You can efficiently seek the benefits you deserve under your employer-sponsored insurance plan when you work with a knowledgeable Houston ERISA lawyer.
If you experienced a violation of your rights under ERISA or your employer’s insurer denied your group long-term disability insurance claim, do not hesitate to contact our team at ERISA Insurance Claim Attorneys. We have 30 years of experience handling disability insurance claims, and we’re ready to assist you.
We have the resources and experience to advocate for your rights and fight for the benefits you deserve. Your Houston insurance claims lawyer can provide a free denial review.
Since we typically work on a contingency basis, we will only collect a percentage of any long-term disability benefits we help you secure. You will pay us nothing out of pocket.
Why You Need an ERISA Lawyer in Houston
You can improve your chances of securing the benefits you paid for and deserve by hiring a Houston ERISA attorney. Our team can provide legal counsel in the following ERISA-related cases:
- Long-term disability insurance
- Life insurance
- ERISA litigation
- Accidental Death and Dismemberment (AD&D) insurance
- Bad faith insurance
Please note that this is not an exclusive list of ERISA-related matters that we handle. We offer a free, no-obligation consultation to our prospective clients, allowing them to determine whether they require the services of an ERISA lawyer.
For a free legal consultation with an erisa lawyer serving Houston, call (225) 201-8311
How We Can Help You
Our dedicated and results-driven attorneys at ERISA Insurance Claim Attorneys can help you with every stage of the ERISA claims process, including:
- Gathering medical records, documentation, and other evidence to prove that you are entitled to benefits
- Arranging medical examinations
- Filling out the necessary forms
- Filing your ERISA-based claim
- Handling communications with the plan administrator and insurance company
- Appealing the insurer’s decision to deny your claim
- Filing a lawsuit against the insurance company after exhausting other administrative remedies
We have a track record of success in handling ERISA-related cases. We’ve built a solid reputation for zealous advocacy and the ability to give every case the personalized attention it deserves.
We handle all matters related to the Employee Retirement Income Security Act, including claim denials, appeals, and ERISA litigation.
Houston ERISA Lawyer Near Me (225) 201-8311
Mistakes to Avoid When Filing an ERISA-Based Claim
While most employees are aware that their employer-sponsored benefit plans are governed by ERISA, many are unfamiliar with the filing process. As a result, many participants and beneficiaries often make mistakes when filing claims. These mistakes can lead to the denial of their claim.
An experienced ERISA lawyer on your side can help you avoid mistakes when filing a claim and seeking benefits under an ERISA-covered plan.
Claimants often make the following mistakes when applying for ERISA-covered benefits without an attorney:
- Not consulting with a lawyer before filing a claim
- Not reading the terms of the benefit plan
- Relying on the policy interpretations from your employer or insurance company
- Thinking that having your primary care physician’s testimony is enough to prove that you are disabled
- Failing to supplement your claim with sufficient evidence, including medical records, to support your ERISA-based claim
- Engaging in activities that could result in the denial of your claim (many claimants do not know which activities are prohibited when seeking benefits)
- Reapplying (or not doing anything at all) when denied instead of filing an appeal
- Failing to follow your doctor’s orders
- Waiting too long to file a claim
You must understand all of your rights and obligations when seeking benefits under an ERISA-covered plan to avoid mistakes and get the benefits you deserve. We can help you with all aspects of your claim, ensuring you avoid mistakes when filing.
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What to Do if You Receive a Denial of Your Claim for ERISA-Covered Benefits
If you are seeking benefits covered under ERISA, but your employer’s insurance company denies your claim, you need to understand what steps you should take to appeal the insurer’s decision and obtain the benefits you paid for—and deserve.
If your claim ends in a denial, the first thing you should do is request a copy of the benefit plan. Under US law, ERISA-protected participants and beneficiaries have a right to request copies of the formal plan document and other plan materials.
You need to follow the procedural requirements for appealing the denial of your claim according to the specific language of the benefit plan.
Time Limits to Appeal a Denial
While the plan documents will specify how much time you have to appeal the denial of your claim, most plans give claimants 180 days to file an appeal.
Your lawyer will help you understand all the nuances associated with appealing the denial of your claim for ERISA-covered benefits.
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Can You File a Lawsuit When You Receive an ERISA-Based Claim Denial?
Under ERISA, claimants have a right to sue their employer’s insurance company or plan administrator if their claim is denied. However, a claimant can only file a lawsuit once they have exhausted their administrative remedies, such as filing an appeal directly to the insurer.
You should seek the legal counsel of an ERISA lawyer if you face a claim denial. An attorney will help you follow all the strict rules regarding handling the appeal. If your appeal case is unsuccessful, we can help with filing an ERISA disability lawsuit.
Once you file a lawsuit in federal court, the defendant (the insurance company) will have 21 days to respond with a counterclaim. Contact an experienced lawyer to prepare you for ERISA litigation. We can give you more information through an overview of ERISA litigation procedures.
Reasons You Should Hire an ERISA Lawyer After a Claim Denial
The denial of any insurance claim is a stressful and overwhelming experience, especially if you are seeking short-term or long-term disability benefits. However, you do not have to go through this alone.
