Our past years of representing insurance companies taught us a thing or two about how they work behind the scenes. Let our experience work for you.
ERISA creates specific procedures that insurance companies are required to follow whenever a person makes a claim, and furthermore limits access for workers to federal courts. However, long before you need to think about these provisions in the law, you must first file a claim with your insurance company.
Every insurance company in Louisiana maintains their own specialized procedures regarding applications for ERISA benefits. Still, there are some common factors that you can look for to potentially give yourself an advantage in the ERISA disability application process in Louisiana.
Receiving a bill should never be the first step in getting help. Our firm knows that when dealing with an ERISA, long term disability or insurance claim, what you need is answers, and we are here to provide them free of charge.
Our firm welcomes telephone calls or the opportunity to visit with you in person to answer any questions you may have. We also provide FREE comprehensive case reviews. There is no obligation to hire us as your ERISA attorney.
Too much is at stake to guess about the best approach and strategy for fighting your denied insurance claim — years and years of financial security.
After spending years representing insurance companies, we don’t guess. We know their playbook and how they work behind the scenes. Using that knowledge, we’ve developed our own Clear Advantage Process for fighting claims.
It’s personally satisfying to use what I’ve learned as an insurance company insider, now for the good — helping families reverse unfair denials of insurance benefits they paid for, need and deserve.
Price McNamara began his law practice in 1990 representing insurance companies.
In 1995, Mr. McNamara founded McNamara Law Offices, where he represents people across the U.S. who are wrongfully denied long-term disability insurance, life insurance, and accidental death insurance benefits, with special focus on ERISA claims and lawsuits.
His is a member of the Louisiana and Texas Bars, with office locations by appointment only in Baton Rouge, Metairie, and Houston. He lives in Baton Rouge, Louisiana with his wife and their three children.
“Price showed no fear. The only thing I can use to actively describe what I saw that day in court was someone standing there protecting our family and fighting for them at the same time…he took control of the situation and was truthful.”
“It was a smooth process. I didn’t have to guess about what was going to happen next…I was reassured that he was going to do the right thing. I was reassured that he was looking out for me.”
“He was ready to fight for me…I felt like he had my best interest in mind. It wasn’t just for the paycheck at the end.”
“Price worked for an insurance company in the past and now he’s working against the insurance company so it was because of that we trusted that he knew how an insurance company worked and how to fight them.”
“I feel blessed that I can help turn things around for my clients who have been denied that piece of mind of financial stability and we make sure that the insurance company and the court realize that these are actual people, these are families that are suffering greatly.”
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…
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…
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…
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…
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…
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…
My client’s cause for an ERISA accidental death and dismemberment denial lawsuit began when both Esther and her husband were involved in a tragic head-on collision with an 18-wheeler. This tragic accident resulted in severe injuries to Esther, as well as David’s untimely death.
Our client, a young husband with two children, sustained closed-head brain injury as a result of an automobile accident. The at-fault driver’s insurance company initially refused to pay, but shortly before trial, agreed to pay the entirety of its insurance policy limits of $2,000,000.
Our client was a floor hand and Jones Act seaman who suffered a shoulder injury while working for Blake Offshore, LLC. Suit was filed in federal court in New Orleans. Blake and its insurance company offered relatively little in settlement, so the case proceeded to trial.
Our client sustained a fractured hip and reduced ability to earn wages in the future as a result of an accident sustained on the offshore drilling rig to which he was assigned. Suit was filed in federal court in New Orleans.
Every insurance company has their own procedures to file a claim. However, ERISA requires these insurance companies to provide their customers with a Summary Plan Description, or SPD. The SPD provides information about what benefits the plan provides, as well as how a potential recipient could file a claim for those benefits.
In general, an application for benefits will ask for information concerning:
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A successful application should state that the injury or illness did not occur while at work, as that scenario would make it a workers’ compensation claim. It should also state that the condition has been ongoing for a number of months and is expected to last for many months into the future. All this information must be verified by a licensed doctor or therapist.
All long term disability plans have a built-in waiting period for people wishing to make a claim. This waiting period is designed to filter out conditions that result in a quick recovery. This waiting period varies on a plan by plan basis, but generally lasts for around three to six months.
A potential applicant cannot file a claim during this time, but they should be visiting with their doctor to receive treatment and obtain that doctor’s professional opinion as to the extent of the condition. Many people are protected by short-term disability plans that can provide income during this waiting period. Potential applicants should consult with their plan’s SPD to identify the proper waiting period.
ERISA strictly controls when an insurance company must make a decision after a worker files a claim. The law states that most claims must be decided within 45 days after receipt by the insurance company. In special situations, the company can apply for a 30-day extension.
After this time passes, the insurance company must either begin to issue benefits or provide the worker with a detailed letter explaining the reason for the denial. This letter should also contain instructions on how to file an appeal.
Anyone who wishes to take advantage of their employer’s long term disability program must follow strict rules. These rules are in place to prevent fraudulent claims and to ensure that insurance companies have all the information they need to make informed decisions.
This process includes making doctor visits, gathering relevant information, and filing the application after completing a waiting period. An attorney could help you understand the ERISA disability application process in Louisiana. They could also assist if you already filed an application and received a denial. Call today to see what options may be available to you.
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