In this video Marc Whitehead, Board Certified ERISA Long Term Disability Attorney, discusses how an ERISA Long Term Disability Policies Work.
If you are having trouble with your employer sponsored disability insurance plan, you are not alone. Lots of Americans have their claims denied or receive confusing answers from their insurers.
And because they don't really understand how a health plan or disability plan is covered by ERISA, they often don't know how to fix the problem.
That's why I decided to break down the basics of how most ERISA plans are set up. It's not gonna make you an expert and you definitely want to still wanna work with an attorney if you need to file a lawsuit against your insurer but hopefully it will make some things clearer.
The first, and most important thing to know, is that if you get insurance from your employer you most likely have a plan that is covered under Federal ERISA Law. After that you have to understand that you are probably going to need to lower you expectations of what you might be expecting to get in your lawsuit. Unlike with independent plans, people covered by ERISA can't sure for punitive damages, bad faith, emotional distress, unfair practices, and many other things that seem like they should be allowed.
How does ERISA insurance work?
Well, first there is a plan. This includes the policy and a core set of defining documents as well as any other amendments.
Second- there is an administrator. Basically the Administration is the on who decides if your coverage for someone is accepted or denied. Insurance companies like to be the one with this power and most of the time it is given to them.
Third- you have to go through an internal review. If your claim is denied and you disagree you are required to have this denial reviewed internally by the insurance company and exhaust your administrative options with them before you are allowed to file a lawsuit. This can be quite time consuming.
If you get denied you will get a denial letter in the mail. ERISA regulations require insurers to send you a denial notice that explains why you were denied and what options you have to appeal this decision within a timely manner. If your insurer meets all the standard requirements it is vital that you act fast to appeal. Because of this an specific rules that have to be followed you want to work with an experience ERISA attorney.
For more information regarding Long Term Disability Claims download our free eBook:
Disability Insurance Policies: How to Unravel the Mystery and Prove your Claim
Visit [ Ссылка ] for a free downloadable copy.
Or Contact our office to discuss your particular LTD issues
Marc Whitehead & Associates Attorney at Law, LLP
403 Heights Blvd
Houston, TX 77007
(713) 228-8888
