Claiming benefits under the insurance policy provided by your employer can be frustrating and overwhelming — especially without an experienced Miami ERISA lawyer by your side. J. Price McNamara has to expertise to help you through the complicated insurance claim as well as appeal processes to obtain the benefits you deserve.
Federally enacted ERISA was supposed to provide protections for employee pensions and insurance — disability, life, and accidental death and dismemberment (AD&D) — benefits. But it backfired. Instead, employees pursuing ERISA insurance benefits faced challenges from the stringent claim and appeal procedures, while insurance companies that determine who receives the benefits were given more power.
Only insurance policies provided by your employer are subjected to ERISA. Both state and local rules apply to non-ERISA insurance policies. A Miami ERISA lawyer can review your insurance policy as well as help you obtain the benefits you deserve.
ERISA states that your employer or plan administrator — who could be a third party, like an insurance company, or your employer — must provide you, in writing, important information related to your disability insurance plan, such as:
Generally, the Summary Plan Descriptions summarizes this information while the Plan Document offers more detailed instructions and information.
To obtain disability benefits, you must first meet the filing deadlines and follow the claims procedures. You should ensure your claim package if complete before filing it with your plan administrator. Do not assume your plan administrator, who does not have any invested interest to ensure you receive benefits, will conduct a thorough investigation of your claim. Your meticulous Miami ERISA lawyer can help compile an effective and comprehensive claim package supporting your insurance claim.
A written notice of the outcome of your claim will be sent to you. If approved, you will receive your benefits soon after. If denied, the letter will explain the reasons for the rejection and provide instructions for an appeal.
You can appeal your denial by doing the following:
You still have other remedies if the plan administrator denies your appeal. After exhausting “all of your administrative remedies,” you can file a new appeal in Federal court. Your Miami ERISA lawyer can package an effective appeal to increase your chances of success.
If your deceased loved one has life insurance through his or her employer, you may be able to receive benefits. These claims, however, are often denied because of the following:
A Miami ERISA lawyer can review your policy, assess your case, and craft your best strategy for benefits.
To qualify for AD&D benefits, the employee’s cause of death or severe injury must be from an accident, not a medical condition or other “non-accident.” A Miami ERISA lawyer can evaluate both the facts and circumstances of your injury or the employee’s death to recommend your best available options.
Even non-employer provided independent or private LTD insurance, which is not subject to ERISA, claims for benefits are often denied. Long term disability lawyer J. Price McNamara can review your LTD policy and subsequently determine your eligibility based on your medical evidence. Your supporting evidence must prove that, depending on your LTD policy’s definition of “disability,” you cannot work your job or any job.
If the insurance company did not fairly and neutrally evaluate your denied insurance claim, as it has an obligation to do, you may be able to receive compensation. And if the underlying insurance claim is not an ERISA insurance policy, then you may also receive punitive damages—the award is to penalize the company for intentional and improper conduct. Bad faith insurance lawyer J. Price McNamara can review your underlying claim and help you file and litigate a bad faith claim.
Whether you are seeking benefits under an ERISA or non-ERISA insurance policy, contact seasoned Miami ERISA lawyer J. Price McNamara at 866.278.8495 for a free consultation.
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 so many others in his field of specialty. He is a consummate professional, extremely knowledgeable
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 use him in the future.
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 to address all of my questions and/or concerns.
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 wants a top-notch attorney who gets results.
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 company knew that it was their fault but of course tried passing the buck. Mr.
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 something or someone else, don’t hesitate to call him.
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