The Employee Retirement Income Security Act often referred to by the acronym ERISA, is a set of laws designed to protect employee benefits from unfair or unwise practices. These laws include provisions that allow workers to sue for relief when they feel an employer has violated their rights under ERISA.
Since ERISA lawsuits can be complex, many people choose to work with a dedicated New Orleans ERISA lawyer when filing a claim. An experienced insurance attorney who understands ERISA claims could explain your options for relief, evaluate your eligibility for benefits, and provide representation throughout the process to work toward the optimal result.
After initiating enacting ERISA in 1974, lawmakers have expanded the provisions with added legislation in subsequent years. The laws currently recognize that employees often base their decisions to accept or remain in employment in consideration of benefits they expect to receive. So, while ERISA does not explicitly require employers to provide benefits to employees, it does require employers to take certain actions to protect those benefits.
Specifically, ERISA imposes a fiduciary duty on employers and plan managers to manage pension funds in a responsible way, so they are unlikely to lose value. ERISA provisions also protect healthcare benefits, including long term disability insurance.
Among the protections provided under ERISA to New Orleans workers is a requirement that healthcare plans must explain to participants how to file claims for benefits, as well as the standards they must meet to qualify for benefits. For instance, the plan must set forth the standards for establishing a “disability.”
ERISA provisions also give employees certain rights regarding long term disability insurance. If the employer’s insurance company denies a claim for disability benefits, the denial must explain the reasons for denying benefits and the steps to appeal the decision.
In many instances, insurance adjusters deny health insurance claims because they report that the applicant has not met the disability definition for their insurance plan. Experienced ERISA attorneys often assist in such cases by devising strategies to counter denials.
Employees also frequently have claims denied due to failure to provide sufficient medical evidence to support the claim of disability. An attorney could assist with establishing a documentary record with the best available evidence presented in a persuasive format. For example, an ERISA lawyer in New Orleans might seek a physician’s statement detailing the reasons that the employee’s disability prevents the performance of job duties.
In addition to healthcare protections, ERISA also protects pension plans by imposing a fiduciary duty on plan sponsors and administrators. The law requires someone with a fiduciary duty to act in the best interests of the party to whom they owe the duty—in this case, employees with a pension plan. This duty requires the plan administrators to not only take certain actions but also to avoid taking improper actions.
For example, it would violate a plan administrator’s fiduciary duty if they took plan assets for personal use or received compensation from a business for using their plan management services. If a plan manager lent money to a person who was disqualified on the basis of conflict of interest rules, that would also be a violation of ERISA protections. When employees believe ERISA regulations were violated, they have the right to sue under the law.
Whether you are trying to determine your rights under ERISA or trying to enforce those rights, an experienced New Orleans ERISA lawyer could help. In addition to determining whether an employee has a cause of action under ERISA provisions, a knowledgeable attorney could provide advice regarding how to proceed with a case.
Moreover, your legal advisor could assist with collecting and presenting evidence to support your ERISA claim. Finally, your attorney could advocate on your behalf at all stages of the proceedings, from informal negotiations to formal hearings. To learn what may be possible in your case, call now.
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