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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.
ERISA — or the Employee Retirement Income Security Act of 1974 — is a federal statute that governs the majority of employer-sponsored insurance plans. Under the statute, employers and insurance companies have a strong incentive for denying benefits. Insurance companies know that if the case ultimately winds up in federal court, the matter will be decided by a federal judge rather than a jury, which is often advantageous to the insurance company.
Fortunately, if your claim for benefits has been denied, you have the option of filing an appeal, and an experienced ERISA appeals attorney in Texas can assist you every step of the way. The knowledgeable legal team at the Law Offices of J. Price McNamara is ready to help you with filing your ERISA appeal and pursuing a favorable result on your behalf.
If your ERISA claim has been denied by your insurance company, the first thing that you should do is thoroughly read the insurance company denial letter and figure out exactly why your claim was denied. The insurance company is required to provide that information to you, in addition to providing the steps for appealing your claim denial.
The insurance company is also required to give you at least one opportunity at filing an administrative appeal. Your lawyer can assist you with gathering the necessary documentation and submitting the appeal to the insurance company on your behalf. In cases of ERISA disability insurance benefits, for example, your lawyer may need to supplement the record with additional medical documentation in support of your disability claim. In addition to supplementing the record, you should ensure that your administrative appeal is filed on time and that you follow all of the instructions mentioned in your denial letter.
If the insurance company denies your administrative appeal, you may have one more opportunity to appeal your case with your insurance company. If that does not work, you can file an appeal in federal court.
After you have exhausted all of the administrative remedies that your insurance company provides, you will have the option of filing an appeal and litigating it through the federal court system. The process begins when your lawyer sues the insurance company in federal court. When the case ultimately goes to a hearing, a federal judge – instead of a jury – will decide the outcome of your ERISA appeal.
An experienced ERISA appeals attorney in Texas can assist you throughout every step of the appeals process, whether it be an administrative appeal or a federal appeal. Your lawyer can also represent you at all court hearings and proceedings.
At the Law Offices of J. Price McNamara, our legal team welcomes the opportunity to file an ERISA benefits appeal on your behalf. To schedule a free case evaluation and legal consultation with an experienced ERISA appeals attorney in Texas, please contact us online today.
Complete the confidential form for a free, no obligation case evaluation and we’ll tell you how we can help.