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Long Term Disability / Life /
Accidental Death / ERISA

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.

Filing an Administrative ERISA Claim Denial Appeal in Louisiana

The Employee Retirement Income Security Act (ERISA) is a federal law that, while providing many important legal protections related to insurance, can serve as a hindrance for many policyholders who wish to appeal a denial of benefits. While ERISA does establish baseline standards that all employer-provided insurance plans must meet, it also places a burden on policyholders to exhaust all administrative remedies before demanding enforcement of a policy in court. As filing an administrative ERISA claim denial appeal in Louisiana can be an intimidating process, it is encouraged for anyone seeking such an appeal to seek legal counsel. Contact a knowledgeable ERISA disability claim denial lawyer to start discussing your options.


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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.

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Helping People Like You…

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.


About J. Price McNamara

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.

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Why Might an Appeal Be Necessary?

ERISA regulations state that all employer-provided health plan administrators must establish an internal appeal process to handle disputes. In addition, a policyholder must exhaust this process before a court can hear a case alleging a breach of insurance contract. However, it is important to know what an appeal entails in this context, as well as why a policyholder might need to pursue one.

An appeal argues that the insurance company improperly denied benefits under a plan. This could be for an administrative reason, such as the policy not being valid at the time of the claim, or one that speaks to the terms of the policy, such as the policyholder not working for a company long enough to collect a pension.

In either event, the insurance company must send the policyholder a denial letter stating the reason for the denial and outlining the appeal procedure. Insurance companies must give policyholders at least 180 days from the date on the letter to file an administrative appeal for an ERISA claim denial in Louisiana.


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Baton Rouge Office

10455 Jefferson Hwy,
Suite 2B
Baton Rouge, LA 70809
Phone: (225) 201-8311
Fax: (225) 201-8313
(By Appointment)

New Orleans Office

4141 Veterans Memorial Blvd.
Suite 212
Metairie, LA 70002
Phone: (504) 458-8455
Fax: (225) 201-8313
(By Appointment)

Houston Office

363 N Sam Houston Pkwy E
Ste 1100 PMB, #114
Houston, TX 77060
Phone: (713) 439-0339
Fax: (225) 201-8313
(By Appointment)

Remedies Following an Unsuccessful Appeal

Oftentimes, a policyholder’s best chance at obtaining benefits is to file a lawsuit in court. This is because an internal appeal process is unlikely to change a decision an insurance company has already made. Still, a United States District Court will refuse to consider such a case unless a plaintiff exhausts this process.

Any lawsuit a claimant files in a local US District Court should include their denial letters as exhibits. These should accompany their claim that the insurance company breached their obligation to provide benefits as proof that the administrative remedy failed to solve the dispute. If successful, the lawsuit could require the insurance company to provide benefits as described by their policy.

Starting a civil suit in a United States District Court is now done completely online and requires a litigant to register with a service. The interface is fairly user-friendly but does require a litigant to state a cause of action, properly identify the defendant, state why the court has jurisdiction, and demand appropriate relief. An attorney could provide invaluable service for all these necessary procedures.

Get Help with Your Administrative ERISA Claim Denial Appeal

The ERISA laws that control employer-provided insurance plans are complex under even the best of circumstances. One area that often complicates a policy holder’s search for benefits is the requirement to exhaust all internal appeals with the insurance company before filing a lawsuit. Only once this is done would a US District Court consider the case.

Filing a lawsuit is also a complex matter, and although litigants are legally allowed to represent themselves, a failure to properly pursue a claim may bar recovery. Contact an ERISA lawyer today to learn more about filing an administrative ERISA claim denial appeal in Louisiana and the steps you may need to take afterwards to successfully recover compensation.

Attorney Advertising. This website is designed for general information only. The information presented at this site should not be construed to be formal legal advice nor the formation of a lawyer/client relationship. Testimonials are not a guarantee, warranty, or prediction of the outcome of your case. By providing certain contact information herein, you are expressly authorizing the recipient of this message to contact you via the methods of communication provided.

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