All people have the reasonable expectation that an employer-provided benefit plan will provide payments when called upon. However, insurance companies make their profits by collecting premiums but refusing to issue payments.
Their reasoning for refusing to provide payments can vary and may include the claims being outside the scope of protection, a failure to provide accurate information on an application, or fraud. However, disputes over benefits are common matters decided by Alabama civil courts. But when the dispute involves a plan governed by ERISA, the procedure changes.
A Birmingham ERISA lawyer could help those who need to enforce the terms of an employer-provided benefit program. A practiced insurance attorney can work to identify the reasons for the denial, formulate a strategy to move forward, and deal with the complications presented by ERISA.
ERISA is a federal law and regulatory scheme that controls employer-provided benefit programs. These typically include life insurance, retirement plans, and health insurance. Many employers use these plans to provide an incentive for skilled workers to take jobs at their company. In addition, workers may view these plans as a necessary source of alternate income for the present and future.
ERISA states that these plans must provide a minimum level of protection. In addition, the insurance plan providers must form and implement appeals processes whereby insurance disputes may be resolved. However, these appeals processes can have an unfortunate effect when an insurance company denies a claim and a beneficiary needs to file an appeal.
Birmingham’s workers, like those around the country, rely upon benefit packages provided by their workplaces for health and financial security. If they were to buy these plans on their own they would be able to ask a local courthouse to decide any disputes over the benefits denied on these plans. A courthouse in Birmingham will have jurisdiction to hear cases demanding enforcement of contracts.
However, employees with ERISA plans must seek enforcement in other ways. In fact, ERISA law states that the providers of these plans must provide an appeals process for the resolution of disputes. Under this law, an aggrieved employee can only ask a court to decide the matter if all internal appeals are exhausted. These appeals are seldom successful since the policyholder must ask the company itself to reverse the decision that they have already made.
In addition, this delay can require a policyholder to wait weeks or even months to obtain the benefits that they need. This could force a policyholder to put off vital surgery, delay retirement, or even cause the families of the deceased to wait for death benefits. A Birmingham ERISA lawyer could help identify the necessary procedures and follow them efficiently.
Employer-provided benefit packages provide physical, mental, and financial stability to employees and their families. Many companies use these packages as a way to lure top talent. While these policies have undeniable value, they do place many policyholders in a difficult position if their claims are denied.
ERISA law states that insurance disputes over employer-provided plans must go through an extensive internal appeal process before a court can decide the issue. A Birmingham ERISA lawyer could help you pursue these appeals and take the case to a Birmingham court if necessary to demand enforcement of a policy. Contact an attorney today to discuss your case.
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