The Employer Never Sent the Conversion Notice. Who Pays?
It is one of the most common — and most preventable — life insurance disasters we see. An employee leaves a job, retires, or goes out on disability. The group life insurance that covered them for years quietly terminates. Nobody explains that they had a right to keep it. Months or years later they die, the family files a claim, and the insurer says there was no coverage. The family assumes they are out of luck. Often, they are not — because the employer and the insurance company had a legal duty to give notice, and failed.
The right almost nobody knows about
Most group life insurance policies contain conversion and portability rights. When group coverage ends, the employee typically has a short window — often 31 days — to convert the group coverage into an individual policy, or to port it, usually without new medical underwriting. That right is valuable, especially for someone who is already ill and could never buy new coverage.
The catch: the window is short, and the right is worthless if nobody tells the employee it exists. That is why plan documents and, in many states, insurance law require notice of conversion rights when coverage terminates.
When that notice never arrives
If the employer or plan administrator failed to send the required notice, the failure can create liability — against the employer, the insurer, or both. Courts have repeatedly held that a family should not lose a death benefit because of an administrator's paperwork failure, particularly where the employee would have converted had they been told.
Our firm recovered $840,000 from an employer that failed to send a conversion notice to a terminated employee, and secured a separate recovery for a beneficiary after an insurer failed to send a conversion notice. ***Prior results do not guarantee a similar outcome.
The situations where this comes up
Termination or layoff — coverage ends on the last day of employment or the end of that month
Retirement — the retiree assumes coverage continues; it often does not
Disability leave — coverage may continue under a waiver of premium provision, or may lapse if nobody files for it
Reduction in hours below the eligibility threshold
The employer changes insurers and the departing employee falls through the gap
What to look for
Did the employee receive any written notice of conversion or portability rights when coverage ended?
What does the summary plan description say the administrator was required to do?
Were premiums still being deducted after coverage supposedly ended? That is powerful evidence.
Did anyone at the employer tell the employee coverage would continue?
Was the employee disabled when coverage ended — triggering waiver of premium?
What to do
Request the summary plan description, the certificate of coverage, the complete claim file, and the employer's records of what notices were sent and when. Gather pay stubs. Then have the file reviewed — determining whether the insurer, the employer, or both are liable is the core question, and it is not obvious from the denial letter.
Contact Kadetskaya Law Firm, LLC
Our firm reviews denials for free and works on contingency — no fees unless we recover your benefits. If your life insurance claim has been denied otr delayed for weeks or months with no payment and no clear explanation, do not wait for the denial letter. The time to act is now.
(888) 510-2212
Free Consultation
No fees unless we win.
Kadetskaya Law Firm, LLC
630 Freedom Business Center Dr, 3rd Floor
King of Prussia, PA 19406
(888) 510-2212
info@life-insurance-lawyer.com
No fees unless we win.
Learn more about portable coverage denials and ERISA claims · denied life insurance claims and beneficiary disputes
***This page is for general informational purposes only and does not constitute legal advice. Contact our firm directly for advice specific to your situation.
