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Disability insurance claims under ERISA

| Jul 6, 2020 | Uncategorized |

Some Pennsylvanians are provided the option of disability insurance benefits through their employers. When employers offer long- and short-term disability insurance to their workers, the plans are covered by the Employee Retirement Income Security Act or ERISA. This law governs employer-provided benefits, including disability insurance. It does not cover private disability insurance that people purchase on their own, however.

There are numerous regulations under ERISA governing how disability insurance plans must be administered and offered by employers and insurance companies. Employers are required to provide their employees with information about how the disability insurance plans work and how they can file claims. The information must also include details about how employees can appeal if their disability claims are denied.

When an employee is injured or suffers a serious illness that prevents him or her from returning to work for weeks or months, he or she can file a claim for disability benefits by following the instructions for submitting it. Within 45 days, the insurance provider should decide whether to approve or deny the claim. This 45-day period can be extended once for 30 days. If the insurance provider denies the claim, the claimant will then be able to appeal the denial. Before a claimant can file a lawsuit in court, he or she will first need to exhaust his or her internal appeals within the insurance company. If the internal appeals are exhausted, the worker may then file a lawsuit to recover disability benefits.

People who are seriously injured or sickened and are unable to return to their jobs may want to get help from experienced ERISA attorneys before they file their claims. The attorneys might help their clients to understand the types of supporting documents and evidence to submit with the claims to make them likelier to be approved. The lawyers can also help with the internal appeals process, and they might file lawsuits for their clients if the internal appeals are exhausted.