Employer Responsible for Denied Claim Due to Failure to Send Conversion Notice

Our client was a beneficiary on her late husband’s life insurance policy through his work. Her claim had been denied due to his failure to submit a conversion application

Her husband stopped working after he was diagnosed with cancer. To ensure that his wife received the life insurance proceeds after his death, he consulted with his employer before leaving work. The Employer’s Human Resources Manager assured him that his benefits would continue. The Human Resource Department then set up life insurance premium deductions from his compensation. The insurance company accepted premiums for his life insurance coverage for two years prior to his death. The employer sent him his Benefits Confirmation and Summary confirming that he had valid life insurance coverage. Both the insured and his wife were convinced that the life insurance coverage remained in effect. 

After his death, however, the insurance company denied our client’s claim. In its denial letter, the insurance company stated that the claim was denied because at the time of his death the insured had no coverage. The denial letter explained that since the insured never returned to work following his illness and since he never completed a Conversion application he was never covered under the policy. It came as a shock to our client who paid for this coverage for 2 years and had several documents from the employer confirming that the coverage was in effect. 

We were proud to have been able to reach a result satisfactory to our client. She received the full benefit due to her under the policy and avoided costly and lengthy litigation. Our life insurance attorneys worked diligently to protect our client’s rights and held the employer liable for its failure to provide a conversion notice and the numerous misrepresentations made to the insured about the effectiveness of his life insurance coverage. 

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