ERISA laws govern most employer-sponsored benefit and retirement plans and outline what is offered, how claims are handled, and what rights are available to you. An ERISA lawyer in Georgia can answer your questions and provide solutions when you are having trouble securing the benefits you may need during a difficult time.
J. Price McNamara: Disability, Life, AD&D Insurance Attorneys, founded in 1990, have the experience and legal knowledge needed to help you turn a claim denial into a more favorable outcome. We aggressively fight for you and help you navigate the various obstacles that can arise during these cases. With the help of a Georgia insurance claims lawyer, you can increase your chances of securing the benefits you need.
J. Price McNamara: Disability, Life, AD&D Insurance Attorneys Provide Compassionate and Fierce Representation
J. Price McNamara: Disability, Life, AD&D Insurance Attorneys know that it can be frustrating when you’re having trouble securing benefits, especially when you’ve kept up with all your premiums regularly. Between specific reasons and insurance company tactics to avoid paying, issues occur far too often when applying for ERISA benefits. That is why it’s important to hire an attorney who has intimate knowledge of these processes.
When you’re wondering what an ERISA attorney does, it’s important to know that they can stand by you in your time of need and take the time to understand your case and identify solutions. Every client’s case is different, and we tailor our approach to your case’s needs so you can get the most favorable results possible. We help you build a strong claim or appeal and negotiate the outcome.
We know that you may feel like giving up hope after dealing with the insurance company, but you likely still have options, and we can help you to pursue them. Founder Price McNamara has been where you are and provides both compassionate support and fierce representation, so you are treated fairly when you apply for benefits. Our firm is an ally and fights for you from start to finish.
For a free legal consultation, call (225) 201-8311
ERISA Benefits and How They Work
Passed in 1974, the Employee Retirement Income Security Act (ERISA) protects an employee’s rights to access health and retirement benefits provided to them by their employer. The funds for these benefits are handled by fiduciaries who manage and pay benefits governed by these laws. Short and long-term disability insurance benefits, life insurance, and accidental death and dismemberment are covered.
ERISA benefits are primarily for employees of private companies. Church and government employees are not eligible, as are companies that have benefit plans that comply only with certain laws, such as disability, workers’ compensation, and unemployment laws. For those who are eligible, ERISA laws govern deadlines, requirements, information disclosure, the appeal process, and so much more.
An experienced lawyer can walk you through ten facts and common myths about ERISA when discussing your case with you. They can prepare you for what to expect and use their extensive knowledge to help you understand what you must do to secure your benefits. Employer-sponsored plans are all a bit different, so reading your policy at the outset is important for understanding what rules apply to you.
Common Reasons Why ERISA Claims Get Denied
Sadly, ERISA claims are denied far too often, leaving individuals wondering what to do next. At a time when Georgia workers need benefits the most, they encounter complications that keep them from receiving them. Insurance companies are required to provide the reason for denying a request for ERISA benefits. Some common reasons for denied claims can include:
- Insufficient medical evidence showing injury
- Benefit application errors
- Missing important deadlines in the claim process
- Pre-existing medical conditions or other policy exclusions
- Ineligible to receive ERISA benefits
- Resistance from the insurance company to pay out benefits
Each one of these denial reasons can have a different impact on your claim and your future. An ERISA attorney in Georgia can review the reason provided in your case and determine what options you may have and if you are eligible to file an appeal. Based on their discoveries, they can provide counsel on what specific steps you must take next in your case, if applicable.
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A Georgia ERISA Attorney Can Help You Navigate the Appeal Process if Your Claim is Denied in Georgia
If filing a claim for your health benefits was unsuccessful and you received a claim denial, then your next step may be to file an appeal to have your claim reconsidered. Under ERISA laws, you have 180 days from the time you received a denial to submit an appeal. Once your appeal is submitted, you may not add new evidence to your case, so it’s important to utilize the 180-day window to strengthen your claim.
You may need to add additional medical information and documentation to your file, correct mistakes, or dispute errors in your case. However, you must first request your case file so your lawyer can review it and determine what’s needed for your appeal. From there, they can take the necessary action to prepare and submit your appeal. Your lawyer can also advocate and negotiate for you through the process.
The same insurance company often reviews your appeal and makes a determination. If your appeal is successful, you may begin collecting benefits. If, on the other hand, your appeal didn’t yield favorable results, you may be able to file a lawsuit to have your case reviewed in court. Your lawyer can provide counsel on whether this is a viable option and ensure that all steps are carefully followed.
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Let J. Price McNamara: Disability, Life, AD&D Insurance Attorneys Fight for You
J. Price McNamara: Disability, Life, AD&D Insurance Attorneys are your allies, whether you need help with the claim process itself or need to resolve an issue or denial in your case.
ERISA claims can be complex, and having a Georgia ERISA lawyer on your side can make a significant difference in the outcome of your case. Schedule a free consultation with our firm today and let us help you secure the benefits you deserve.
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