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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.
The Employee Retirement Income Security Act of (1974), better known as the ERISA statute, is a federal law that controls most employer-sponsored plans of insurance. These insurance plans often include health insurance, dental insurance, long-term disability insurance, life insurance, and accidental death insurance plans.
If you have been denied the benefits you deserve under one or more of these plans, you may be able to file a lawsuit in federal court and pursue ERISA litigation. However, prior to doing so, there are certain prerequisites that you have to satisfy. If you or someone you love has been denied benefits under an ERISA insurance policy, the experienced El Paso ERISA litigation lawyers at the Law Offices of J. Price McNamara can assist you with pursuing your case in the federal court system, if it goes that far.
Insurance companies deny benefits under ERISA policies on a regular basis. In some instances, the insurance company may claim that you did not file your claim on a timely basis. At other times, the insurance company might argue that you did not submit all of the necessary documentation.
Whatever the reason for your claim denial, the insurance company must send you a letter that states exactly why your claim is being denied. Moreover, the insurance company must offer you at least one opportunity to file an administrative appeal of your claim denial. During the administrative appeals process, you have the opportunity to supplement the record with additional documentation that supports your ERISA claim.
Our experienced El Paso litigation lawyers can assist you with filing your administrative appeal in a timely manner.
ERISA litigation cannot begin until the time comes when you have exhausted all of your administrative appeals at the insurance company level. Once that has happened, if you still have not been granted the insurance benefits that you need, your lawyer can file a complaint on your behalf in the federal court system. In this complaint, your insurance company will be named as a defendant.
During ERISA litigation, the complaint will be served on defense counsel for the insurance company, and both sides may engage in discovery, in order to learn more about each other’s versions of the case. The litigation process concludes with a hearing in front of a federal judge. The judge, rather than a federal court jury, will decide the ultimate outcome of the ERISA litigation. In other words, the judge will make a determination about whether or not you are entitled to ERISA insurance benefits.
At the Law Offices of J. Price McNamara, our knowledgeable and experienced team of lawyers is ready to guide you through the ERISA litigation process, in the event your case reaches the federal court level. To schedule a free case evaluation and legal consultation with an experienced El Paso ERISA litigation attorney, please contact us online today.
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