Your Life Insurance Claim Was Denied. Now What?
A life insurance denial arrives on top of a loss you're still absorbing. This page explains why insurers deny claims, how ERISA and state law shape your options, and how Dorian Law builds cases that get denials reversed.
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Why Dorian Law's Approach to Life Insurance Claims Works
Life insurance is supposed to be the one part of a devastating loss that isn't complicated. When an insurer delays, disputes, or denies the claim, families are left fighting a company with far more resources and far less urgency than they have. Dorian Law exists to close that gap.
We build the case a court would need to see — from day one.
Most firms focus the appeal on the insurer. We focus on what a federal judge or jury would need to rule in your favor, then work backward. That's the Litigation Back Approach — a framework built from over 500 resolved disputes that keeps every letter, record request, and argument tied to the record we'd need if the case goes to court.
We've taken cases other firms turned down — and won.
From Los Angeles to San Diego to San Jose and nationwide, Dorian Law has recovered life insurance and AD&D benefits in cases involving misrepresentation allegations, lapse disputes, and contested claims that other attorneys declined to pursue.
"Brent Brehm is an excellent attorney. He assisted me in my case against a life insurance company. He is both knowledgeable and professional. With his expertise, my case was resolved in a very timely manner. I was extremely pleased with the settlement. I highly recommend Brent Brehm."
— Beverly, posted on AvvoCommon Reasons Life Insurance Claims Are Denied
Insurers cite a narrow set of reasons far more often than any others. Recognizing which one applies to your denial letter is the first step toward challenging it.
Misrepresentation or Fraud
The insurer alleges the applicant misstated health history, tobacco use, or other application details. This is the single most litigated denial reason in life insurance and has its own dedicated misrepresentation denial page.
Policy Lapse
The insurer claims premiums went unpaid before the date of death — sometimes correctly, sometimes because of a missed grace-period notice or an employer's payroll error on a group plan.
Policy Exclusions
The cause of death is excluded outright — suicide within the statutory exclusion window, or a death the insurer attributes to a specifically excluded activity.
The Contestability Period
Deaths within roughly the first two years of a policy trigger heightened insurer investigation. Discrepancies found during that window are the most common basis for post-claim underwriting denials.
Browse by Insurance Company
Denial tactics vary by carrier — the exclusions they lean on, how aggressively they pursue misrepresentation findings, and how they handle appeals differ from company to company. We're building out carrier-specific pages as our case experience with each insurer grows.
Don't see your insurer listed? We handle life insurance denials against every major carrier nationwide — contact us and we'll tell you what to expect from yours specifically.
Types of Life Insurance Policies We Handle
Term Life
Coverage for a defined period — typically 10, 20, or 30 years.
Whole Life
Lifelong coverage, often with a cash value component that grows over time.
Universal Life
Flexible premiums and death benefits that can be adjusted as circumstances change.
Group Life
A single contract covering an entire group — typically offered through an employer, association, or labor organization. Almost always governed by ERISA.
Accidental Death & Dismemberment
Pays a benefit when death results directly from an accident. See our full AD&D overview.
FEGLI
Federal Employees' Group Life Insurance. Governed by its own federal framework, not ERISA. Visit the FEGLI Lawyer for details.
Understanding ERISA and Life Insurance Claims
The Employee Retirement Income Security Act of 1974 (ERISA), codified at 29 U.S.C. § 1001 et seq., governs most employer-sponsored life insurance plans. Whether ERISA applies to your policy changes the deadlines you face, the evidence a court will consider, and the remedies available to you — so it's the first question we answer on every case.
When ERISA Applies
ERISA generally applies when a life insurance policy is part of an employer-sponsored benefits package in the private sector — including most group life and group AD&D coverage.
When ERISA Doesn't Apply
ERISA typically does not govern individual policies purchased outside an employer plan, or plans sponsored by government entities or churches. These claims proceed instead under state insurance law and bad-faith principles.
Fiduciary Duty
Under ERISA, the people who administer your plan owe fiduciary duties: to act with prudence, avoid conflicts of interest, and provide accurate information about the plan. A denial issued without a reasonable basis, or misleading communications about coverage, can amount to a breach — and open the door to remedies beyond the denied benefit itself, including equitable surcharge or reformation of the plan.
When More Than One Person Claims the Benefit
Sometimes the fight isn't with the insurer — it's with another claimant. When an insurance company faces conflicting claims to a death benefit, it can file an interpleader action: a lawsuit that names every potential claimant, deposits the disputed funds with the court, and asks a judge to decide who is entitled to them.
Interpleader actions commonly arise from unclear multiple-beneficiary designations, contested changes to a beneficiary made shortly before death, an outdated designation naming a former spouse, or competing creditor claims against the estate. Being named in one of these actions does not mean you'll lose — it means the outcome now depends on the strength of your claim and your representation.
We cover interpleader strategy in full on our dedicated Winning Interpleader page, including how these actions work and how we build a claimant's case for entitlement to the proceeds.
How We Can Help
Determine if ERISA applies. We review your policy and the circumstances of your coverage to establish which body of law governs your claim — and what that means for your deadlines and remedies.
Review your policy and denial letter. We identify the specific provisions the insurer relied on and where their reasoning is vulnerable.
Build the appeal record. Medical records, financial documentation, and witness statements — gathered with the eventual litigation record in mind, not just the appeal.
Negotiate. Many claims resolve without litigation once the insurer faces a well-documented, litigation-ready file.
Litigate when necessary. If the insurer won't reverse course, we file suit and represent you through trial.
Frequently Asked Questions About Life Insurance Claims
We typically work on a contingency fee basis — you pay nothing upfront, and we're only paid if we recover benefits for you. Hourly arrangements are available in some cases. Our interests are aligned with yours: if you don't win, we don't get paid.
Don't let the deadline pass while you decide. Contact Dorian Law for a free consultation — we'll review your denial letter, policy, and circumstances to assess your appeal options under ERISA or state law. Deadlines are strict and often shorter than people expect. See our Effective Life Insurance Appeals page for more detail.
The contestability period is typically the first two years after a policy is issued. During that window, the insurer can investigate the original application and deny claims based on alleged misrepresentations. After the period runs, the insurer generally must pay the claim absent fraud. We frequently challenge denials issued both during and after this window.
A material misrepresentation is a significant inaccuracy or omission — such as misstating medical history — that would have changed the insurer's decision to issue the policy or its premium. Insurers frequently overreach with this standard. Read more on our misrepresentation denials page.
Insurers can request reasonable documentation, but some overreach to delay or discourage a claim. If the demands feel excessive, we can step in to protect your rights and keep the process moving. More detail is on our Help Making a Death Claim page.
If you're asking, the answer is sooner rather than later. You don't need a denial in hand to get help — we can advise on claims in progress, insurer delays, or eligibility concerns before a denial ever arrives. Early guidance gives you the strongest position.
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