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.
Most people have never heard of ERISA, or the Employee Retirement Income Security Act until they experience a personally and financially devastating situation that requires them to seek insurance benefits from their policy. ERISA controls the majority of employer-provided benefits throughout the country including life insurance, accidental death and dismemberment insurance, and short and long term disability insurance. Although ERISA was enacted to protect claimants’ rights, in reality, and in practice, it can give insurance companies the upper hand over victims pursuing a claim for insurance benefits. If you were negatively affected by one of the flaws of ERISA law, do not hesitate to speak with a seasoned ERISA lawyer in Louisiana who could help.
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.
Manipulating ERISA begins with the initial claims process – one that is wracked with conflicts of interest. When a victim files a claim, the initial decision to pay or deny it is almost always made by the insurance company itself. The insurance company loses money when they have to pay claims and profits when they can deny them. So, if an insurance company’s entire business model is to maximize the money they make from their customers who think they’re buying protection, then they will naturally work to minimize what they have to pay in claims.
Our number-one goal is getting you and your family back to financial security as soon as possible.
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If the insurance company initially denies the claim, which is the norm, ERISA prohibits the claimant from filing a lawsuit until the insurance company completes an independent administrative appeal. However, the same insurance company decides whether to uphold or overturn the original denial at the administrative appeal level. By independent, they simply mean different staff members of the same insurer that initially denied the claim. So, what’s the incentive for them to draw a different conclusion than the result their colleagues want? The typical result is the denial of the claim on administrative appeal. One of the major flaws of ERISA law regards the appealing process.
After the insurance company denies the administrative appeal, ERISA allows the victim to file suit in federal district court. A federal district court judge ultimately conducts a trial, but one which is different than what most people would picture. Unlike most lawsuits, ERISA suits are not tried before a jury. Nor do any live witnesses testify. Instead, the trial evidence is limited to the administrative record. That is, the judge is only permitted to consider the same evidence the insurance company reviewed in the process of denying the claim.
The actual administrative claim file is filed into the court record, and attorneys representing the victim and the insurance company file trial briefs arguing the merits of the victim’s cases in light of ERISA law and the evidence in the administrative record. The district court judge reviews all of this and then may or may not allow the attorneys to give oral arguments before issuing an opinion and judgment for either the insurance company or the claimant.
What this means for the claimant, is that the initial claim and administrative appeal process is critical to success. If they do not present important evidence to the insurance company during the initial claim or administrative appeal, the court is generally prohibited from considering it at trial. ERISA law can require that the judge completely disregard even evidence it considers critical or outcome determinative if presented at trial if not made part of the administrative record before the claimant files suit. For that reason, handling the initial claim and administrative appeal process properly before filing suit is crucial. The claimant’s ERISA attorney’s job is to navigate these flaws ERISA of law and assure that all evidence conceivably helpful to the claimant is gathered and made part of the administrative record before filing suit. Otherwise, the judge cannot consider it when the case inevitably lands in court after the insurance company denies the claim.
In addition to ERISA’s constraints on the courts’ consideration of the evidence, ERISA law in most cases requires that the court give a deferential review to the insurance company’s decision to deny a claim. This often means that a judge must uphold a denial even if they think the insurance company was wrong, and even if they would have ruled the other way. It’s not uncommon for a judge to expressly state in a written opinion that they believe the insurance company was wrong for denying a claim, and that the judge would have ruled differently, but must rule in the insurance company’s favor because of ERISA’s deferential standard of review.
These flaws of ERISA law are just some of many and they should serve as a call to action for all of us to repair the injustices in the legal system. If you or a loved one was denied your rightful benefits under an ERISA plan, contact an experienced Louisiana ERISA lawyer right away.
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