If your claim was denied, a life insurance attorney can help you understand why the insurer denied the claim, what deadline applies, and what evidence may be needed to challenge that decision.
J. Price McNamara: Disability, Life, AD&D Insurance Attorneys represents beneficiaries nationwide in denied, delayed, and underpaid group and individual life insurance claims. We know how difficult it can be to deal with an insurer while grieving, so we handle the appeal or lawsuit while keeping you informed about what comes next.
Put a former insurance company insider on your side. Contact J. Price McNamara for a free denial review. Call 225-201-8311 to get started.
Why Choose J. Price McNamara: Disability, Life, AD&D Insurance Attorneys
Families choose us because life insurance denials are a core part of our practice, not a sideline.
Here’s what sets us apart:
- Insider Experience: Price McNamara began representing insurance companies in 1990 and knows how insurers review life insurance claims.
- Relevant Results: Our firm has obtained benefits after challenging a suicide-exclusion denial, a UNUM conversion denial, and a competing-beneficiary claim in federal court.
- A Focused Practice: 30+ years focused on disability, life, and AD&D insurance-benefit claims.
- Recognition: AV Preeminent peer review rating, Martindale-Hubbell; 10/10 rating, Avvo; A+ rating, Better Business Bureau; and The National Trial Lawyers Top 100.
Here are our four guarantees to you: No Fee / No Cost; Transparency; No Risk of Regrets (30-day trial); Complete Convenience (100% virtual).
All new clients have a 30-day opportunity to determine whether we’re the right fit. Contact J. Price McNamara at 225-201-8311 for a free denial review.
For a free legal consultation, call (225) 201-8311
How Can a Lawyer Help After a Life Insurance Claim Denial?
A life insurance claim lawyer can help you appeal a denial of employer-provided coverage governed by the Employee Retirement Income Security Act (ERISA) and, if necessary, pursue the claim in federal court. You can challenge a denial of an individual policy under state law.
At our firm, our life insurance attorneys handle the appeal or lawsuit for you while we advance all costs. You pay us only if we recover benefits for you.
Why Do Life Insurance Claims Get Denied?
Life insurers usually deny claims because they say coverage was not in force, the application contained a misstatement, an exclusion applies, or someone else has a better claim to the money. The reason in the denial letter shapes everything about the response.
| Denial Reason | What It Usually Means | How We Respond |
| Coverage lapsed or ended | Premiums were missed, or group coverage ended with a job | We check the plan terms, notice requirements, and grace periods closely |
| Failure to convert or port | The insured didn’t move group coverage to an individual policy in time | We examine what the employer and insurer told the insured |
| Application misrepresentation | The insurer says the health history was misstated | We test whether the statement was material and whether the contest period had passed |
| Policy exclusion | A suicide or other policy exclusion is cited | We hold the insurer to the exact exclusion language and its burden of proof |
| Competing beneficiaries | Two or more people claim the same proceeds | Our life insurance claim lawyers present your claim |
A single denial letter can rely on several of these grounds at once, so every stated reason has to be answered in the appeal.
Group Life Coverage After a Job Ends
Group life insurance through an employer often ends when the job ends unless the employee converts or ports the coverage within a short window. Many of the claims we handle involve families who were told coverage had lapsed, even though the notices the insured received were incomplete or confusing.
We have recovered benefits both on appeal and in court in these conversion disputes.
The Contestability Period
Many life policies allow the insurer to investigate the application during an initial contestability period, typically two years. A death during that period often triggers a review of the insured’s medical history, and an insurer may try to rescind the policy for a misstatement even when it had nothing to do with the death.
Suicide and Other Exclusions
Many life policies exclude death by suicide within a set period after coverage begins, often two years, and some include other exclusions for specific causes of death. The insurer generally has to prove an exclusion applies, and the medical examiner’s findings, toxicology, and witness accounts can all bear on that question.
In one recent case, our client’s husband died, and the insurer denied benefits under a suicide exclusion. We appealed the denial, and the insurer reversed its decision and paid the benefits.
Click to contact our insurance claim lawyers today
What Is the Deadline to Appeal a Denied Life Insurance Claim?
For employer life insurance governed by ERISA, the plan must give you at least 60 days after a denial to file an appeal under the federal claims rules. Many plans allow only that minimum, which makes it the deadline families most often miss.
The same rules generally give the plan 60 days to decide the appeal, with one possible extension for special circumstances. If the plan doesn’t follow its required procedures, the claim may be treated as exhausted, which can allow a lawsuit to proceed sooner.
Deadlines to Sue
After a final ERISA denial, the time to file suit is usually set by the plan’s own limitations provision. Federal rules require disability denial letters to state that date, but life insurance denials carry no such requirement, so you need to check the plan documents directly.
Individual policies follow state law and the policy terms, so the deadline to sue can differ from one claim to the next.
