Denied Prudential Life Insurance Claim Successfully Resolved by Our Top Attorneys
Our top life insurance attorneys are pleased to announce the successful resolution of a denied Prudential life insurance claim. This claim involved an employer-sponsored group policy and was initially rejected due to allegations of misrepresentation during the application process. After conducting a comprehensive investigation, presenting new evidence, and challenging the insurer’s interpretation of the facts, we secured the full benefit for our client. This victory is one of many we’ve recently achieved against major insurers, including Iowa Farm Life, American Enterprise Life, Delaware Life, ReliaStar Life, Globe Life, Simplified Life, Christian Fidelity Life, Philadelphia American Life, and United Republic Life.
Why Life Insurance Claims Through Work Get Denied
Group life insurance policies provided through an employer can offer valuable protection—but they also come with pitfalls. Claims are often denied due to unique issues related to employment status, policy terms, and administrative missteps. Understanding the common reasons for these denials is crucial for beneficiaries pursuing a payout after the death of a loved one.
1. Misrepresentation or Non-Disclosure of Medical History
One of the most common reasons for life insurance claim denial—especially during the contestability period—is misrepresentation. When applying for coverage, even through work, employees may be required to complete health questionnaires or undergo basic underwriting. If an insured fails to disclose a pre-existing condition, ongoing treatment, or past diagnosis, the insurer may argue that the policy was obtained under false pretenses. This breach of the duty of uberrima fides—utmost good faith—can lead to denial if the omission is deemed material to the risk.
2. The Contestability Period
Group life insurance policies, like individual policies, generally include a two-year contestability clause. If the insured dies within two years of policy issuance, the insurer has the right to investigate the application for misstatements. If inconsistencies are found—whether intentional or not—the insurer may rescind the policy and deny the claim. After the contestability window closes, insurers can typically only deny a claim based on fraud or non-payment of premiums.
3. Policy Exclusions
Most life insurance policies have specific exclusions. Common exclusions include death by suicide during the first two years of the policy, death resulting from illegal activity, or engaging in high-risk activities such as scuba diving, mountain climbing, or operating aircraft. If the death falls within an excluded category, the claim may be denied—even if the policyholder was otherwise covered.
4. Employment Status and Group Policy Complications
Employer-sponsored policies present unique challenges. If the insured was no longer employed at the time of death, the claim may be denied due to ineligibility. Many group policies terminate coverage upon job separation—unless the employee takes advantage of conversion or portability options to continue the coverage independently. Failure to convert the policy in time can result in a lapse. Likewise, discrepancies between employer and insurer records can result in a wrongful denial—particularly if an employer failed to remit premiums or misrepresented the insured's eligibility status.
5. Administrative Failures and Recordkeeping Errors
Another overlooked issue involves administrative errors made by HR departments or benefits administrators. For example, an employer might tell an employee they are covered when they are not, or fail to submit necessary forms to the insurer. In such cases, we investigate both the employer's and insurer's conduct to determine liability. Our firm has successfully recovered life insurance proceeds even when coverage was allegedly not in force—by proving negligence or miscommunication.
We Handle All Denied Life Insurance Claims—Group or Private
Whether your claim involves a group policy through work or a private life insurance policy, our attorneys can help. We handle:
Denied claims based on misrepresentation or exclusions
Contestability period disputes
Group policy terminations and conversion issues
Beneficiary disputes and interpleader lawsuits
Delays and bad faith claim handling
We’ve successfully resolved claims for clients across the U.S., recovering policy proceeds that were initially denied for unjust or unlawful reasons. Our results include wins against both private life insurance companies and employer-sponsored group policy administrators.
No Win, No Fee—Nationwide Representation
We work on a contingency basis, which means you pay nothing unless we win your case. Our firm offers free consultations and handles life insurance litigation in all 50 states.
FAQ: Denied Life Insurance Claims Through Work (Group Policies)
Why do life insurance claims through work get denied?
Common reasons include misrepresentation during the application, the death occurring during the contestability period, policy exclusions, or the insured no longer being eligible due to job termination or retirement.
What is a conversion option in group life insurance?
A conversion option allows an employee to convert their group life coverage into an individual policy upon leaving their job. If this is not done within the designated time frame (usually 31 days), coverage may lapse.
What happens if the employer failed to submit paperwork to the insurer?
If employer negligence resulted in coverage being lost or not activated, we may hold the employer or administrator liable. Courts have ruled in favor of beneficiaries in cases involving administrative error.
Can a claim be denied due to suicide?
Yes—if the suicide occurs within the first two years of the policy, most policies include a suicide exclusion clause. After that period, suicide is generally covered.
What is a contestability investigation?
If the insured dies within two years of the policy’s start date, the insurer may investigate the original application for errors or omissions. Misrepresentation during this time can result in denial.
Can I sue for a denied life insurance claim?
Yes. If the denial was improper or based on incorrect legal reasoning, you have the right to challenge the denial in court. We file lawsuits and appeals on behalf of clients nationwide.
Does it matter if the claim was denied due to employer error?
Yes. We can pursue legal remedies even when an employer or benefits administrator caused the loss of coverage due to negligence.
Is there a time limit to file a claim or appeal a denial?
Yes. Group policies, especially those governed by ERISA, have strict deadlines for filing appeals and lawsuits. Contacting an attorney quickly is essential.