What are the time limits around an ERISA appeal?

On Behalf of | Jul 14, 2021 | ERISA Disability Benefits

When filing an ERISA claim, it is crucial to understand the time limits within which you need to act. Filing a successful claim is hard enough without ruining your chances on a timing technicality.

Your insurance company has 30 days to respond to your initial claim. They can, however, extend this a further 15 days if they cannot reach a decision. To do so, they must let you know the following within the original 30 days: Why they need more time, what extra information you must send them and when they will confirm their decision.

How long do I have to appeal if my ERISA claim is denied?

If the insurance company denies your claim, you must submit your application for a review within 180 days. That does not mean you can wait 170 days to start thinking about how to appeal. If the insurer turned down your initial claim, you would need to compile more evidence to back up your second attempt. Getting this together can take time, so it is best to start as soon after you receive the formal denial as possible to ensure you have the maximum amount of time to prepare.

If your ERISA plan provider turns down your appeal, you may need to look at other options to get them to pay you the benefits you feel you are due. 

An ERISA claim is rarely straightforward, so it is crucial to have as much information about the process as possible to increase your chances of getting the maximum amount available. Delays could leave you struggling financially and increase the stress on you during an already difficult time. Working with an experienced advocate may help ease the way.