ERISA Claims

Filing a lawsuit against an employer or plan carrier is a major decision that should not be taken lightly. Unfortunately, it may be necessary if you believe your employer violated ERISA or if your employer-sponsored plan denied you benefits.

Fighting back against a plan carrier or employer can be intimidating, but by working closely with a lawyer, you may be able to obtain the benefits you need. Read the following information to learn more about the benefits of an ERISA lawyer.

Understanding ERISA

The Employee Retirement Income Security Act, often referred to as ERISA, was established by the federal government in the 1970s. The Act regulates the operation and formation of retirement and pension funds, as well as health and disability insurance plans offered by employers.

The act also sets various fiduciary standards for plan administrators and the trustees in charge of investing the retirement savings of employees. ERISA further regulates the following employer-sponsored benefits issues:

• The amount of time it takes to process claims and offer appeals
• Disclosure of important benefits information to employees
• What type of employees are offered benefits
• The claims appeal process and lawsuits against employers
• Addressing employee grievances

Finally, ERISA also states employees have the right to file a lawsuit against a plan carrier if they believe they have been unfairly or erroneously denied coverage.

Fighting Back Against a Claim Denial

There are numerous benefits of an ERISA lawyer, especially in the wake of a claim denial. Plan carriers (usually insurance companies) often attempt to make the claims submission and appeals process as complex as possible and it is normal for individuals to overlook one of the countless steps included in these processes. Even when a person does take the right steps and submits the included administrative and medical forms, many plan carriers still find a way to deny them the benefits they deserve.

Fighting back against a plan carrier can be difficult without the right legal knowledge, especially because the claims process for most health, life, and disability insurance companies are intentionally difficult to follow, but with help from an attorney, workers can obtain the benefits they need.

Dealing With Plan Carriers

As implied above, dealing with plan carriers can be very difficult. When a person files a disability or health insurance claim, the plan carrier will likely consult its own team of doctors, nurses, psychologists, and other medical professionals.

These medical professionals have no interaction with the claimant and only have limited access to their medical information. To make matters worse, they are often encouraged implicitly to deny claims. A skilled ERISA attorney can help by obtaining additional medical records from additional medical professionals to help bolster the claim. A lawyer may also be able to carefully inspect the criteria an insurer uses to approve or deny claims and determine if it has been properly applied to the situation.

Learn More About the Benefits of an ERISA Lawyer

Learning how to use your employer-sponsored benefits can be difficult, but when a plan carrier or employer jeopardizes those benefits, life can become even more difficult. Therefore, it is important to take every precaution to help ensure the success of a claim.

No one should have to deal with the prospect of having their claims denied for no reason. Learn more about the benefits of an ERISA lawyer by contacting a well-versed attorney. Call today for a free consultation.