Employer-provided life insurance is one of the most common benefits offered to Florida employees. But when a loved one passes away and the policy was purchased through their job, beneficiaries are often surprised to learn that the rules are very different from those governing private policies.
If you are facing a denied claim or beneficiary dispute involving workplace life insurance in Florida, understanding your rights is critical.
Is Employer-Provided Life Insurance Different?
Yes. Many employer-sponsored life insurance policies are governed by a federal law called the Employee Retirement Income Security Act of 1974 (ERISA).
ERISA changes:
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Where your case can be filed
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What damages you can recover
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The procedures you must follow before filing suit
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The timeline for appealing a denial
This is very different from a privately purchased life insurance policy governed primarily by Florida contract and insurance law.
What Types of Employer Life Insurance Policies Exist?
Employer-based coverage typically falls into two categories:
1. Basic Group Life Insurance
This is often automatically provided at no cost to the employee. Coverage amounts may be:
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1x salary
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A fixed amount (e.g., $25,000 or $50,000)
2. Supplemental or Voluntary Coverage
Employees may purchase additional coverage through payroll deductions.
Both types are commonly subject to ERISA if offered as part of an employer-sponsored benefit plan.
What Are Your Rights as a Beneficiary?
If you are named as the beneficiary under an employer-sponsored life insurance policy, you generally have the right to:
ā Receive Plan Documents
You can request:
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The full insurance policy
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The Summary Plan Description (SPD)
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The administrative record if the claim is denied
These documents explain the insurer’s obligations and your appeal rights.
ā File an Administrative Appeal
Before filing a lawsuit, ERISA requires you to go through the insurance company’s internal appeal process. Missing deadlines can permanently bar your claim.
ā File a Federal Lawsuit
If the appeal is denied, you can file suit in federal court under ERISA. However, ERISA cases are typically decided based on the written record — not a jury trial.
What Happens If the Claim Is Denied?
Life insurance claims through employers are often denied for reasons such as:
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Alleged misrepresentations on enrollment forms
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Coverage lapses due to employment termination
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Failure to convert group coverage after leaving employment
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Disputes over beneficiary designations
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Claims that the employee was not actively at work
Under ERISA, you must carefully build your case during the administrative appeal phase because you may not be allowed to introduce new evidence later.
Can You Recover Extra Damages?
In most ERISA-governed cases, you can typically recover:
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The policy benefits
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Possible interest
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Attorney’s fees (in some cases)
You generally cannot recover:
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Emotional distress damages
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Punitive damages
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Bad faith damages under Florida law
This is one of the most significant differences between employer-based policies and individually purchased policies.
What If There Is a Beneficiary Dispute?
Employer-based policies frequently involve disputes between:
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Current spouses and former spouses
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Children from prior marriages
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Competing named beneficiaries
Under ERISA, the insurance company usually must follow the plan documents strictly.
If there is uncertainty, the insurer may file an “interpleader” action in federal court and let the court decide who receives the proceeds.
What If Employment Ended Before Death?
Many disputes arise when:
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The employee was terminated
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The employee retired
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The employee went on disability
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COBRA coverage was misunderstood
In some cases, group coverage can be converted to an individual policy. Failure to properly notify the employee of conversion rights can create legal issues.
Are All Employer Policies Governed by ERISA?
No. Some plans are exempt, including:
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Government employer plans
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Church plans
These policies may be governed by Florida state law instead of ERISA, which can significantly change your legal options.
Key Deadlines You Must Know
Employer-based life insurance claims have strict deadlines:
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60–180 days to file an appeal (depending on the plan)
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Plan-specific time limits for filing suit
Missing these deadlines can permanently bar recovery — even if the denial was wrongful.
What Should You Do If a Claim Is Denied?
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Request the complete claim file immediately
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Calendar the appeal deadline
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Review the policy language carefully
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Submit all supporting medical and employment records during the appeal
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Consult an attorney experienced in Florida life insurance disputes and ERISA litigation
Because ERISA cases are often decided on a paper record, the appeal stage is the most important part of your case.
Final Thoughts: Employer Life Insurance Claims Are Legally Complex
When a Florida life insurance policy was purchased through an employer, your rights may be governed by federal law — not Florida insurance bad faith law.
The difference can dramatically affect:
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Where your case is filed
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What damages you can recover
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How your claim must be handled
If your claim has been denied or delayed, acting quickly and strategically is critical.
If you are dealing with a denied employer-sponsored life insurance claim in Florida, understanding whether ERISA applies may be the most important step in protecting your rights and recovering the benefits your loved one intended for you to receive.
Have you or someone you know been denied a life insurance claim? Contact Florida Life Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Miami Attorney Gonzalez-Sirgo directly at jp@yourattorneys.com or by text at (305) 929-8935.
This article is for informational purposes only and does not constitute legal advice.
