What you need to know about ERISA overpayments

On Behalf of | Sep 9, 2021 | ERISA Disability Benefits

The Employee Retirement Income Security Act (ERISA) protects the interests of millions of Americans nationwide. When it comes to disability payments through ERISA, some benefactors of this plan may be blindsided by having to repay insurance companies.

This payment is known as an overpayment. The amounts needed to be paid back to the insurance company vary according to the benefactor’s insurance plan. But how is the overpayment determined? And how much is the insurance company entitled to?

What is an ERISA overpayment?

Overpayments are a common enough issue that many benefactors of ERISA need to deal with. Those who receive payments according to an ERISA plan, and then receive additional payments for the same condition, are responsible for reimbursing insurance companies for surplus funds distributed.

An ERISA plan may dictate a benefactor receive a certain amount of funds every month for an indefinite period. If, at any point, the benefactor receives additional funds for the same condition, say from an insurance payout from another company or assistance from the social security administration, the insurance company is not obligated to pay the amount received through other means.

How to approach repayment

Insurance plans are numerous and complicated. It is difficult to extrapolate specifics on generalities. The amount benefactors will need to repay insurance companies differs from plan to plan. Because of this, an insurance company may be mistaken about funds that need to be reimbursed.

But how does one determine the correct amount to be reimbursed? It is a complicated matter that involves going through medical records, court documents, insurance plans, and other complicated legal or technical writings. As an individual disputing the insurance company’s claim, it is certainly a daunting task.

Individuals in this situation may find professional assistance convenient or even necessary to ensure all legal and financial nuances are correctly interpreted.