WHY YOU NEED A LAWYER TO REPRESENT YOU REGARDING YOUR ERISA CLAIMS
Hacker Murphy, LLP
7 Airport Park Boulevard
Latham, New York 12110
Tel: (518) 783-3843
If you have been denied disability benefits under an employer sponsored policy, your claim is likely governed by the Employee Retirement Income Security Act, otherwise known as ERISA. ERISA was intended to help employees and protect their benefits, including total disability and short term disability benefits. Unfortunately, since its enactment ERISA has been more effective at protecting the employer than the employees.
Insurance carriers will seek to deny individual disability claims or seek to limit long term disability insurance benefits, forcing you to sue them under the ERISA statute. This will require a lawsuit in Federal Court. There are very specific and particular aspects to ERISA litigation and you will need a lawyer who has experience with that process in order to be effectively represented. Certainly, it will be confusing and frustrating to attempt to handle this process on your own.
You should hire an attorney before you submit your administrative appeal. Often times when a client is denied coverage, the denial letter will recite certain provisions of ERISA giving the insured the right to file what is known as an internal appeal with the insurance carrier. It is absolutely critical that you have an attorney during this process as you will be foreclosed from submitting additional material once that appeal has been concluded. Getting it right during the appeal process is the single most important component of a successful lawsuit down the road in Federal Court. An experienced ERISA lawyer will know how to gather persuasive evidence for inclusion in the administrative record on appeal
Remember, insurance carriers have a myriad of resources, including staff who are well-trained in finding creative ways to deny or terminate your claim, often times unjustly. In order to adequately prepare yourself and to level the playing field, it is essential that you retain competent attorneys experienced in ERISA litigation.
Additionally, utilizing an attorney during the initial claims process will improve your chances of being approved. Legal representation will help not only with initial claim approval, but potential settlement following initial denials down the road.