Each year, millions of ERISA disability claimants are denied access to the benefits they paid premiums for. Some denials are legal and have a valid basis and some are illegal. If you were denied an ERISA disability claim, even if you were denied your first or second appeal, you do have another option.
Instead of giving up and accepting that you will not get your benefits, you may want to consider taking your claim to court. The representation of a qualified attorney may make filing an ERISA disability lawsuit in Texas less stressful and potentially successful.
After a claimant received notice that their ERISA disability claim was denied, they can decide to do nothing and live with the decision or to take other steps to attempt to get their claim approved. If they decide on the latter, consulting an experienced ERISA insurance lawyer may help. Under the new law 29 C.F.R. § 2560.503-1, claims filed after January 1, 2018, can be litigated even while administrative remedies are being pursued.
Claims filed before that date will require the claimant to exhaust at least one, possibly two appeals, prior to filing a lawsuit. An attorney can help a denied claimant determine whether the case falls under the old or new laws.
In general, there are two types of claims a plaintiff can make in an ERISA disability case, a benefit claim and a breach of fiduciary duty claim. A benefit claim requires the plaintiff to prove that they cannot work due to a specific medical condition.
A fiduciary duty claim arises when those responsible for running the insurance plan misrepresent the plan, engage in unlawful acts, make imprudent investments, or fail to follow instructions. This type of claim can hurt the entire insured group or just one individual.
When a plaintiff files an ERISA disability lawsuit in Texas, their damages will be limited under the law. The individual can claim the benefits themselves, interest on the benefits that were previously due, and, under some circumstances, may be able to recover part of their legal fees. A plaintiff recovers these fees only if they win and only for the actual litigation time not the time spent on other remedies such as filing appeals.
The process of applying for, appealing, and filing an ERISA disability lawsuit in Texas can be quite complicated and overwhelming. There are deadlines to meet and specific information that must be submitted to comply with federal laws. If these policies are not followed, the chances of being awarded your disability claim may completely disappear.
No matter where you are in the process, seeking the assistance of an attorney who is well-versed in insurance law can help make this process easier and potentially successful. If you have considered filing an ERISA disability lawsuit in Texas, contact a knowledgeable ERISA attorney today. They may be able to help you through the process and seek a positive outcome.
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