According to ERISA act of 1974, "ERISA requires plans to provide participants with plan information including important information about plan features and funding; sets minimum standards for participation, vesting, benefit accrual and funding; provides fiduciary responsibilities for those who manage and control plan assets; requires plans to establish a grievance and appeals process for participants to get benefits from their plans; gives participants the right to sue for benefits and breaches of fiduciary duty; and, if a defined benefit plan is terminated, guarantees payment of certain benefits through a federally chartered corporation, known as the Pension Benefit Guaranty Corporation (PBGC)."
Yes, you can challenge a denial of life insurance benefits under ERISA. The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans.
An employee or beneficiary of an employee has the right to challenge how the employer is operating an ERISA governed plan, including a life insurance benefit.
If your claim for benefits under an ERISA plan is denied, you cannot immediately file a lawsuit to collect your benefits. Instead, you will be required to file at least one appeal with the very same company that denied your claim. While the insurance company may allow you to conduct the appeal without the assistance of an attorney, you might be handicapping your chances of winning a lawsuit if/when the company denies your appeal.
Accordingly, when confronted with ERISA insurance claims appeals under a life insurance plan governed by ERISA, the best thing you can do to increase your chances of appeal is to hire an experienced ERISA attorney to help you through the process.
The Law Office of Julie A. Mersch will evaluate your long-term disability, health or life insurance claim/case options. Choosing the right law firm to prosecute your ERISA case can have a significant impact on your case and is perhaps the most important decision you can make with respect to your long-term disability, health or life insurance claim/case.
Companies often provide employees with group life insurance coverage as a benefit of employment. Although most group disability, health and life insurance policies are subject to ERISA, there are exceptions, even when the policies are not issued by a church organization or governmental entity. Federal courts have held that there are basic requirements in order for a group disability, health or life insurance policy to be subject to ERISA.
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