As most people know, filing an appeal or lawsuit against an insurance company is not an easy task. However, it may be necessary if your employee-contracted insurer denies your claim without a valid reason for doing so.
According to the Employee Retirement Income Security Act of 1974, often abbreviated as ERISA, you have a right to file an appeal if you believe you deserve coverage. To fight back successfully, though, you may need to work closely with a skilled Fort Worth ERISA lawyer.
A dedicated employment attorney may be able to help you obtain the benefits you work so hard for and that you may need to maintain your current lifestyle. Before you decide to file an appeal or lawsuit, be sure to learn more about ERISA and its accompanying rules and regulations.
The Employee Retirement Income Security Act details various rules and regulations for employers in regards to how they handle employee pension and retirement funds. It also sets forth rules for third-party insurance companies these employers contract to provide policies to their employees.
According to ERISA, there are certain fiduciary standards plan trustees and administrators must adhere to. The Act also outlines rules regarding:
According to ERISA, all employees have a right to take legal action against an insurance company if they believe that company unfairly denied them coverage. A Fort Worth ERISA attorney could help any employee who wishes to take such action file an appeal of their denial and then file suit as needed after that.
Fighting back against an insurance claim denial typically takes time, patience, and a thorough knowledge of ERISA law. Insurance companies and other plan carriers frequently make the claims and appeals processes as difficult and lengthy as possible, and if an employee overlooks a single step, they can legally be denied coverage.
Even when an employee follows all the correct steps and submits a sufficient amount of corroborating evidence, their insurance company may still choose to deny them coverage. This can be frustrating, but an ERISA lawyer in Fort Worth may be able to provide employees with the legal knowledge and guidance they need to file a successful appeal.
As stated above, fighting back against insurance companies can be immensely difficult for regular employees working on their own. When a person files a claim with their insurer, the insurer will usually consult its own team of doctors, lawyers, psychotherapists, and other professionals.
These professionals do not know the claimant personally, so it is usually impossible for them to accurately gauge the claim of an individual. To make matters worse, these consultants are often implicitly encouraged to deny claims in an effort to save money.
Skilled attorneys are aware of such tactics, and they may need to obtain additional testimony from medical professionals to win against insurers. They may also need to carefully study and evaluate the criteria companies use to deny or approve claims.
Dealing with insurance companies on your own can be exhausting, and many employees simply give up. This is understandable, but you may have no choice but to fight back and take advantage of ERISA laws if you want the coverage you have been working for and deserve.
Very few people have the legal knowledge needed to successfully appeal an insurance decision on their own, but a seasoned Fort Worth ERISA lawyer could help you handle every step of the process. Call today to schedule an initial consultation.
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