Life insurance can be purchased one of two ways, either through your employer, in which case ERISA applies, or from a private life insurance company.
You need the help of an experienced life insurance attorney to assist you when either types of these claims have been denied.
For more information on each types of these claims, select one of the two options below:
Frequently Asked Questions on ERISA Life Insurance
What is ERISA Life Insurance Coverage?
The Employee Retirement Income Security Act of 1974, or ERISA for short, establishes standards for life insurance, disability insurance and other such benefits made available through your employer. A life insurance policy offered through your employer is covered by ERISA, but life insurance purchased independently is not.
What does ERISA do?
The ERISA law regulates insurance companies and employers as the administrators of your benefits plan. ERISA requires your plan administrators to do their jobs with the highest degree of responsibility. Generally, ERISA regulates such things as reporting and accountability, disclosures, procedural safeguards and financial interests of plan participants. An experienced life insurance attorney can explain ERISA regulations to you and discuss your options during a free case evaluation.
What should I do if my ERISA life insurance claim has been denied?
ERISA imposes a lot of regulations on life insurance companies, but it also has strict deadlines and requirements for plan participants. If your ERISA life insurance claim has been denied, you are required to file a written appeal before you can sue the insurance company. Your appeal will typically be reviewed by an independent claims examiner who will decide your appeal. You will likely only have one chance at an appeal and there are strict deadlines to file.
Retaining experienced ERISA life insurance lawyers may ensure the success of your ERISA appeal. ERISA life insurance lawyers will handle the deadlines and complexities of filing your administrative appeal. Most importantly, an experienced ERISA life insurance attorney will make sure that everything you need to prove your case has been submitted with the appeal. If your ERISA life insurance claim appeal is denied by the examiner, only the evidence submitted during the appeal will be allowed in a lawsuit.
What should I do if my ERISA life insurance appeal is denied?
After you have exhausted the ERISA life insurance appeal process, your experienced ERISA life insurance attorney will prepare your denied life insurance claim for litigation. There are many limitations on the lawsuit and, again, there are strict deadlines that must be met. Getting a life insurance attorney involved early in your case will greatly improve your chance of success in court.
An experienced life insurance lawyer knows how to prove your case in court. We will ensure that all of the evidence to prove your case had been filed with the appeal, and that a proper record of the administrative appeal is filed with your lawsuit. The judge in ERISA life insurance cases may only consider the record from the appeal. No other evidence can be submitted, and no witness testimony will be heard by the court.
Do I need to hire an ERISA life insurance lawyer?
You are not required to hire an attorney, but in most cases, you will be far better off if you do. The process can be daunting to a lay person, and one missed deadline or forgotten piece of evidence could mean the end of your case. You should retain an experienced ERISA life insurance attorney as soon as your claim has been denied.
Your attorney will handle the rest for you. You can also retain an ERISA life insurance attorney without any money upfront. In fact, our ERISA life insurance lawyers only get paid if there is a successful outcome in your case, so there is no reason to delay.
Call us, or request a free claim evaluation today. We are here to help.
Frequently Asked Questions on Private Life Insurance
What are exclusion clauses?
Every life insurance company has one goal in mind: to make money. Insurance companies do not make a profit by paying every claim, so they incorporate exclusion clauses into life insurance policies that, of course, favor them. For example, most insurance policies have a “dangerous activity” clause. They use this clause to exclude claims resulting from dangerous activity such as base jumping and skydiving unless you pay a much higher premium.
What are some possible life insurance exclusions?
There are a number of possible life insurance exclusions, including but not limited to:
Act of war
Aviation (private aircraft crash)
Alcohol and drug use
Misstatement of age
What is a time period exclusion?
Often, life insurance policies have an initial time period of exclusion, usually two years, during which a life insurance claim may be denied for numerous reasons. This may be the most common reason why claims are denied. For example, a friend or family member purchased a private life insurance policy, and then 30 days later, he was killed in an accident that was deemed a possible suicide. The private life insurance policy may deny that claim based on two possible exclusions in the life insurance policy. First, the death occurred within the first two years of the policy where benefits can be reduced or denied, and second, the death was deemed a possible suicide within the first two years of the policy, and suicide is a specific exclusion during the first two years that the private life insurance policy was in effect.
Insurance companies will deny your private life insurance claim based on any number of exclusions or ambiguous language in the private life insurance policy. We take on big private life insurance companies and make them pay our clients every penny they deserve.
What is a contestable period?
When you apply for life insurance, private life insurance companies do little to verify the information on your application. Some life insurance companies will make an effort, requiring things like a health examination, but others will rely on you to state your health, age, and other information correctly.
However, when you die, private life insurance companies can take as long as they want to investigate your claim. They will examine all of the information that you provided on your private life insurance application, looking for flaws. Private life insurance companies will often deny your life insurance claim due to an omission or mistake that you made on the private life insurance application, no matter how small. To make matters even worse, your private life insurance company may have noticed the error before the policy was issued and did nothing to correct it. They did so with full knowledge that your private life insurance would later be denied.
If this sounds familiar to you, we won’t let the private life insurance company deny your claim without a fight. We will take on the private life insurance company for you.
Can private life insurance companies use ambiguity to deny my claim?
Although state laws limit exclusions, private life insurance companies often use terms ambiguously and later interpret that language in their favor to deny your life insurance claim. They do this by manipulating facts, inventing excuses and even discounting official autopsy reports. Skilled representatives also know where to look for loopholes.
Private life insurance companies are experts at denying claims. We won’t let them get away with it.
Call us, or request a free claim evaluation today. We are here to help.