Tampa ERISA Lawyer
At some point in their lives, many people will run into a dispute with an insurance company. This can involve whether a policy was in effect at the time of a loss, whether all premiums were paid, or something as basic as whether an event triggered a loss demanding payment of benefits.
Any insurance dispute can be a complex matter, but the situation can become far more confusing if the Employee Retirement Income Security Act (ERISA) comes into play. ERISA governs the administration of all employer-provided benefit and insurance plans, creating a baseline of coverage but also greatly complicating the appeals process.
A Tampa ERISA lawyer could help you better understand ERISA and how it interacts with your insurance plan. If necessary, your dedicated insurance attorney could then work to exhaust all required appeals and file complaints in court demanding enforcement of an insurance contract.
Common Sources of Insurance Plan Disputes
Insurance policies are contracts between policyholders and plan administrators. In exchange for the receipt of premiums, the insurance company agrees to pay benefits in case of a loss or the maturity of the policy.
However, collecting benefits may not be as simple as it at first appears. Insurance companies will typically take any chance they can get to collect premiums but not pay for a loss. They may argue that premiums were not up to date at the time of the loss, the policy holder provided incorrect information on an application, the loss is not within the scope of the policy, or any one of several other excuses.
Typically, a policy holder could ask a court to intervene in a dispute. However, the presence of ERISA greatly complicates and lengthens the steps that a policy holder must take to seek relief.
How ERISA Affects an Insurance Dispute
ERISA is a federal law that regulates all employer-provided insurance plans, which typically include health insurance, pension plans, and even life insurance. ERISA creates a baseline for all these plans concerning coverage levels and policy dispute appeals. For example, under ERISA, an insurance company must provide a denial letter to a policy holder outlining the reasons for a denial and instructions for how to file an appeal.
In many ways, these regulations provide significant benefits to policyholders. However, ERISA states that all policyholders must go through their insurance company’s internal appeals process before petitioning a court to settle a dispute. This can lengthen a dispute for months while a person awaits critical medical care or seeks payments to cover the cost of a funeral.
Still, this is a necessary part of seeking the benefits that a policyholder may deserve. A Tampa ERISA attorney could work with a policyholder to take the necessary steps to fulfill all the appeal requirements ERISA establishes. Once this is complete, a skilled lawyer could work to file a lawsuit in a United States District Court demanding enforcement of an employer-provided benefit plan.
Talk to a Tampa ERISA Attorney Today
Although the protections the Act provides are important, the presence of ERISA regulations may also greatly complicate and lengthen your journey to collect benefits from an employer-provided benefit plan. This can delay necessary medical treatment, lengthen the waiting period for the receipt of death benefits, or even force you to delay retirement.
Fortunately, a Tampa ERISA lawyer may be able to help. They could work with you to examine the reason for a denial, determine the necessary appeal steps, and complete those steps as quickly as possible. Once this is done, a lawsuit filed in a Florida branch of the United States District Court could demand enforcement of the insurance policy. Call today to schedule a consultation.