Long Term Disability Insurance claims are usually governed under federal ERISA regulations. If a claimant goes through the administrative appeals process and is denied their disability benefits, their only remedy is to file a civil lawsuit to enforce their rights under the policy. This leads to several important questions. In part one of this two part blog we explore who can sue and who can be sued:
Who Can Sue?
Any Plan beneficiary or participant may bring suit to enforce their rights under the plan or policy. This generally means the disabled individual but in some cases could be a spouse, an estate or an heir.
Who Do You Sue?
Typically in a disability claim, the suit will be brought against the Plan or the Plan Fiduciaries, often called the Plan Administrator. Frequently, the plan administrator is the underwriting insurance company. Hence, the reason we generally refer to the insurance company throughout this e-book when are speaking about the Plan. Occasionally, but not often the proper defendant is the claimant’s employer. The test is who had the authority under the plan to grant or deny the disability claim. Most major insurance carriers such as Unum, MetLife, Cigna and Aetna follow this structure.
ERISA based federal lawsuits are complicated and can’t be filed in your local county or small claims court. Always consult with an experienced ERISA attorney before pursuing legal action. In part two of this post, we will discuss where to file your lawsuit and how long do you have to file your lawsuit.
If you have questions, ask disability attorney, Marc Whitehead by visiting www.DisabilityDenials.com or you can download Marc Whitehead’s free E-book, Disability Insurance Policies-How to Unravel the Mystery and Prove Your Claim.