Legal Question in Insurance Law in Georgia

The first, and perhaps only, question is do you qualify for the benefit under the terms of the insurance contract? From your post, you do not and your request was denied on that basis. You mention a "form file" (without telling us what that is), or what someone told you. You are far from clear on that, but had they told you the correct information, or the "form file" had been correct, would you have been ineligible? It seems like your complaint is more along the lines that you did not know you were not eligible ... but you would have been ineligible either way?

In my opinion there is a basis for you to challenge this decision although you will have to jump through a number of hoops. First, since this life insurance policy is through your employer it is covered by the ERISA statute which is complicated and always favors the insurer. You will have to "administratively appeal" (that is what they call asking the insurer to look at it again) before you can challenge it in a real court. Then, the case has to be brought in Federal court, with all its arcane rules and pomp and circumstance. That said, if you can prove a difference between the Summary Plan Description (the documents they gave you) and the Plan (policy) itself you can win. Also, this provision seems to me to violate the laws against age discrimination, as well. That could operate to void the offensive clause, too. Do NOT try to do this without a lawyer who knows about ERISA and is experienced in litigation against insurance companies. There is also a possible class action here as the insurer is probably doing this to lots of other people nationwide.