What Does an ERISA Life Insurance Attorney Do—and When Do You Need One to Recover Your Benefits?
When a loved one passes away, filing a life insurance claim should be straightforward. Unfortunately, beneficiaries often discover that the process is anything but simple—especially when the claim falls under ERISA, the federal law that regulates most employer-provided (group) life insurance policies.
If you are dealing with a delayed, denied, or mismanaged group life insurance claim, an ERISA life insurance attorney can be one of the most valuable resources you have. These lawyers focus on navigating the complex ERISA rules that govern employer-sponsored life insurance plans and help beneficiaries recover the money they are legally entitled to receive.
This guide explains what ERISA is, what an ERISA attorney does, and the signs that it’s time to hire one to recover life insurance death benefits.
What Is ERISA and Why Does It Matter for Life Insurance Claims?
The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for most employer-sponsored benefit plans, including:
Group life insurance
Accidental death & dismemberment (AD&D) policies
Disability insurance
Retirement and pension plans
Health insurance plans
If your loved one had life insurance coverage through their employer, the claim is likely governed by ERISA. This matters because:
1. ERISA Preempts State Law
Unlike individual life insurance policies, ERISA life insurance claims follow federal law—not state insurance law. This drastically changes the appeals process and even limits what evidence you can later use in a lawsuit.
2. ERISA Gives Insurers and Employers Specific Duties
Employers and plan administrators must provide accurate information, maintain coverage properly, and follow strict rules when processing claims.
3. ERISA Claims Have Highly Technical Deadlines
Miss a deadline—such as the administrative appeal deadline—and you may lose your right to sue entirely.
Given these complexities, hiring a life insurance lawyer experienced in ERISA is often essential, especially when a claim is denied.
What Is an ERISA Attorney?
An ERISA attorney is a lawyer who specializes in representing beneficiaries and plan participants in disputes involving employer-sponsored life insurance plans.
Unlike general insurance lawyers, ERISA attorneys understand:
Federal ERISA regulations
Plan administrator duties
Employer fiduciary obligations
Complex policy wording
Administrative appeal procedures
Federal court litigation rules under ERISA
When a life insurance company wrongfully delays or denies a claim, an ERISA attorney builds the appeal, gathers evidence, holds employers accountable, and—if necessary—files a federal lawsuit to recover the death benefit.
When Should You Hire an ERISA Life Insurance Lawyer?
You should contact an ERISA life insurance attorney if anything about your group life insurance claim seems off, confusing, or unfair.
Here are the most common situations where hiring an ERISA lawyer is critical:
1. Your employer or insurer gave incorrect or misleading information about coverage.
For example, they may have told the insured they had coverage when they did not—or provided an inaccurate Summary Plan Description.
2. Coverage was terminated without proper notice.
This is a frequent ERISA violation. Employers must notify employees of changes in coverage, continuation rights, or conversion options.
3. Your employer failed to inform you of your rights after termination.
If the insured left their job, went on medical leave, or became disabled, employers must properly explain continuation or conversion rights.
4. Premiums were deducted for coverage that never existed.
This is one of the most common reasons ERISA life insurance claims are denied, and it is often a breach of fiduciary duty.
5. Evidence of insurability issues
If the employee completed health forms and premiums were deducted—but the insurer later claims they were “never approved”—you need an ERISA attorney immediately.
6. The insurer refuses to provide the policy or plan documents.
Under ERISA, beneficiaries have a legal right to receive these documents upon request.
7. Your beneficiary rights were revoked without explanation.
If you were removed as beneficiary, this may violate ERISA rules or may involve an improper Qualified Domestic Relations Order (QDRO).
8. Your claim has been delayed with no clear timeline.
ERISA requires timely, transparent claim processing.
If any of the above has happened to you, a life insurance lawyer who specializes in ERISA can help protect your rights. You can call (888) 510-2212 for a free consultation.
What ERISA Attorneys Do to Help Recover Denied Life Insurance Benefits
ERISA life insurance claims require formal procedures, strong legal arguments, and detailed documentation. At our firm, our ERISA attorneys guide beneficiaries through every step, including:
1. Explaining Your Rights Under ERISA
We break down how your plan works, which federal rules apply, and what benefits you are entitled to receive.
2. Filing the Initial ERISA Claim
If the claim has not yet been filed, an attorney ensures all required documents are submitted correctly to avoid technical denials.
3. Addressing Claim Delays
Many denials begin as “delays.” ERISA sets strict deadlines for insurers. We ensure they comply.
4. Reviewing and Analyzing the Denial Letter
ERISA denial letters must include specific information about why the claim was denied. We identify inconsistencies, omissions, and legal violations.
5. Preparing the ERISA Administrative Appeal
This is the most crucial step.
ERISA limits future litigation to only the evidence contained in the appeal record, which means:
If evidence is missing from the appeal, you might not be allowed to present it later in court.
Our attorneys:
Conduct an independent investigation
Gather medical, employment, and coverage records
Interview witnesses
Identify fiduciary breaches
Draft a comprehensive legal appeal brief
Challenge inaccurate claim evaluations
A strong ERISA appeal often results in the insurer overturning its denial—saving beneficiaries months or years of litigation.
6. Filing an ERISA Lawsuit in Federal Court
If the insurer still refuses to pay, our ERISA lawyers litigate in federal court and fight to recover your full benefits.
7. Handling Beneficiary Disputes
If multiple people claim the same benefit, or if a QDRO is involved, an ERISA attorney protects your rights.
8. Addressing Employer Misconduct
ERISA attorneys can hold employers accountable for:
Mishandling enrollment
Failing to submit evidence of insurability
Misrepresenting coverage
Deducting premiums for nonexistent policies
Violating fiduciary obligations
These violations are often the real reason life insurance benefits are denied.
Can You Appeal an ERISA Life Insurance Denial Without a Lawyer?
Technically, yes—you can file your own ERISA appeal.
But you should not.
ERISA appeals are extremely technical, and insurers know most beneficiaries do not understand the rules. Common mistakes include:
Missing the appeal deadline
Submitting incomplete records
Failing to include expert opinions
Not recognizing legal violations
Relying on emotional arguments rather than legal standards
Not understanding what evidence will be allowed in litigation
Once the appeal window closes, your record is “locked,” and your attorney cannot add new evidence. That makes winning in federal court extremely difficult.
Hiring an ERISA life insurance attorney gives you the best possible chance of winning the appeal and securing your death benefits.
ERISA Attorney Fees: What Should You Expect?
Most ERISA life insurance lawyers—including our firm—work on a contingency fee basis, meaning:
You pay nothing upfront
You owe nothing unless we win your case
The fee is taken from the recovered benefits
This allows beneficiaries to pursue justice without financial risk.
If your ERISA life insurance claim has been delayed, denied, or mishandled, call (888) 510-2212 for a free case evaluation.
We represent clients nationwide, and our ERISA life insurance attorneys have the experience and results you can trust.
