Our past years of representing insurance companies taught us a thing or two about how they work behind the scenes. Let our experience work for you.
If your initial claim for disability benefits has been denied by your plan administrator, it is essential that you realize that, under ERISA, you cannot file a lawsuit until you have exhausted all administrative avenues of appeal. Appeal procedures differ from plan to plan; your summary plan description (SPD) will outline the exact steps you must follow to appeal your claim denial.
If you fail to follow the appeal process as defined by your plan and proceed with litigation, the court will have grounds to dismiss your case with prejudice of the claim.
Receiving a bill should never be the first step in getting help. Our firm knows that when dealing with an ERISA, long term disability or insurance claim, what you need is answers, and we are here to provide them free of charge.
Our firm welcomes telephone calls or the opportunity to visit with you in person to answer any questions you may have. We also provide FREE comprehensive case reviews. There is no obligation to hire us as your ERISA attorney.
Too much is at stake to guess about the best approach and strategy for fighting your denied insurance claim — years and years of financial security.
After spending years representing insurance companies, we don’t guess. We know their playbook and how they work behind the scenes. Using that knowledge, we’ve developed our own Clear Advantage Process for fighting claims.
It’s personally satisfying to use what I’ve learned as an insurance company insider, now for the good — helping families reverse unfair denials of insurance benefits they paid for, need and deserve.
Price McNamara began his law practice in 1990 representing insurance companies.
In 1995, Mr. McNamara founded McNamara Law Offices, where he represents people across the U.S. who are wrongfully denied long-term disability insurance, life insurance, and accidental death insurance benefits, with special focus on ERISA claims and lawsuits.
His is a member of the Louisiana and Texas Bars, with office locations by appointment only in Baton Rouge, Metairie, and Houston. He lives in Baton Rouge, Louisiana with his wife and their three children.
“Price showed no fear. The only thing I can use to actively describe what I saw that day in court was someone standing there protecting our family and fighting for them at the same time…he took control of the situation and was truthful.”
“It was a smooth process. I didn’t have to guess about what was going to happen next…I was reassured that he was going to do the right thing. I was reassured that he was looking out for me.”
“He was ready to fight for me…I felt like he had my best interest in mind. It wasn’t just for the paycheck at the end.”
“Price worked for an insurance company in the past and now he’s working against the insurance company so it was because of that we trusted that he knew how an insurance company worked and how to fight them.”
“I feel blessed that I can help turn things around for my clients who have been denied that piece of mind of financial stability and we make sure that the insurance company and the court realize that these are actual people, these are families that are suffering greatly.”
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…
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…
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…
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…
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…
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…
My client’s cause for an ERISA accidental death and dismemberment denial lawsuit began when both Esther and her husband were involved in a tragic head-on collision with an 18-wheeler. This tragic accident resulted in severe injuries to Esther, as well as David’s untimely death.
Our client, a young husband with two children, sustained closed-head brain injury as a result of an automobile accident. The at-fault driver’s insurance company initially refused to pay, but shortly before trial, agreed to pay the entirety of its insurance policy limits of $2,000,000.
Our client was a floor hand and Jones Act seaman who suffered a shoulder injury while working for Blake Offshore, LLC. Suit was filed in federal court in New Orleans. Blake and its insurance company offered relatively little in settlement, so the case proceeded to trial.
Our client sustained a fractured hip and reduced ability to earn wages in the future as a result of an accident sustained on the offshore drilling rig to which he was assigned. Suit was filed in federal court in New Orleans.
By establishing such stringent requirements for filing ERISA lawsuits, insurance companies are hoping that most claimants will simply let the matter drop, even if they feel that their claims were unfairly and unreasonably denied. In reality, this happens far too often, leaving legitimately injured employees without the benefits they absolutely deserve. Claimants become intimidated by the very idea of taking on powerful insurance companies with vast legal resources, so they don’t bother to review their rights and options with a qualified lawyer. They just give up.
Don’t let this happen to you. With a skilled and reputable Louisiana ERISA lawyer such as J. Price McNamara in your corner, you can obtain the full measure of disability benefits to which you are entitled. He will make sure that you have fulfilled all of the prerequisites to filing a lawsuit according to the criteria set forth in your plan document. When the time for litigation arrives, he will prepare the strongest case possible and may even be able to reach a favorable settlement before the case reaches a federal judge. Even the biggest insurance companies tend to change their tunes once they know that the playing field isn’t tilted entirely in their favor.
Our number-one goal is getting you and your family back to financial security as soon as possible.
Complete the confidential form for a free, no obligation case evaluation and we’ll tell you how we can help.
Most people whose disability claims are unfairly rejected don’t fight back. Those who do fight back, however, often win.
This question is at the heart of every ERISA case, and only you can answer it. It’s a very different question from “If I file an ERISA lawsuit, can I win?” Unless you have already filed an appeal that left out vital documents and information, the answer to this question is generally “yes,” especially with qualified legal representation. But first you must decide whether filing a lawsuit is worth your time and effort.
In the vast majority of cases, the plan vests the plan administrator with full discretion over the acceptance and denial of claims, as well as over the interpretation of the plan’s terms. In these cases, the court can overturn the plan administrator’s decision only if it can be proven that the decision was made in an “arbitrary and capricious” manner. Deference must be given to the decision of the plan administrator.
If the plan administrator is not granted this discretionary authority in the official plan document, then the court will review the claim denial de novo – that is, without giving deference, or even consideration, to the insurance company’s prior decisions.
While de novo review is generally preferable for claimants, it has become rare in ERISA cases. Almost certainly, your case will not meet the requirements for de novoreview, in which case you will be waging an uphill battle. It is ultimately a battle youcan win, but an uphill battle nevertheless.
In considering whether you should pursue litigation, you must also keep in mind that ERISA does not allow claimants to recover punitive damages via the courts, nor does it allow claimants to collect compensation for breach of contract, insurance bad faith, or emotional distress. You will have the opportunity to collect the benefits to which you are entitled along with any interest accumulated and, at the court’s discretion, at least part of your attorney’s fees. Claimants who hope to receive windfalls may decide that ERISA litigation is not best suited to them.
Your summary plan description will attach strict deadlines to every part of the appeal process. While it may be possible to get an extension if you request one in writing, you will be in violation of the terms of the plan if you simply ignore the deadlines. As such, you will almost certainly be precluded from pursuing your disability benefits in a court of law.
If you would like to have your ERISA case evaluated free of charge and obligation, please contact the Law Offices of J. Price McNamara today. Attorney McNamara can advise you of your legal rights and options and help you follow the terms of your plan to the letter.
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