Navigating the complex ERISA regulations can be challenging and confusing for many, with many procedures and rules to follow. This is especially true when you’re trying to get the employment benefits your employer promised when you signed on to your new job. While ERISA is meant to protect your interests as an employee, there are times that your ERISA claim can be unjustly delayed, denied, or underpaid. That’s mainly because most insurance companies and employers are always protecting their own interests and will look for ways to discredit your claim to avoid paying out your benefits.
However, you can take legal action against your employer and their insurance company by filing an appeal or a lawsuit in court to ensure you recover your benefits. Contacting an attorney for employee benefits like those from this site to assist you to navigate the complex claim and appeal process can increase your chances of securing your benefits. Your attorney can help evaluate your claim, take you through the entire process, and argue your case to ensure the insurance company approves your claim.
Here are some of the situations that may need you to seek the counsel of an experienced employee benefits lawyer.
1. When Facing Pension Plan Issues
Pensions are designed to offer you a guaranteed income during retirement because you’re not earning a steady income from employment. If you’ve been contributing to your pension plan during your employment period, the Employee Retirement Income Security Act protects you and ensures you get paid upon retirement.
The ERISA Act provides a wide range of protections for employees, including enacting a fiduciary duty on pension plans. However, there are many issues you could face with your pension plans. These issues include mismanagement of your pension funds, poor investment returns, employer bankruptcy, and poor investment returns. You should consider hiring an employee benefits attorney if you face issues with your pension plan.
An employee benefits attorney can help protect your pension if you believe it has been mismanaged. If your employer has improperly invested the company stock risking your returns or terminated your pension plan due to employer bankruptcy. Contacting an employee benefits lawyer when your pension and retirement plan is denied is crucial to help you navigate the complex appeal process and ensure you get the support you deserve.
2. When Your Disability Benefits Claim is Denied
If you apply for disability benefits, but your claim gets denied, or your benefits are terminated, it’s advisable to hire an experienced attorney immediately. If your employer denies your disability benefits, you have a short time of about 180 days to submit an appeal to the plan administrator or the insurance company. You must file an appeal before taking legal action against your employer and their insurer in court. If your appeal is unsuccessful, you’re not allowed to bring any new evidence in court.
The judge only reviews the evidence you present or supplied by the insurance company during the claim and appeal process. It’s crucial that you ensure you’ve gathered enough evidence to present before the court during the appeal process. Otherwise, the insurance company will ensure they have enough evidence to fight your disability benefits claim and appeal in court.
This is why you need an attorney specializing in ERISA disability benefits claims to assist you in collecting sufficient evidence and documentation to prove your disability benefits claim. They will also help you understand your rights, file your appeal properly and file a lawsuit if needed to recover your benefits.
3. After an Employer’s Life Insurance Denials
Most American workers have life insurance provided by their employers. That’s because employer-provided life insurance is paid for by your employer and is usually more affordable than buying it on your own. While your employer’s life insurance should benefit you and your beneficiaries, your employer or the insurance company can deny paying out your benefits for different reasons.
You should contact a life insurance benefits attorney if you’ve been wrongfully denied your life insurance benefits and your employer didn’t provide you a proper notice to secure your benefits after firing or laying you off. An attorney can also help you if your partner unexpectedly dies and their company life insurance plan or employer denies your claim.
If your employer-funded life insurance is denied, filing an ERISA appeal is your best chance to provide supporting evidence and documentation to build a strong case against the insurance company for litigation. This is when you need to hire an experienced employee benefits lawyer to help you prepare your appeal by collecting and providing the insurance company with all the relevant vocational and medical information needed to get you the compensation you’re entitled to.
A knowledgeable and experienced attorney can help you understand how insurance companies operate, the specific terms of your employer’s life insurance, negotiate on your behalf, and advise you through every step of the process, increasing your chances of getting your claim approved. Working with an attorney is important because not following the proper appeal procedures after a life insurance denial could make you lose your right to sue the insurance company and your employer.
The insurance company will also have a team of top attorneys on their side, so it’s vital to have an attorney to represent and negotiate on your behalf. They will collect the necessary evidence and documentation and argue your case through a written appeal to your employer and the insurance company to ensure you get the settlement you deserve.
Endnote
While you can file a claim for your employee benefits without an attorney, you may not get paid since insurance companies usually have top attorneys to discredit your claim. The insurance company’s goal is to ensure they retain as much profit as possible. Also, ERISA timelines and guidelines tend to favor insurance companies more than individuals, making the claim process harder for you, not to mention the unique appeal procedures, strict deadlines, and specialized evidentiary rules involved in ERISA cases.
An experienced employee benefits attorney is knowledgeable about the rules, deadlines, and procedures around appealing denials, filing claims, and applying for benefits. They also know how to best negotiate with the insurance company and design the best strategy to defend your claim and ensure you get your benefits.
