Over 50% of workers in this country earn health benefits through their jobs, in addition to other benefits such as profit sharing, retirement plans, COBRA plans, and disability insurance. If you are one of these Americans and have been denied benefits to which you believe you are entitled, having an experienced ERISA attorney on your side can dramatically impact the results of your appeal.
ERISA, the Employee Retirement Income Security Act of 1974, is a critical federal plan designed to protect the interests of employees who work under the umbrella of the plan. These plans relate to private employers who offer employer-sponsored benefits and do not cover religious or government entities. ERISA creates standards of accountability and transparency, setting forth specific requirements to inform employees about their plans. Canons of conduct for fiduciaries and plan managers are designed to ensure that monies are not abused or mismanaged.
Let us say you have filed a claim and were surprised to see that your provider denied the benefits. What now? Section 503 of ERISA guarantees claimants the right to a fair review of denied claims. The appeals process, however, can be quite daunting, so this is the time to get some serious legal assistance. The coming weeks and months will involve a fair amount of paperwork and some aggressive maneuvers:
Within a specified period of time—it varies depending on the type of claim–you should receive written notice of the claim decision. In the event it is still denied, the explanation must include the explicit reasoning behind the decision and unambiguous references to provisions within your plan to back up the denial. At this point, your lawyers will have to negotiate through a second appeal. Ultimately, all internal procedures must be exhausted prior to ultimately taking the case to court in a civil action.
If you have been denied the benefits you need, it can be incredibly frustrating, adding to the agony of an already untenable health event. In Pottstown, the experienced ERISA legal team at the Law Offices of J. Price McNamara is dedicated to pursuing your claim to get you the help you need as quickly as possible. Quite often, simply tightening up the documentation in the appeal is all that is necessary. But when further action is required, we do not shy away from the task. If you have been blindsided by an unfair denial, contact us today for a free, confidential 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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