ERISA and Denied Employee Benefits Claims

How Our ERISA Attorneys Can Help You Win Your Appeal

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that governs claims from most employee benefit plans in private industry to provide protection for enrolled individuals. ERISA was designed to protect legal rights of employees and their beneficiaries. In practice, however, many ERISA plan participants have difficulties recovering the benefits they are entitled to. ERISA is a complex law and it is best to consult with an experienced employee benefit attorney if your claim was denied. 

One of the reasons it is best to have legal help when faced with an ERISA denial is a strict appeal deadline. Under ERISA, an adverse benefit determination (a denial) must be appealed administratively before a lawsuit can be filed. For most plans, the appeal deadline is 60 or 180 days from the date of the denial letter. It means that a beneficiary whose claim has been wrongfully denied has only 60 (or 180) days to investigate the denial, draft an appeal, prepare supporting documents, and submit the appeal before the deadline. Unfortunately, an appeal prepared without a legal brief is rarely winning. Another important factor to consider when dealing with an ERISA life insurance claim denial is providing an insurer with all legal arguments and documents that the beneficiary plans to include in the lawsuit. A poorly submitted ERISA appeal may restrict the beneficiary from bringing up new issues or documents during litigation. 

A beneficiary who lost a loved one may still be going through a grieving process and may not have the strength to review complex life insurance policies and perform a thorough investigation in order to submit a comprehensive brief. Further, an appeal based on the same set of documents is bound to be denied. 

When a life insurance lawyer prepares an ERISA appeal, they draft a legal brief based on ERISA law and the results of an independent investigation and research. This forces the insurance company to look at the case from a new perspective. Beneficiaries who win ERISA appeals at an administrative level save time and money that would otherwise be spent on litigation. At our ERISA law firm, we urge everyone whose benefit claim was denied to hire an ERISA counsel before filing an appeal to increase chances of winning. 

Our ERISA Areas of Expertise

At Kadetskaya Law Firm, we have a high success rate of recovering insurance proceeds on ERISA appeals and will make sure your ERISA appeal is handled professionally and competently.

Our ERISA lawyers have considerable experience in winning cases involving claim denials including:

  • Denial based on failure to provide a conversion application 
  • Denial based on change in marital status
  • Denial based on exclusions
  • Denial based on employer non-payment of premium
  • Denial based on failure to apply for waiver of premium
  • Denial based on failure to provide an evidence of insurability form
  • Denial based on employer’s mistake
  • Denial based on not being actively at work 
  • Denial based on dependent ineligibility

Here are just a few cases successfully handled by our ERISA lawyers:

In most ERISA cases, an administrative appeal is a necessary step before the claim proceeds to court. If you decide to sue your insurance company without first exhausting administrative remedies, your court action may be barred. Therefore, you need to consult an experienced ERISA attorney who will file an appeal on your behalf. Our life insurance lawyers can help you recover your wrongfully denied claim fast, no matter the reason invoked by the insurer.

Read more about how ERISA appeals and ERISA lawsuits take place and what is important to know as a beneficiary.

No Legal Fees Unless We Win Your Case!

Our attorneys work on a contingent fee basis. It means that we do not charge legal fees unless we collect the ERISA proceeds for you. Only then will we charge a reasonable legal fee. We take pride in offering competitive contingent fee structures and will work with you to ensure you are comfortable with the fee.  

If your claim has been denied or delayed, consult legal counsel. Call (888) 510-2212 for a free consultation. We have the experience you can trust.

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