Why Are Supplemental Life Insurance Claims Denied?
Denials of supplemental life insurance benefits can come from several different angles. Sometimes, it’s the insurer who raises the issue. Other times, the denial stems from actions—or inaction—by the employer or even the employee.
1. Errors Made by the Employer
In many cases, the denial traces back to mistakes made by the employer during enrollment or administration. Common employer-related reasons for denial include:
Failing to submit completed EOI forms on behalf of the employee
Misrepresenting an employee’s eligibility for coverage
Incorrectly stating that coverage was approved when it never was
Not informing the employee that additional approval was needed for supplemental benefits
These employer missteps can create devastating consequences for beneficiaries. What’s worse is that employees often don’t know anything went wrong until after a death occurs and a claim is denied.
2. Mistakes or Omissions by the Employee
An employee might unintentionally contribute to a future denial by misunderstanding the policy or failing to follow up. For instance, a worker might believe that supplemental coverage is automatic when in fact, it required medical approval. Other times, an employee might forget to submit necessary health documentation, or they might provide inaccurate health information during the application process. Any of these issues could lead to a denial later.
3. Faulty Administrative Processing by the Insurance Company
Although less common, insurance companies are not immune to making clerical or administrative errors. If documents were lost, mishandled, or never processed correctly, coverage may never have been activated—even if the employee paid premiums. Unfortunately, insurers often fail to own up to these errors without pressure from a legal team.
How to Respond to a Denial of Supplemental Life Insurance
If you’ve received a denial letter, the first step is to request a clear explanation in writing. Both the insurer and employer must provide you with the specific reason for the denial. This documentation is crucial for your legal rights and can often reveal where the mistake originated.
Keep in mind that you are not powerless. Even if the denial appears final, an experienced life insurance attorney can review your case and determine if you have grounds for appeal. Many denied supplemental claims are reversed when employers fail to meet their legal duties or when insurers ignore their obligations under ERISA (if the policy is employer-sponsored).
When Legal Help Makes the Difference
Our firm regularly handles denied supplemental life insurance claims and knows how to uncover where things went wrong—whether it was a failure in enrollment, a lack of evidence of insurability, or a miscommunication between the employer and the insurance carrier. In many of these cases, we’ve recovered full benefits for surviving families after demonstrating that the employee took all reasonable steps to secure coverage.
Remember: insurance companies and employers are equipped with legal teams that prioritize their bottom line. You deserve the same level of advocacy. Working with a law firm that specializes in wrongful denials can make the difference between a failed claim and a six-figure payout.
Final Thoughts
The supplemental life insurance process is supposed to offer peace of mind—not confusion and legal roadblocks. Unfortunately, denials are common when claims aren’t administered properly or when policies are misunderstood. If you're facing a denied supplemental life insurance claim, don’t try to fight it alone. Our attorneys are here to investigate, advocate, and help recover the full amount your loved one intended for you to receive.