Fighting For The Insurance Benefits You Deserve
Fighting For The Insurance Benefits You Deserve

Which employers does ERISA apply to?

ERISA applies to private-sector employers who offer employee benefits plans, regardless of the size of the companies.

How do I know if ERISA applies to my employee benefits?

ERISA does not apply to government or church plans. It also doesn’t apply to any plan created solely to ensure compliance with unemployment, workers’ compensation or disability laws. A knowledgeable attorney like Robert can help you determine if ERISA applies to your benefits.

If my claim is denied, does it mean my claim is illegitimate?

No, it doesn’t. Many valid claims are initially rejected due to missing information, inadequate medical documentation or administrative errors. You have the right to appeal the decision, and many denied claims are approved after an appeal.

What options are available to an employee when their ERISA claim has been denied?

If your ERISA claim is denied, you have the right to appeal the decision. Start by requesting a review of the denial within the time frame specified by your plan. You may need to provide additional documentation or clarification. If the appeal is denied, then you may have the option to file a lawsuit in federal court.

What steps can I take to help ensure that my claim is approved?

To increase the likelihood of your claim being approved, make sure to:

  • Complete all required forms thoroughly.
  • Provide detailed medical documentation.
  • Follow your doctor’s treatment plan.
  • Keep comprehensive records of your medical visits and treatments.

Finally, you should submit your claim and any required documentation within the specified deadlines.

How can an attorney help with an ERISA appeal?

An attorney can assist by reviewing your denial letter, gathering necessary medical evidence and preparing a strong appeal. They can also represent you in communications with the insurance company and, if necessary, in court. Legal assistance can significantly improve your chances of a successful appeal.

What are my options if the appeal isn’t successful?

After an unsuccessful appeal, you may have the option to file a lawsuit in federal court. This process can be complex and requires a thorough understanding of ERISA law and procedures, which is why the attorney you hire is an important decision to make.