Prerequisites to ERISA LitigationPrior to starting ERISA litigation in the federal court system, there are several prerequisites that you must satisfy. First, you must read the denial letter which your insurance company sends you – and which explains why your benefits claim was denied in the first place. Second, you must exhaust all of the administrative appeal remedies provided by your insurance company. An administrative appeal is an appeal that is handled in-house by the insurance company, and your insurance company is required to offer you at least one administrative appeal opportunity. At this level, you have the ability to supplement the administrative record with additional documentation in support of your ERISA claim.
What Happens During ERISA Litigation?You can begin the ERISA litigation process once you have exhausted your administrative remedies with your insurance company. During ERISA litigation, you or your lawyer will do the following:
- File a formal legal complaint against your insurance company in the federal district court and have it served on legal counsel for the insurance company
- Take part in the discovery process, in which both sides to the dispute exchange documentation and other information pertaining to the case
- Attend a federal court hearing during which a federal judge will decide if you are entitled to ERISA benefits