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Macon ERISA Claims Lawyer

Macon ERISA Claims Lawyer

The federal government created the Employee Retirement Income Security Act of 1974 (ERISA) to safeguard health plans, pension plans, disability plans, and life insurance for workers in the private sector when employers chose to privately fund these plans. Employees and their beneficiaries who experience health issues or death are eligible for benefits under these plans. Plan managers and fiduciaries are tasked with managing the funds and ensuring that the company’s legal obligations are carried out. Even so, far too many individuals find they face multiple obstacles when it comes to collecting the benefits to which they are entitled. If you find yourself bewildered by rejection letters following a legitimate claim, seeking the assistance of an experienced ERISA attorney can make a significant difference.

Details of Plans

While every company offers different benefit packages, it is useful to understand the basics of each type of coverage.

  • Health Plans: ERISA guidelines provide that health insurance information be provided to employees, including the details about the features of the plan and the funding mechanisms involved.  The steps required to file grievances and appeals must also be shared. In some cases, COBRA insurance is available to assist employees after losing a job or under other special circumstances.
  • Employees must also be informed about pension plans, which could include 401K’s, ESOP plans, and profit sharing options.
  • Both short-and long term disability plans are designed to protect individuals in the event they are unable to work
  • Life insurance, including Accidental Death and Dismemberment riders, are both governed by ERISA rules in order to protect workers and their beneficiaries.

Denied Claims

When individuals file a claim, they generally anticipate that they will quickly be reimbursed for expenses related to the claim.  It can be incredibly frustrating when a provider rejects a claim. At the Law Offices of J. Price McNamara, our dedicated team will fight to obtain the benefits you deserve. Here is what we can do for you:

  • Conduct a thorough examination of the claim denial  in order to determine the specific concerns behind the rejection;
  • Assemble the appropriate documents to substantiate the claim, including comprehensive health and vocational history, medical records, and physicians’ conclusions;
  • Summarize the documentation in an articulate report;
  • Conduct negotiations with providers;
  • After exhausting all administrative remedies, pursue further legal action if necessary.

Moving Forward

The fact of the matter is, ERISA plans are generally quite complex, and the claims procedure complex and convoluted. Plan administrators, unfortunately, sometimes take advantage of the fact that laymen do not always know precisely how to proceed when they need their plans the most. Unfortunately, there are far too many situations when administrators must be compelled to treat employees fairly. If you find yourself exasperated with the hoop-jumping required to get the benefits you need, rely on us at the Law Offices of J. Price McNamara in Macon. Make the call today. You will be glad you did.

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