Complete a Free Case Evaluation form now
What to Do After a Life Insurance Claim Denial to Prepare for an Appeal
You need information after a life insurance claim denial, and the documents you gather in the first few weeks can make or break a life insurance appeal.
Start with what you have, and let your life insurance claim attorney request the rest:
- The denial letter and the envelope it came in
- Any policy, certificate of coverage, or benefits booklet
- Recent pay stubs or benefits statements showing life insurance deductions
- Letters or emails about leaving a job, converting coverage, or premium notices
- The death certificate and any autopsy or medical examiner report
- Names of the insured’s doctors in the years before death
Pay stubs and benefits statements are especially useful in coverage disputes because they can show premiums were still being taken when the insurer says coverage had ended.
Ask for the Claim File in Writing
ERISA plans must provide relevant claim documents free of charge when you ask. A written request creates a clear record of what you asked for and when, and the file it produces often reveals what the insurer reviewed and what it overlooked.
Avoid Recorded Statements Before Advice
Insurers sometimes ask beneficiaries for recorded statements about the insured’s health or habits. Those statements become part of the claim file, so it helps to talk with a life insurance claim lawyer before giving one.
How a Life Insurance Attorney Builds the Appeal
We build life insurance appeals around evidence because, under ERISA, a judge usually reviews only the record the insurer had when it made its final decision. Our process follows our “Win My Benefits” Custom 5-Step Plan:
- Gather: Our team gets the policy, plan documents, enrollment records, and the insurer’s complete claim file.
- Organize: We’ll sort the evidence around each reason the insurer gave.
- Analyze: Your life insurance claim lawyer examines the policy language, notice requirements, and the controlling law.
- Build: We add new evidence, such as medical opinions, employer records, or witness statements.
- Execute: Your attorney submits a complete appeal, preparing for court if the insurer will not pay.
You have the right to a full and fair review, and the claim file usually shows where the insurer’s reasoning is weakest.
How Do ERISA Life Insurance Claims Differ From Individual Policies?
Employer-provided life insurance is usually governed by ERISA, while a policy you bought on your own is governed by state insurance law. That difference affects the remedies available, the court that hears the case, and the evidence a judge will consider.
ERISA claims require an internal appeal before a lawsuit, and the lawsuit may be filed in state or federal court. ERISA’s civil enforcement section allows a beneficiary to sue for benefits due under the plan, and the court may award reasonable attorney’s fees.
State-law bad faith claims tied to an ERISA plan are generally preempted under Pilot Life v. Dedeaux, so the federal benefits claim is usually the main remedy.
All states have their own insurance laws and deadlines. For example, individual policies issued or delivered in Louisiana (R.S. 22:1811) require the insurer to settle a death claim within 60 days of receiving due proof of death. If it fails to do so without just cause, the amount due bears interest at 8% per year from the date the insurer received proof.
FAQs: Life Insurance Attorney
How much does a life insurance attorney cost?
It costs you nothing to get started with our life insurance attorneys. You only pay a fee if we recover benefits for you. Our firm also fronts all case costs.
Can I fight a life insurance denial without a lawyer?
You can file an appeal without a lawyer, but the appeal often becomes the only record a federal judge will review in an ERISA case. A thin appeal can limit what a court considers later, which is why many families seek counsel before submitting it.
What happens if two people claim the same life insurance?
When two or more people claim the same life insurance proceeds, the insurer often files an interpleader lawsuit, deposits the money with a court, and asks the judge to decide who receives it. Each claimant then presents evidence about the beneficiary designation and any changes to it.
How long does a life insurance company have to pay a claim?
Under ERISA, a plan generally must decide an initial life insurance claim within 90 days, with one possible 90-day extension. For individual policies in Louisiana, the insurer must settle a death claim within 60 days after receiving due proof of death or pay interest on the amount due. Each state has its own rules.
Can a life insurance company deny a claim after paying premiums for years?
An insurer can deny a claim even after years of premiums, usually by citing an exclusion, a lapse, or a coverage gap after a job change. Long payment history does not settle the claim, but it can be important evidence when coverage status is disputed.
Get Answers After a Life Insurance Denial
A denial can feel final, especially when it arrives in the middle of grief, but you can challenge the insurer’s decision by addressing its reasons with the policy terms and supporting evidence. J. Price McNamara: Disability, Life, AD&D Insurance Attorneys can review the letter, explain your deadline, and tell you honestly what it would take to challenge it.
You don’t need to have every document in hand before you call. Tell us what the insurer said and when the letter arrived, and we’ll help you figure out what comes next, including whether a related AD&D or second policy claim may also be available.
Put a former insurance company insider on your side. Contact J. Price McNamara for a free denial review. Call 225-201-8311.
Call or text (225) 201-8311 or complete a Free Case Evaluation form
