ERISA governs certain benefits that employees or their families to receive from their employers, including:
ERISA is a complicated law and so are the insurance claims under the law. Discuss any concerns with ERISA lawyers in San Francisco.
Just because these benefits exist, and they are subject to a federal law does not always mean that they are easy to get. Insurance companies can make the process more difficult for families when they are in a time of need. Even when they make the claim, it does not always mean that it is approved. ERISA does not punish insurance companies for denying claims, and many have a financial incentive to make it harder for people to get the benefits that they need.
ERISA imposes its own system for appealing any denial of benefits. On the surface, this seems like it favors the insurance companies. However, it is a process in which you must participate if you want to receive benefits. You cannot file a lawsuit until you have exhausted the administrative appeals process.
The first step in the appeals process is to convince the insurance company to reverse its original decision denying benefits. This actually has been known to happen with some frequency. Many times, your initial claim may not have been as extensive as it needed to be to get benefits. The denial explained the reason for the denial, and the appeal fills in what may be missing from the claim. In other cases, the insurance company can dig in its heels and continue denying the claim.
Nonetheless, you must put your best foot forward in the administrative appeals process. The strength of your appeal could determine whether you receive benefits, even if the insurance company denies it. This is because you have the right to go to court to take on the insurance company. The judge will only look at the evidence that was in the record on the appeal. You are not allowed to add anything else. Therefore, you should hire an attorney for your ERISA appeal because getting legal help at the lawsuit phase may be too late.
With an ERISA appeal, it is all about the documentation that you present. It must tell the story why you are entitled to benefits. Your case will need to be made in writing, and you need someone on your side who is experienced at putting together a record. Even if your case went to court, you would not have a trial in a traditional sense. ERISA can be a difficult law to understand, and insurance policy documents can be dense. An ERISA attorney could help you understand the process and work on an effective appeal that may show that you are legally entitled to benefits.
Claimants can always benefit from the help of an ERISA lawyer, even when they first apply for benefits. At the appeal stage, an experienced ERISA attorney is a must. Contact Roberts Disability Law, P.C. to discuss your case. This is a call that cannot wait, especially if your claim has been denied.
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