If a disability, health or life insurance claim is denied, gathering information, staying within deadlines and communicating with all relevant parties to gather necessary information is essential in order to overturn the decision. When a dispute over any insurance benefits arises, being told “no” is not the final word. If the coverage at issue is […]
The subject of pre-emption under the Employee Retirement Income Security Act is challenging, as illustrated by multiple Supreme Court rulings that have attempted to address pre-emption issues. The general rule is that any state law which relates to employee benefit plans is pre-empted if the law conflicts with the administration of an ERISA claim. However, […]
Obtaining disability insurance is tricky. If you are purchasing coverage to supplement employer-supplied insurance or seeking insurance because you have no other coverage, there are a lot of variables to consider. It’s a sad fact, but many Americans give little thought to disability insurance coverage until it is needed. Understanding the following information will strengthen […]
Claim regulations in the Employee Retirement Income Security Act impose deadlines on claimants and plan administrators to submit claims and render claim decisions. Strict deadlines also apply to claim appeals. Claimants are allowed up to 180 days to submit appeals from denials of disability benefit claims, and if a claimant submits an appeal even a […]
The Employee Retirement Income Security Act requires that whenever a benefit plan denies a claim such as one involving disability or health insurance, the claimant is entitled to a “full and fair” review of that denial. But what does the term full and fair review in ERISA (29 U.S.C. Section 1133) actually mean? A recent […]
Approximately 50 percent of Americans receive health insurance through their employer, making most of those plans subject to the Employee Retirement Income Security Act of 1974 (“ERISA”). After passage of the Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”), the majority of health plans that cover mental health treatment, including large employer- sponsored […]