Many people suffer from a disability or illness that impairs their ability to work. Some of them can take advantage of long-term disability benefits offered by their employer. However, just because a company provides these benefits doesn’t mean the insurance company administering the plan will approve the claim.
When insurers issue denials, the federal Employment Retirement Income Security Act (ERISA) protects workers’ rights to receive benefits when they meet the requirements of their employer-offered plan. Insurance companies routinely, and often wrongly, reject claims for a variety of reasons.
ERISA guidelines outline several violations
It’s not surprising why insurance companies make the process of getting these benefits as complex as possible. Their main concern is protecting their bottom line, not your well-being. Insurers and employers can violate ERISA rules in many ways, including:
- Denying benefits: Current employees who meet the plan requirements are entitled to benefits. Employers or insurers violate these rules if they withhold payments or provide fewer benefits than are owed.
- Failing to inform employees: Employers who offer ERISA-backed long-term disability coverage must disclose the plan along with the covered disabilities and illnesses to their workers.
- Fiduciary failures: Insurers that administer these plans have a fiduciary duty to run the plan solely for the best interests of plan participants.
Understand your rights to claim benefits
Just because an insurer rejects your claim doesn’t mean you have to accept their decision. Unfortunately, too many workers are in the dark regarding ERISA protections. That’s why looking for guidance from a disability lawyer specializing in ERISA-backed plans is advisable if your claim is denied.
Attorneys knowledgeable about employer-offered long-term disability benefits understand insurer tactics to deny or terminate benefits. Even if your claim is rejected, working with an experienced lawyer aids in an appeal or lawsuit if your appeal is wrongly denied.