Having your long term disability claim wrongfully denied by your insurer is one of the most frustrating things that anyone can go through. How can companies that are supposed to be there for you when things go wrong bend and sometimes even break laws – all just to avoid giving their customers the benefits that they deserve? If you or someone you love is in a situation like this, there’s a good chance that you not only want to get the benefits that you asked for in the first place, but also punish your insurer by making them pay punitive damages for putting you through so much trouble.
Unfortunately, for many Americans with insurance, that’s just not possible. If your insurance plan falls under ERISA (as most plans from employers do), the law says that you can’t seek damages against your insurer. But that doesn’t mean that everyone is out in the cold.
Who is Eligible for Punitive Damages?
While ERISA covers the majority of insurance plans in our country, it doesn’t govern all of them. The below groups can still sue their insurers for punitive damages.
Those who are independently insured. If you contacted an insurance company yourself and purchased an individual plan (i.e. not one offered by your employer), your plan isn’t governed by ERISA. People in this group are generally self-employed, small business owners, or those who can’t get insurance from their job.
Those who work for the government. Work for the Post Office? Library? A public university or school? If so, then your insurance plan is not covered by ERISA even if it is provided by your employer. That means that you can go after them as hard as you want if they try to wrongfully deny your claim.
Those on church plans. People who work for churches and other religious organizations and have “church plans” are also exempt from ERISA and may try to obtain damages from their insurer.
For a free legal consultation, call 800-562-9830
What About Those on ERISA Plans?
People on ERISA plans may not be able to sue their insurers for punitive damages, but that doesn’t mean you shouldn’t work with a qualified long term disability attorney to ensure that you get the benefits to which you are entitled. And though it doesn’t make up for the fact that you can’t sue your insurer above and beyond what your policy allows, ERISA policyholders can still ask to have their attorney fees covered if they win.
Learn more about the workers disability claim process by downloading our free eBook on disability insurance policies. Be sure to check our weekly blog for more information on Long Term Disability claims!
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