The Employee Retirement Income Security Act (ERISA) regulates private employer-sponsored health insurance plans. Employees, in private industries, across the country have ERISA-sponsored healthcare plans. In fact, about 54 percent of workers earn retirement benefits from ERISA, while 59 percent earn health benefits, according to the U.S. Department of Labor.
When filing an insurance claim, you may receive a denial of benefits for one reason or another. In this case, if you received a denial on your claim, you can appeal the decision. The appeal is the most crucial part of an ERISA claim. Your appeal might be your last opportunity to have your claim heard and accepted.
How can an ERISA attorney help you?
One common mistake that people make when trying to appeal on their own is immediately filing a lawsuit against their insurance company to collect benefits. The court could dismiss your claim if you do this. You have 180 days to file an appeal after denial of your claim. An attorney will ensure your appeal is filed in a timely fashion. Your attorney can also help you to gather medical evidence and other documentation to help your claim. Additionally, they can look through the insurance company’s previous denial and determine if any errors were made. The attorney can then bring up those issues at the appeal.
Trying to handle the appeals process on your own can be difficult and detrimental to your case. If you lose the appeal, your options might be more limited. Consider speaking with an experienced ERISA attorney if you have recently received an adverse benefit determination and want to appeal the decision.