You should have representation from a skilled lawyer who can help you pursue the right course of action in your particular case.
Let’s discuss the four reasons you should hire a Houston ERISA lawyer when a plan administrator or insurance company denies your claim. Your attorney can:
Help You Understand Your Rights and Options
Navigating the insurance claims process can be a confusing experience. Many claimants are not fully aware of their rights when pursuing benefits under ERISA-covered plans. Your attorney will help you navigate the claims process and ensure that you receive the benefits you deserve.
We can explain what to expect during an ERISA claim.
Know How to Appeal the Denial of Your Claim and Sue the Insurance Company
When you receive a denial of your ERISA-based claim, we cannot overstate the importance of acting as quickly as possible. You have a limited time to file an appeal after your claim gets denied. Our lawyer will help you appeal the insurer’s decision and, if the appeal is not successful, file a lawsuit on your behalf.
Gather the Required Evidence to Win Your Case
If a plan administrator or insurer denies your claim, you have no time to waste. You need to begin preparing evidence for your appeal. If your claim ends in denial, the insurer is likely to deny your claim when you file an appeal unless you submit clear and convincing evidence proving your entitlement to the benefits.
The evidence you submit to the insurer may also be used in ERISA litigation when you pursue a lawsuit in federal court.
Help You Get the Benefits You Need
Many insurance companies undervalue claims in an attempt to pay claimants as little as possible, while others outright deny valid claims. You need to understand how much your claim is worth to know what benefits you are entitled to. Your ERISA lawyer will properly evaluate your case to ensure that you receive the full amount you need.
You can schedule a free, no–obligation consultation with us to discuss your options and determine whether or not you need an attorney in your ERISA claim.
What Does ERISA Cover?
Many private employers offer their employees insurance benefits plans, most of which the Employee Retirement Income Security Act (ERISA) of 1974 covers.
In addition to health insurance, many employees also receive disability and life insurance benefits through their employers. However, it is not uncommon for insurance companies to deny employees’ claims for ERISA-covered benefits.
ERISA Provides Many Benefits
ERISA is a federal law designed to protect the rights of employees who receive employer-provided insurance benefits, such as retirement benefits, health insurance benefits, and other forms of employee benefits.
The 1974 law establishes minimum requirements for benefit plans offered by private employers in Houston, Texas, and nationwide. The vast majority of employer-sponsored retirement and health plans are covered by ERISA, while government-funded benefit plans are largely exempt from federal law.
The Employee Retirement Income Security Act provides three fundamental protections for employees (beneficiaries and participants):
- The right to sue for plan benefits when their attempts to appeal are unsuccessful;
- The right to file a lawsuit against fiduciaries for failure to fulfill their obligations under ERISA; and
- The right to continue receiving benefits covered by the Pension Benefit Guaranty Corporation (PBGC) when the original plan is terminated.
Contact a skilled Houston ERISA lawyer if you have experienced an ERISA violation. We help employees address the various obstacles they face during the ERISA claims and appeals process.
What are ERISA Standards?
ERISA sets strict standards for the following aspects:
- Conduct: ERISA requires fiduciaries to adhere to stringent rules of conduct.
- Reporting: ERISA sets strict requirements for reporting to the federal government.
- Disclosures: Plan administrators must provide certain disclosures to participants and beneficiaries, including guidelines for obtaining ERISA-covered benefits.
- Procedures: ERISA requires fiduciaries of covered plans to establish written policies as to how participants should file claims, how they can appeal denials, and explain other procedural requirements and nuances.
- Good faith: ERISA requires plan administrators to act in the best interests of participants. Administrators must handle claims in good faith and fulfill their fiduciary obligations.
Speak with an experienced attorney to find out more about ERISA standards and regulations. You can also get information about employee benefit plans from the Department of Labor.
What are the ERISA Fiduciary Obligations?
ERISA provides protections for beneficiaries and participants in covered benefit plans and also imposes fiduciary obligations on those who manage employee benefit plans and assets. ERISA requires fiduciaries to act with a reasonable degree of care, prudence, and diligence.
While fiduciaries, including ERISA plan administrators and insurance companies, are legally required to act in the best interests of beneficiaries and participants, breaches of fiduciary duty are not unheard of in ERISA-related cases.
A participant or beneficiary can sue a fiduciary for their failure to fulfill their obligations imposed by ERISA, including:
- Mishandling plan assets
- Failing to handle a claim on time
- Failing to properly calculate plan benefits
- Not following the terms of the benefit plan
- Wrongfully denying an ERISA-based claim
If you believe that a plan administrator or another party breached their fiduciary duty when processing, handling, or denying your claim, do not hesitate to speak with an ERISA lawyer.
Talk to Us About Your ERISA Insurance Claim
You can get professional help from an ERISA attorney in Houston when you need assistance getting the benefits you deserve. Our team at ERISA Insurance Claim Attorneys can help with your initial benefits application. We’re also here to support you after a denial.
You can reach out to us now to discuss your next steps and to help with understanding ERISA.
Call or text (225) 201-8311 or complete a Free Case Evaluation form