ERISA Experience You Can Rely On.

Common myths about ERISA denials

On Behalf of | Nov 24, 2022 | Erisa

Filing a claim under your employer’s long-term disability insurance plan can be a complicated and exhausting task. That’s especially true when an illness or injury renders you unable to earn a living. Combining lost income, mounting medical bills and day-to-day living costs only adds more stress to your debilitating medical condition.

Even when you determine the condition is covered under your employer’s plan, getting an insurer’s approval for benefits can be challenging. Some people get discouraged after hearing about insurer denials for their best friend’s uncle or reading online gossip that makes their chances seem hopeless. But instead of surrendering to despair, it’s crucial to understand the facts and get experienced guidance.

Debunking ERISA myths

We are bombarded with so much negative and unsubstantiated information these days it’s crucial to separate fact from fiction. Here are three untrue statements regarding Employment Retirement Income Security Act (ERISA) claims:

The insurer’s decision is final

Fact: Most long-term disability claims are initially denied by insurers. However, you have the right to appeal rejected claims as well as approvals where insurer benefit payments are less than you deserve.

You can immediately sue an insurer over a denied claim

Fact: Insurance companies must give a valid reason for the denial and send you a letter outlining how to file an appeal. Once the appeals process runs its course, you can file a lawsuit against the insurance company for wrongly denying a valid claim.

Any lawyer can help with my long-term disability claim

Fact: Lawyers specializing in ERISA law give you the best chance to receive the benefits you deserve. It’s advisable to consult with an experienced ERISA attorney before filing a claim to make sure your paperwork is correctly filled out and that you meet all the deadlines.

Get the facts before filing a claim

Another mistake some people make is thinking of an ERISA claim in the same light as workers’ compensation. However, ERISA disability claims are much more complicated, with potential long-term consequences when done incorrectly. Getting the proper guidance from the get-go can not only result in getting benefits sooner but forcing insurance companies to follow the rules.