Many jobs in Athens and around Georgia offer fringe benefits as a way to attract top talent to their company. This can include discounted health insurance plans, retirement investment accounts, and life insurance policies. These perks will often influence an employee’s choice of jobs and may even make the difference in decisions concerning continued employment.
With such an emphasis on these plans as a central part of choosing where to work, it is only fair that the employees be able to rely on those plans when needed. Sadly, disputes over whether a plan applies to a worker’s specific situation are common. When these disputes concern a work-provided benefit plan, any disagreement is controlled by ERISA.
An Athens ERISA lawyer could help employees and their families who are having difficulties obtaining benefits under plans that are controlled by ERISA. A detail-oriented lawyer could work to help you understand the applicable laws and pursue appeals needed to obtain the benefits you deserve.
The Employee Retirement Income Security Act or ERISA, is a federal law that was first enacted in 1974. This law was intended to create a baseline of regulations for all employer-provided benefit packages. While this may seem like it is a good thing for workers, in reality, this framework only serves to delay the receipt of many benefits.
This is because ERISA controls when a courthouse can hear a case concerning disputes between insurers and their policyholders. Typically, a disagreement between an insurance company and a policyholder is a matter concerning the enforcement of a contract. Civil courts in Athens and throughout the state have the authority to hear and rule on these matters.
However, an ERISA controlled policy requires the policyholder to exhaust all internal appeals processes established by the insurance company. This can cause weeks or even months of delay while a policyholder may be desperately waiting for resolution. An Athens ERISA lawyer could help navigate these appeals processes quickly to allow the case to get to court as soon as possible.
All the same issues of contention in insurance cases between independently controlled policies affect ERISA governed claims. This is because outside of the fact that a policy is controlled by ERISA, these plans are identical to the others.
Examples of ERISA policies and disputes include:
Normally, if an insurer denies a claim, a policyholder can allege simple breach of contract in a civil court. It is also true that a court may ultimately hear such disputes in ERISA policies. However, the claimant must first exhaust all internal appeals processes created by the insurance company before going to court. An Athens ERISA lawyer could help policyholders comprehend their policies and take appropriate legal action.
Failing to collect benefits on an insurance plan is a frustrating experience. It is reasonable to expect that plans will provide payment when their provisions are triggered. However, insurance companies make their profits by refusing to pay claims. When these refusals occur on policies governed by ERISA, the process for appeals becomes much more complex.
An Athens ERISA lawyer could help you exhaust the applicable insurance company appeals so that you can get the coverage you deserve. Contact an attorney today to learn more.
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