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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The Employee Retirement Income Security Act of 1974, which is more typically known as ERISA, was originally enacted by Congress for the benefit of employees. The goal of the law was to help make sure that these individuals were able to receive the benefits that they needed through an employer-sponsored insurance plan. However, that does not always work out. In fact, in many instances, insurance companies will look for ways to deny benefit claims.
ERISA plans cover various types of benefits, and if your claim for benefits is denied, there are legal actions that you can take. The experienced ERISA lawyers near you at the Law Offices of J. Price McNamara can assist you with filing a claim for ERISA benefits, and if necessary, pursuing an appeal, either administratively or in the federal court system.
ERISA plans are usually sponsored by an employer and often cover a variety of benefits. For example, these plans may cover life insurance, accidental death insurance, vision insurance, health insurance, and long-term disability insurance benefits.
Over the lifetime of a particular policy, the insured pays premiums. Then, when a certain event occurs, either the insured or the beneficiary will be able to make a claim for benefits under the plan of insurance. While insurance companies should award the benefits when a claim is made, that does not always happen. In fact, insurance companies will sometimes look for a reason to deny a benefits claim. This is because insurance companies, which are big businesses, routinely try to save themselves as much money as possible.
If your claim for benefits under an ERISA policy gets denied, there are several legal options that may be available to you. First, you can file an administrative appeal with your insurance company and submit additional documentation in support of your claim. Your insurance company will review the administrative appeal and then make a decision about your entitlement to benefits.
Once you have exhausted all of the administrative opportunities which your insurance company offers, you may be able to file an ERISA appeal in federal court. A federal court appeal begins by filing a legal complaint directly against your insurance company with the court. At the conclusion of litigation, a formal hearing will take place, during which a federal judge will decide whether or not to award you benefits.
An ERISA lawyer near you can assist you with filing an appeal in your case and helping you pursue the best possible outcome.
At the Law Offices of J. Price McNamara, our legal team can answer all of your questions about ERISA and your eligibility for benefits under an ERISA insurance plan. To schedule a free case evaluation and legal consultation with an experienced ERISA attorney near you, please contact us online today.
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