First things first – most people don’t have non-ERISA insurance policies. If you get your insurance from an employee benefit plan, you fall under the giant umbrella of ERISA and have to follow the guidelines outlined by that law.
Those of you who individually pay for your own insurance, though (freelancers, small business owners, and so on) are not governed by ERISA. Congratulations, because it’s a law that’s designed to protect the insurance companies at the expense of policyholders. By having your own individual plan, you’ve given yourself far more of an ability to stand up to your insurer and fight for your rights.
What’s the downside? Well, for one, it’s a lot harder to talk to you about what you need to do for your workers disability claim because every single state has different rules. There are a few general things that I can tell you, though, so read on to get a start, and then call me if you have more questions.
How Non-ERISA Claims and Lawsuits Work
One thing that doesn’t change no matter where you live is the idea that you want to try to give your insurance company ample opportunity to settle the matter with you before making it a legal matter. Things you should know?
- Put all communication in writing
- Give time for your insurer to reply (statutory deadlines differ by state)
- Look for contractual remedies
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This last one is something that you probably want to talk to an experienced attorney about, because they’ll know exactly what to look for. Just a few possible routes that you can go include things like bad faith, breach of contract, loss of credit, mental anguish, deceptive trade practices, and insurance code statutory damages. What all of these really mean are that your insurance company didn’t pay your workers disability claim when they should have and it caused problems for you. And if you have to go to court and deal with a drawn out legal battle, don’t worry – unlike with ERISA policies, non-ERISA policyholders can try to get their attorney fees reimbursed!
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