Each year, countless families are needlessly denied life insurance benefits under policies provided by a deceased loved-one’s employer. When life insurance is part of an employee group benefit plan, a denied claim can be further complicated by a federal law known as ERISA — the Employee Retirement Income Security Act.
Unfortunately, ERISA laws gives insurance companies many outlets to delay or deny a valid life insurance claim. Insurers face no real penalties for denying ERISA claims. With nothing to lose, they often use this to their advantage to unfairly avoid paying out death benefits.
Due to the intricacies and implications of these laws, hiring an attorney with extensive knowledge of ERISA can mean the difference between winning and losing a case. Marc Whitehead & Associates are passionate about helping those who must fight not only an oppressive insurance company, but the complex legal process of ERISA.
The Appeal – the Most Important Part of Fighting Denials of Employer Sponsored Life Insurance Benefits
The administrative appeal is the key to overturning a claim denial in these cases.
- The policy will have specific wording about coverage, exclusions and other key questions that will form the basis for the appeal process;
- Strict time constraints are in place and must be followed;
- The appeal is the final chance to state your case and introduce new facts or evidence into the case.
Our attorneys will meticulously load the administrative record to account for all medical history, expert opinions and other legal evidence and arguments that will support your claim. Should a lawsuit become necessary, our appeal serves as a fully developed case, prepared with future considerations of the court in mind.
What if an ERISA Life Insurance Appeal is Denied?
You can only file a lawsuit against the insurance company after an appeal is denied and the administrative process is exhausted. Many other options are not available to a claimant under ERISA:
- Employees and their beneficiaries have no rights to a jury trial; cases are tried in federal court and heard by a judge;
- Employees and their beneficiaries are not allowed to sue for compensatory and punitive damages;
- Since state insurance laws do not apply in ERISA claims, a plaintiff cannot sue for breach of contract or bad faith;
- You can, however, sue for breach of fiduciary duty.
Come to Us about Denials of Employer Sponsored Life Insurance Benefits
If your loved one’s life insurance was provided by his or her employer, ERISA likely governs your claim. Accidental Death and Dismemberment claims may also be governed by ERISA.
It is recommended that beneficiaries do not attempt to appeal these cases without qualified legal help. Not even all attorneys possess the legal skills and experience to effectively pursue ERISA claims.
At Marc Whitehead & Associates, our lawyers have dealt with the nation’s largest insurance companies to overturn unfair denials of ERISA claims for our clients. If an insurer has unjustly declined to pay on a life insurance policy, we can help you appeal the denial and pursue a lawsuit as necessary.
While these cases may sound difficult to overcome, they can be overcome indeed. We hope you will request your free consult with a life insurance lawyer as soon as possible by calling 800-562-9830.