In this video Marc Whitehead, a Board Certified Disability Attorney, explains why you’ll have a no State Law claim under ERISA Law.
ERISA Plans favor the insurance companies quite a bit and in a number of ways.
One of the prominent examples of this is the fact that you are not allowed to file any State Law Claims against the insurer for engaging in Bad Business practices.
What does that really mean though? How much does it matter in the grand scheme of things?
Hopefully it wont matter for you at all in your disability insurance claim. But the blanket refusal of State Law Claims forbid you from going after your insurance company for a number of potential issues.
What does the elimination of State Law Claims keep you from doing?
If you have insurance through your employee you have no recourse in State Law for the following:
No mental anguish claims. Lets say that your insurer gives you the run around when you are trying to get disability and the extra time leads to a worsening of your condition that harms your mental health. Under normal circumstances your should be able to file suite against them for their part in your suffering. This is not the case under ERISA Law.
No Consequential damages claims: Did your insurer knowingly try to prevent you from obtaining disability benefits even though they knew that you met the requirements? This isn’t legal, but it also isn’t something that you can argue against or punish if you have disability insurance through your employer.
No punitive damage claims: This is designed to legally and financially punish those who engage in actions that may cause those others harm. For example: an insurance company that refuses to give you disability until their condition has worsened to the point that you can’t fight it anymore. Private plans allow you to sue the insurance company for illegally forcing you to wait but ERISA plans just don’t work that way.
No deceptive trade practices claims: Do you think that your insurer acted in a deceptive manner when they handled your claim or engaged in behaviors that attempted to break their contract with you? If you are getting your disability through your employer this point isn’t allowed to come into play due to the fact that you can’t sue them under Federal ERISA Law.
No mandatory Attorney fee reimbursement: That’s correct, as someone insured under ERISA you are not guaranteed to get your Attorneys fees reimbursed if you win your claim.
While ERISA Law protects insurance companies from having to answer for their wrong doing there are still plenty of ways for winning disability benefits. This is why having an experienced ERISA Attorney on your side is so important. Some disability Attorneys are unfamiliar with all of the ERISA regulations and don’t know the best way for going about winning your benefits.
Marc Whitehead & Associates has over 20 years of experience fighting for disability benefits under ERISA guidelines and we can help you too.
