insured provided incorrect information about medical history or lifestyle. These denials are common during the contestability period. To uphold the denial, MetLife must prove that the misstatement was material and that the policy would not have been issued if the truth had been known. Many denials fail because the insurer overstates the significance of the alleged misrepresentation.
AD&D Denials Based on Exclusions
Accidental death claims are denied at a high rate. MetLife often relies on exclusions involving intoxication, illness, drug use, or hazardous activities. The insurer may classify an accident as a medical event or argue that an exclusion applies even when the evidence is unclear. These denials require a detailed review of medical records, autopsy findings, and the exact wording of the policy.
Beneficiary Disputes and Delays
When MetLife receives conflicting claims or unclear beneficiary designations, payment may be delayed or the insurer may file an interpleader lawsuit. These cases often involve divorces, outdated forms, or competing family members. Beneficiaries should act quickly to protect their rights and avoid losing the benefit due to procedural issues.
What To Do If MetLife Denies Your Claim
A denial from MetLife is not the end of the process. Beneficiaries have strong rights under ERISA and state insurance laws. The key is to respond strategically and gather the right evidence.
Request the Complete Claim File
MetLife must provide all documents, internal notes, medical reviews, and communications used to deny the claim. This file often reveals inconsistencies, missing information, or flawed reasoning.
Review the Plan Documents and Policy Language
Group plans often include complex rules about eligibility, enrollment, and evidence of insurability. Beneficiaries should review the summary plan description, the certificate of coverage, and any amendments.
Investigate Employer Errors
Because MetLife relies heavily on employer provided information, many denials are rooted in HR mistakes. Payroll deductions, enrollment confirmations, and internal emails often show that the employee believed they had coverage.
Challenge Unsupported Findings
If MetLife relied on incomplete medical records, incorrect assumptions, or broad interpretations of exclusions, these findings can be challenged with evidence and expert review.
File a Strong Appeal
A well prepared appeal can reverse a denial and secure full payment. Under ERISA, the appeal is the most important stage because it becomes the entire record for any future lawsuit.
Why MetLife Denials Are Often Reversible
Many MetLife denials are based on administrative errors, incomplete investigations, or misinterpretations of policy language. When beneficiaries challenge these decisions with a structured, evidence based approach, they often succeed. MetLife must follow strict legal standards, and when they fail to meet those standards, beneficiaries can recover the full benefit.
Get Help With a MetLife Life Insurance Denial
If MetLife has denied your life insurance claim, delayed payment, or filed an interpleader lawsuit, you do not have to navigate the process alone. A strategic review of the denial can uncover the path to recovery and protect your rights.