ERISA Life Insurance Policy Denials, Claim Delay, Disputes

If you are the beneficiary of an ERISA life insurance policy and are having trouble getting paid, call a Florida ERISA life insurance lawyer at the Law Offices of Jason Turchin today for a free consultation.

 

The death of a loved one is not only emotionally devastating, but it can be financially crippling as well. When a loved one dies, the family often scrambles to find financial security and stability following the loss of his or her income. Life insurance is designed to be a “life line” to such families, providing a predetermined amount of money directly to the beneficiaries chosen by the deceased. State law oversees individuals who privately purchase life insurance, while Federal law is reserved for life insurance plans that are distributed or offered by an employer under ERISA.

 

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What is ERISA and how does it impact life insurance?

ERISA is short for Employee Retirement Income Security Act of 1974, which sets the standard for almost all employment based benefits in the United States. Some such benefits include health insurance, disability benefits, retirement, and life insurance. It is not uncommon for an employer or place of business to offer group life insurance plans and other benefits to its employees. ERISA was passed under Federal law as a response to a lack of consistency in how individual states were distributing and managing benefits for their employees.

 

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How can you make a claim for life insurance on an ERISA policy?

You should look carefully at the Policy itself, and also the Plan Documents from the Plan Administrator for the company or organization providing the policy benefit. Oftentimes, the Plan Documents set forth how to make a claim, and who may make a claim. The two documents may be read together, or may even conflict, leading to a potential life insurance dispute.

 

What happens if your life insurance policy is denied and it is an ERISA policy?

You should be aware that you as the beneficiary may have legal rights. In the event that your claim as the beneficiary is denied, you have a few options. First and foremost, you generally must file an appeal in writing to the insurance company itself. This appeal is a request or a demand that the insurance company pays you the benefits in which you are rightfully owed. If the insurance company does not comply and the appeal is denied, you may file a lawsuit in federal court and/or you may file a lawsuit against the insurance company itself for a breach of fiduciary duty, among other possible causes of action.
 

What are some reasons an ERISA life insurance policy would be denied?

There are many ways in which insurance companies try to avoid paying life insurance beneficiaries. Employment related denials are common. An insurance company, for example, may try to claim that the decedent was not working full time or did not meet enough hours or they were out of work due to illness. Other common reasons for denial include problems and misinterpretations with the application itself, delayed payments, and apparent ineligibility.   

One common dispute we see if where a former spouse is the listed beneficiary. Some policies specify how the former spouse should be treated under the ERISA policy. Florida's divorce law may conflict, and lawsuits may arise as to which laws apply, and which policy or Plan Documents apply.

How can we help if your ERISA life insurance claim was denied?

ERISA is a complicated federal statute that can be extremely frustrating and confusing to those unfamiliar with legal procedures. If you had a ERISA claim denied, contact a life insurance lawyer at the Law Offices of Jason Turchin to see if you may still be entitled to benefits. You can reach us at 800-337-7755 or submit your question through our contact form.