If you ultimately win a disability dispute, you might think the insurance company will be instructed to pay the attorney fees, even in ERISA disability claims.
However, that is not how it usually goes. This video describes yet another way ERISA disability claimants must fight an uphill battle:
- If a lawyer helps you prepare the administrative appeal and you win, you must pay the attorney’s fees.
- Even if you win your case in court, the decision of recovering attorney fees in ERISA disability claims is left up to a judge’s discretion. This includes the amount (percentage) of attorney fees the insurer might be ordered to pay.
Our attorneys fight for our clients to ensure they get the best possible outcome—including pursuing recoverable ERISA attorneys’ fees. Read on to learn about attorney fees and your group disability claim.
What if my initial claim is denied but I win on appeal?
ERISA does not provide for the award of attorney fees – or any fees – for time spent and legal work done during the administrative appeal process.
For example, suppose the insurance company denies your initial claim for benefits, and you file an administrative appeal. Upon appeal, the insurance company changes its mind, decides in your favor and you win the claim. You still must pay your attorney fees. In an ERISA disability case, if a lawyer has helped you appeal and win, but a lawsuit is never brought in a court of law, it is your obligation to pay the fees.
Attorney fees in ERISA disability claims can only be awarded to a plaintiff in cases that go to litigation — and then there is no guarantee.
So essentially, when dealing with unfair insurance companies, the laws of ERISA cause you to spend money that most disabled claimants do not have. The administrative appeal is a long and frustrating period of time when disability benefits could have been paid to you – but instead, you had to pay an ERISA disability lawyer to help you win.
What if I am denied on appeal and my case goes to court?
During litigation, ERISA allows for the possibility of recovering attorney fees – whether you win or lose. Case law has made it clear that you do not need to be the “prevailing party” in order to be awarded attorney fees. Still, there is no guarantee of any award at all.
Generally, you need to show what is called “success on the merits of your claim.” But this alone can result in random and inconsistent practice and is why courts use the Five Factor Test (as explained in our video above) to decide whether to order the insurance carrier to pay all or part of the attorney’s fees.
Serving Our Clients’ Goals in Obtaining Attorney Fees in ERISA Disability Cases
Our firm understands the laws of ERISA attorney fee provisions. We also realize how important this is for you, and apply the laws to your advantage. Our attorneys strive to recover the most in lawyers’ fees that can be awarded fairly.
If you need help with your disability insurance claim, contact us without delay. At Marc Whitehead & Associates disability law firm, we work on a contingency fee basis for the majority of our cases.
This means we advance all costs of the process, and you pay no fee up front to retain our firm. We are paid a percentage of the recovery only when and if we reach a successful outcome in a settlement or a judgement in court.