How long does it take to get a decision about your ERISA claim?

On Behalf of | Apr 25, 2022 | ERISA Disability Benefits

If you have ever waited for a critical decision from an insurance company or other entity, you know that some determinations can take a long time. Recently disabled persons enrolled in ERISA benefit plans often worry about the length of time it will take to receive a decision about their claim.

You can take comfort knowing that ERISA plans have preset time limits for reviewing and deciding your claim in most situations. Participating insurers must comply with these rules when making decisions about disability (and other) claims.

A sample timeline to review

Under ERISA, disability claim decisions must occur in a reasonable period. That way, disabled persons do not have to wait an unduly long time to receive their benefits upon approval.

It should take about 45 days to receive a decision about ERISA disability claims, but sometimes, it can take longer. When participating insurers need more time to evaluate your claim, they must inform you of the situation.

If the plan requires further evaluation and you do not need to submit more information, you should receive a notification within 45 days. The plan will then have another 30 days to evaluate your claim.

If the plan requires more documentation, they must notify you within 45 days. You will have an additional 45 days to submit the documents. The plan will then have 30 days (from receipt of the information) to decide.

If the plan still needs more evaluation time after extending the timeline, they must notify you of this before the 30-day extension expires. You will have another 45 days to submit any requested documentation, resulting in another 30 days for further evaluation.

Learning more about ERISA and your options to increase the odds of an early approval can help in Louisiana and nationwide disability claims.