The federal laws and regulations known collectively as ERISA can complicate many relationships between insurance companies and those they insure. Because ERISA controls benefit packages that provide services to employees, policyholders who wish to take advantage of their benefits may have to take extra steps.
ERISA states that holders of employer-provided benefits must fully exhaust all internal appeals processes before a court can become involved. This can frustrate many policyholders who are forced to wait for long periods to collect compensation. An Austin ERISA lawyer could you determine your options for collecting the benefits you need. Reach out to an experienced attorney today to discuss your case.
The Employee Retirement Income Security Act or ERISA originally controlled employer-provided retirement plans. Over the years, Congress has expanded these laws to control all employer-provided benefits plans. This includes:
ERISA performs a number of functions. Most relevant here are creating a baseline that all insurance companies that provide these plans must follow and establishing rules for appealing decisions made by insurers.
This appeals process rule is especially important if policyholders and insurers come to conflict over whether benefits should be issued. ERISA requires companies to create an appeal process and requires policyholders to follow this procedure before taking a case to court. This process is generally a waste of time for policyholders who may need to take advantage of these plans at a critical time. An Austin ERISA lawyer could help those in need of their benefits deftly navigate the ERISA process.
ERISA plans must follow different appeal rules than individually obtained policies. The holders of individual policies can demand that a court immediately order the insurance company to honor their policy. This is because an insurance policy is no more than a contract between the two parties. This contract states that the insurance company will provide benefits if the holder pays premiums.
While ERISA questions may ultimately be decided by a similar court in Austin, the policyholders must exhaust the insurance company’s internal appeals process. These processes will vary from company to company and from policy to policy. Only once this is complete will a court accept a case for trial. An Austin ERISA lawyer could help policyholders understand these processes and pursue cases in court when appropriate.
The benefits packages and insurance programs offered as perks by many employers form the core of any person’s decision to take a job. These plans are regulated and controlled by the federal ERISA laws. These laws require employers to create internal appeals processes in case of a dispute. Only once this is complete will a court hear a case from a policyholder demanding enforcement of a policy.
An Austin ERISA lawyer could help you determine whether your plan is controlled by ERISA and how this affects your quest to collect benefits. They can also help pursue the necessary appeals and file suit in court. Contact an attorney today to discuss your case.
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