ERISA cases are highly unusual in that they are not tried before a jury, and in most cases the federal judge who has sole discretion over the outcome of the case is compelled by the law to give deference to the insurance company being sued. Claimants have no opportunity to speak to the judge, call or cross examine witnesses, or introduce new evidence. The only information that will be considered is that which is contained in the administrative record.
Although it may seem as though the laws are stacked against you, ERISA cases can be won with the aid of an experienced attorney. J. Price McNamara has stood up to the largest, most powerful insurance companies in the nation, representing a variety of injured employees who were denied the benefits to which they were entitled.
The following descriptions of complications that commonly arise in ERISA lawsuits are not meant to discourage you from pursuing your benefits in court. Rather, they are intended to emphasize the importance of securing skilled legal counsel if you want to even the odds against you:
Because ERISA law trumps state laws regarding insurance and disability claims,ERISA lawsuits must be filed in a United States District Court, which is a federal court. ERISA lawsuits filed in state courts are generally not dismissed, but rather “removed” to the appropriate federal courts. Once the suit reaches a federal judge, he or she will examine the complaint meticulously to ensure that it meets the pleading requirements established by the official plan document.
If the federal judge reviewing the case finds that the claimant has not fulfilled his or her obligation to exhaust all administrative remedies after the denial of his or her claim, as specified in the summary plan description (SPD) and including the possibility of two rounds of appeals, then the case may be dismissed with prejudice.
While ERISA allows employees to file a lawsuit after the final denial of their claims, the law does not specify which party should be named the defendant in such suits. The courts have arrived at contradictory decisions regarding this matter:
Naming the incorrect defendant can put a lawsuit in immediate jeopardy.
Although they are not successful in most cases, the defendants named in ERISA lawsuits often file a motion to dismiss for failure to state a claim on which relief may be granted. In other words, the defendant asks the court to dismiss the lawsuit on the basis that the claimant failed to present sufficient facts to indicate that he or she was entitled to legal remedy. This motion is usually rejected on the grounds that the claimant has presented sufficient facts to make a claim at least superficially plausible.
In fact, in many ERISA cases, discovery – the allowance of the plaintiff and the defendant to “discover” the evidence the other side has to present – is not permitted. Generally, any document that is part of the administrative record is allowed to be submitted into evidence and is the only evidence considered by the court. The only instance in which discovery is allowed is when there are claims of due process violations or bias on the part of the plan administrator.
I needed an attorney with a specific specialty and Price McNamara was definitely the right choice. His representation was based on principles that are probably unsurpassed by any other attorney in the field. McNamara represents individuals, not big-money corporations, like so many others in his field of specialty. He is a consummate professional, extremely knowledgeable
I found Mr. McNamara to be practical and efficient. He did what I needed in a reasonable amount of time, keeping me well informed and with excellent results. He communicated with me clearly and on a timely basis. I will use him in the future.
I am a current client of Mr. McNamara’s. He is very accessible and responds to my emails and phone calls in a timely manner. I find him to be very professional and knowledgeable, as well as ready, willing and able to address all of my questions and/or concerns.
I am an attorney. Price represented me, and in a separate suit represented my daughter, for injuries. He moved the cases at lightning speed and obtained maximum recovery. I was grateful and surprised. I would recommend Price to anyone who wants a top-notch attorney who gets results.
I would recommend Mr. Mcnanmara to anyone at any time. He was the best attorney that my family and I came in contact with. About three years ago we had a very tragic, accidental death in our family and the company knew that it was their fault but of course tried passing the buck. Mr.
Price and Sara are great. They helped us in a time of need. Their communication was always spot on and I never felt out of the loop with what was going on with our case.
Price is very professional, honest, and reliable. Whatever he says, he will follow through with the utmost integrity. He will turn over every stone and pays close attention to even the smallest detail. I’m glad I secured his services.
Without going into the painful details regarding the reason for having to hire Price, his compassion and communication helped my family during an extremely difficult time. If you need legal help because you or a family member was injured by something or someone else, don’t hesitate to call him.
Complete the confidential form below for a free, no obligation case evaluation and we’ll tell you how we can help.
You may also call us at the number below. J. Price McNamara and his legal support team are focused on building a strong case for you.
How did we do?
Note: Your review may be shared publicly.