Imagine spending years battling a serious illness, only to discover after your loved one’s death that their life insurance coverage lapsed without warning. That’s exactly what happened to Lorenza Avila—and her story is a wake-up call for anyone relying on employer-provided life insurance.
In Avila v. MetLife & Dell Inc., a federal court addressed a crucial issue: does an employer or insurance provider have a duty to inform a seriously ill employee of their right to keep life insurance coverage if they take certain steps before it lapses?
The Facts
Lorenza Avila sued MetLife and her late husband’s employer, Dell, under ERISA after MetLife denied her claim for life insurance benefits. Her husband, Arseny Lepiavka, had been a long-time Dell employee and was insured under a group life policy issued by MetLife. When he left work on disability due to cancer, neither he nor Avila received notice that his group coverage would end unless he proactively converted it to an individual policy. He passed away nearly a year after his group coverage ended.
MetLife claimed it had sent a notice of conversion rights. Avila denied ever seeing it and pointed to Dell’s intimate knowledge of her husband’s serious illness and disability status as evidence that Dell should have done more to alert him of the risk of losing coverage.
The Legal Issue: Fiduciary Duty to Inform
The central legal question was whether Dell, as a fiduciary under ERISA, had an obligation to inform Lepiavka of his conversion rights—even though he did not request that information directly.
Dell argued that under standard ERISA rules, there’s no fiduciary duty to explain plan terms unless a participant asks. But the court disagreed.
Drawing from existing Fifth Circuit case law, the court acknowledged that while a general duty to proactively educate employees does not exist, special circumstances can trigger such a duty. And in this case, those circumstances were clear:
Dell knew Lepiavka was battling cancer.
He had coordinated two separate disability leaves through Dell’s HR department.
The CEO of Dell personally offered assistance to him.
In other words, Dell wasn’t dealing with a nameless employee—it was dealing with someone whose medical struggles were well known within the company. That context mattered.
Why This Case Matters
The court ruled that Avila had alleged enough to plausibly claim a breach of fiduciary duty by Dell. This sets an important precedent: when an employer has actual knowledge of a participant’s vulnerable condition and the high stakes involved, it may be legally obligated to go beyond boilerplate notices.
This ruling reinforces a basic truth under ERISA: fiduciaries must act in the best interest of plan participants. That includes not staying silent when inaction could cause real harm.
What You Should Know
If you’re on long-term disability or leaving your job due to illness, don’t assume your life insurance coverage continues automatically. Here’s what to do:
Ask in writing about your conversion or portability rights.
Request a copy of your plan documents to see what deadlines or actions are required.
Document all communications with HR or the insurance provider.
Act quickly—these windows to convert or port coverage are usually short and unforgiving.
If you’ve already experienced a denial and believe you were not properly informed of your rights, consult an attorney who specializes in ERISA claims.
Our firm has decades of experience handling ERISA claims and life insurance denials. We know how to hold employers and insurers accountable when they fail to provide clear, timely, and necessary information.
If you’ve been denied life insurance benefits after the death of a loved one—or if you’re unsure whether your own rights have been properly explained—contact Stennett & Casino today. We offer compassionate, strategic legal representation with a focus on results.
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