If you have a benefits plan through your employer, then you might have heard of the term ERISA. The Employee Retirement Income Security Act covers employee benefit plans, including long term disability, health plans, pensions, and retirement plans. It has been in existence since 1974.
ERISA does many things. It requires plan sponsors to provide participants with information about the plan. It establishes standards of conduct for those who oversee and administer the plans. Most importantly, it ensures that the funds in the plan are protected so that when a participant needs the money, it is readily available. The funds are protected even if a company goes bankrupt.
However, not all plans are covered under ERISA. In order for a policy to be covered, it must be a fund, program, or plan established by an employer or employee organization. It must also be provided to employees and/or their beneficiaries for the purpose of providing benefits for medical issues, disability, accidents, death, unemployment, and vacation.
In 2013, ERISA protected 2.4 million health plans, 2.4 million welfare benefit plans, and 684,000 retirement plans. ERISA is important because it protects plans from abuse and mismanagement. It also holds plan sponsors accountable for their actions. It is enforced by the Internal Revenue Service, Employee Benefits Security Administration, and the Pension Benefit Guaranty Corporation.
While ERISA appears to be very helpful to employees, that is not always the case. ERISA has changed a lot since it was first implemented in 1974. It has, unfortunately, become less and less employee friendly. When ERISA cases go to court, judges tend to side with the insurance company. In addition, these cases now go to federal court, and very few lawyers are familiar with the procedures involved with trying a case in federal court.
In many ERISA cases, there are no trials. Many judges now solely use evidence that the insurance company received before the lawsuit was even filed. This can be detrimental to one’s case, especially if new evidence resurfaced later on.
Even if you do win your case, your benefits will be limited. You are not allowed to receive benefits due to the wrongful denial. Punitive damages are also gone. If you win your case, you will only get your benefits repaid and maybe attorney’s fees if you are lucky.
Although ERISA is supposed to protect employees, disability insurance policies tend to favor the insurer. If you have been disabled due to an injury, you may not receive the benefits you deserve.
If your claim has been denied, do not let that stop you from obtaining the benefits you are entitled to receive. It is time to take legal action with a Raleigh ERISA lawyer. Contact the Law Offices of J. Price McNamara. As a former insurance company attorney, he has knowledge about the process and understands what happens on the other side. He is done representing insurance companies and is ready to represent you. He has your best interests in mind. Schedule a free consultation today by visiting our website.
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