What To Expect During An ERISA Claim Part 2

March 11, 2016 | J. Price McNamara
What To Expect During An ERISA Claim Part 2

In last week’s blog, we discussed “What To Expect During An ERISA Claim Part 1”. This week, we will finish up the discussion by addressing the second part of what happens when you have an ERISA claim. Will My Procedure Vary From State To State? Yes, the way your suit is handled will depend on the rules of the state court where your case is pending. It is in the best interest of the parties to get the case resolved as quickly and efficiently as possible. If you are unable to settle your case, the court requires that you attempt to agree to as many relevant procedural issues as possible. After this happens, the parties will file documents with the court related to your particular ERISA claim. Next, the parties' attorneys will prepare court “briefs” that outlining the positions of each party. What Will The Trial Be Like? With ERISA cases, there is not a trial in the traditional sense. After all appropriate documents have been submitted, the court will decide your case based upon the substance of the record that is created during your appeal process. This was your opportunity to protest the way your particular case was handled and request an alternate decision. If the court rules with your insurance company, then the claim decision will be upheld and your ERISA case is over. One exception to this is if your appeals is up-held and the original decision is reverses. What Is The Administrative Record And How Does It Apply To My ERISA Case? When your case is being heard and decided, an attorney cannot evaluate the merits of your case until they review the administrative record. The administrative must be disclosed during your litigation. What Can I Recover If I Win My Appeal? Under ERISA, recovery is limited to benefit that are due from the original claim. Sometimes parties can also obtain attorney's fees and costs. What Are The Odds That I Will Be Successful In My ERISA Case? No law firm or attorney can guarantee that you will be successful in your ERISA case. The reason for this is that appeals ERISA law was created to support insurance plans, retirement plans and the applicable administrators. This can make it difficult to prevail on appeal, which makes it even more critical that you obtain an experienced and skilled ERISA Attorney. What Are The Typical Costs For An ERISA Case? ERISA claims cases can be expensive. The cost of an appeal (without including your attorney's fees) is usually a few thousand dollars or more. On those cases which are appealed the appeal is lodged within 30 days of the District Court's final order. How Long Will My ERISA Case Take? Once your paperwork is filed, a case can typically take between one (1) to two (2) years to complete. However, since there is no trial you will not appear in court. A decision will usually be rendered within sixty (60) days after your attorney argues your case. What Are The Typical Fees For An ERISA Case? Most lawyers and law firms handle fees for ERISA cases differently. Some attorneys or firms require the client to pay a retainer upfront and then bill on an hourly basis against that retainer to handle the case. Other firms will require a retainer up front only to cover costs, but will handle the attorneys' fee aspect of the claim on a contingent fee arrangement. You will need to contact your attorney or firm directly to find out how the fees for your case will be handled. Regardless of what you agree to, you must be given the fees in writing and sign a form stating that you understand and agree to the fees. Is The Recovery Award From My ERISA Case Taxable? Any monetary reward from your ERISA lawsuit could be taxable. However, this will likely depend on a number of factors. If you undertake an ERISA lawsuit and obtain a reward, you should consult with a qualified tax professional regarding the taxability of any proceeds from your case.

Call J. Price McNamara For Help With Your ERISA Case Today

Only an attorney with knowledge of the appropriate laws can help you get you the outcome you deserve for your ERISA case. The legal team at J. Price McNamara ERISA Insurance Claim Attorney is waiting to help you resolve your case. Call us today to schedule your free case review and get an experienced insurance attorney on your side.
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J. Price McNamara


Losing my own brother, then my father and sister after long, disabling illnesses just a few months apart drove a career change for me. Before that experience, I never truly understood the place you’re in. I never understood the dramatic impact that receiving (or not receiving) the disability and life insurance benefits you paid for and counted on can have on your life especially when you need to focus on family and healing. What I experienced with my own family now drives the way I view my clients and my work, and I will never forget it!

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