When a loved one passes away, it can be one of the most difficult and emotional times in life. If the deceased had employment-based life insurance, it can provide a financial safety net for the surviving family members and beneficiaries. However, navigating the process of filing a claim for life insurance can be confusing, especially when it comes to understanding the terms and conditions that apply. At times like these, it’s important to have the right support and guidance. If you’re facing challenges with an employment-based life insurance claim, know that you don’t have to go through it alone. The legal team at Trief & Olk understands what you’re going through and is here to help you navigate these tough circumstances.
What Is Employment-Based Life Insurance
Employment-based life insurance, often referred to as group life insurance, is a type of life insurance policy that an employer offers to employees as a benefit. This type of insurance provides coverage for employees and sometimes their families. Unlike individual life insurance policies, employment-based life insurance is typically purchased by the employer for a group of employees, and the premiums are often subsidized by the employer.
One of the main reasons employers offer this benefit is to help employees financially in the event of their death. While the employer generally handles the administrative aspects of the policy, the beneficiaries—the individuals designated by the employee—will receive the life insurance payout in the event of the employee’s passing.
Understanding Key Terms of Employment-Based Life Insurance
There are several important terms that beneficiaries should understand when it comes to employment-based life insurance. These terms help explain how the policy works and what to expect when filing a claim. Having a basic understanding of these key terms can make the entire process clearer and less stressful.
Policy Beneficiary
The beneficiary is the person or group of people who will receive the life insurance payout when the employee passes away. It is important for the employee to designate a beneficiary during the enrollment process. Without a proper beneficiary designation, the life insurance payout may go to the employee’s estate, which could lead to complications.
As a beneficiary, you may be required to provide proof of your relationship to the deceased or complete forms to make sure you are properly listed as the recipient of the payout. It’s crucial that the beneficiary information is updated whenever there are significant life changes, such as marriage, divorce, or the birth of a child.
We contacted Trief & Olk to help us with a life insurance issue and Shelly Friedland was the attorney assigned to our case. Before Shelly took our case she explained to us that the likelihood of our success without going to court was possible but not likely. Unfortunately we did not get the outcome we had hoped for but it was our decision to not move forward and have our case litigated. Shelly is very knowledgeable and was very straight-forward in her assessment of our case as we moved forward. She was very patient and thorough in answering our questions. She always responded in a timely manner and listened to our concerns. We would certainly recommend Shelly and would use her firm again in the future.” - John Ramig If there is any possibility of winning your life insurance case – this is the place to do it for you. They are efficient, honest and will achieve the best possible outcome. Shelly Friedland worked on my case where a life insurance policy had lapsed and was even a few days beyond the grace period. Farmers had rejected my claim twice and was unwilling to take a second look. Shelly was able to get them to pay the entire claim without going to court, and the full amount was deposited in my account within a couple months. Highest recommendation.” - Kathleen Brown Trief & Olk is a superior law firm. Their attorneys and other legal professionals have a brilliant understanding of the law and the litigation process. They diligently perform their work in an efficient, strategic and cost-effective manner to ensure the best possible outcomes for their clients. - Christopher Hughes
Premiums
Premiums refer to the amount of money that is paid to maintain the life insurance coverage. For most employment-based life insurance policies, the employer pays the premiums on behalf of the employees, though in some cases employees may be required to contribute a portion of the cost. If the employee leaves the company, they may have the option to continue the coverage by converting it into an individual policy, but they may be required to pay higher premiums on their own.
Understanding how premiums are paid can help beneficiaries avoid confusion about coverage and ensure that the policy remains active when it is needed most.
Policy Amount
The policy amount, or the death benefit, is the amount of money that the beneficiary will receive when the employee passes away. This amount can vary based on the terms of the policy, the amount of coverage the employee selected, and whether any additional riders were added to the policy. In some cases, the death benefit may be a fixed amount, while in other cases it may be tied to the employee’s salary or other factors.
Beneficiaries should always verify the policy amount to ensure they know what to expect when the claim is filed. Sometimes, employees have the option to increase their coverage during their employment, so it’s important to be aware of any changes in the policy amount over time.
Settlements & Verdicts
Claim Process
The claim process is the procedure that beneficiaries must follow in order to receive the life insurance payout. This process generally involves submitting a claim form along with the necessary documentation, such as a death certificate, proof of identity, and possibly additional forms requested by the insurance company. It’s important to follow the claim process closely to avoid delays or denials.
Each insurance company may have its own specific requirements for filing a claim, and beneficiaries may need to work with the employer to ensure the necessary paperwork is submitted in a timely manner. If complications arise during the claims process, it’s important to seek legal assistance to protect your rights.
Conversion Options
Some employment-based life insurance policies allow employees to convert their group coverage into an individual policy if they leave the company. This is referred to as a conversion option. This can be especially useful if the employee is in good health and wants to continue their life insurance coverage after leaving the company. However, the premiums for an individual policy may be higher than the rates available through the employer’s group plan.
As a beneficiary, understanding whether the employee had this option and whether they converted the policy can be important when determining how the claim will be handled.
Exclusions
Exclusions are specific situations in which the life insurance policy will not pay out a death benefit. Common exclusions may include deaths that result from suicide within a certain period after the policy is issued, deaths caused by illegal activities, or deaths that occur during high-risk activities such as certain types of travel or extreme sports.
Beneficiaries should carefully review the policy’s exclusions so they know what circumstances might prevent the payout from being issued. If there are concerns or uncertainties about exclusions, legal assistance can help clarify the situation.
Important Deadlines
Every life insurance policy has deadlines for filing claims, and missing these deadlines can result in a denial of the claim. Beneficiaries should be aware of these time limits and ensure they submit the necessary paperwork as soon as possible after the employee’s death. If you’re unsure about the deadlines or need help with the claims process, an experienced attorney can assist you in meeting these important deadlines.
What To Do If the Claim Is Denied
Sometimes, insurance companies may deny claims for employment-based life insurance. A denial can happen for many reasons, including missing information, failure to meet certain criteria, or issues with the policy’s terms. If you are the beneficiary of an employment-based life insurance policy and your claim is denied, it’s important to understand why the denial occurred.
In many cases, a denial can be appealed, and the process may involve submitting additional documentation or clarifying information that was initially overlooked. An attorney can help you navigate the appeals process and fight for the benefits you are entitled to.
Dealing with the death of a loved one is never easy, and understanding the ins and outs of employment-based life insurance can add an additional layer of stress. However, knowing the key terms related to the policy can help alleviate confusion and ensure that you are properly prepared to file a claim. The process can be overwhelming, but having the right legal support can make a significant difference.
If you need assistance with your employment-based life insurance claim in Massachusetts, Trief & Olk is here to help. Our team has experience in handling life insurance cases and can guide you through the process, ensuring that your claim is filed correctly and efficiently. We understand the emotional toll that such cases can take, and we are dedicated to achieving the best possible outcome for you. Contact us today to get the support you need.