Being disabled and wrongfully denied benefits is a hard pill for many to swallow. Various reasons exist for being turned down, particularly concerning insurance claims related to ERISA. While discouraging, applicants should know that the initial ruling is not the final say. Options exist to secure the benefits you deserve.
While you have a right to an appeal, time is of the essence. ERISA plans limit the time to 180 days to complete those steps.
A lengthy and complex process
After receiving an electronic or written denial, carefully read the document to understand why the rejection relates to your plan and the evidence you provided. Requesting relevant information from your insurance company regarding your claim can only help your chances of approval.
With all the evidence gathered, the first step is filing an internal appeal with your insurance provider before even considering court proceedings. Again, the time span is short. Your options to recover benefits may be extremely limited if you miss the deadline.
A thorough approach to your claim
Attention to detail is paramount, particularly if your case goes to federal court. You could lose the option to submit any new evidence once you formally file the appeal. Ensure that all documentation is both complete, relevant and paints a strong picture of your need for long-term disability benefits.
Should the case go to court, a judge, not a jury, will review both your initial claim and appeal before rendering a decision about benefits. It is important to note that many ERISA plans will require two appeals before you can file a lawsuit.
As with any complicated legal process, before starting the ERISA appeals process, you should consult an attorney with comprehensive knowledge of the specific information that helps you cross the finish line and secure the benefits you deserve.