The Employee Retirement Income Security Act is a vital piece of federal legislation. It provides protection for individuals participating in the majority of private-sector employee benefit plans, including disability insurance plans.
If you’re a resident of Louisiana, it’s crucial to understand ERISA’s role in disability benefits.
ERISA and disability insurance
Employer-sponsored disability insurance plans are typically covered by ERISA. This law requires that plans provide participants with information about plan features and funding. It establishes standards for plan fiduciaries, who are obligated to act in the best interest of the participants and beneficiaries. Additionally, ERISA ensures you have recourse if you’re unjustly denied benefits.
Filing a claim
If you become disabled and need to access your disability benefits, you must file a claim with your insurance company. ERISA provides a specific process that must be followed, including giving the insurer a set amount of time to evaluate your claim. If denied, you’ll be provided with the reasons for denial, and you have the right to appeal the decision.
Appealing a denial
If your claim is denied, ERISA gives you the right to a full and fair review of the denial. During this appeal, you can submit additional evidence to support your claim, and an independent party will review the decision. Remember, you only have a specific amount of time to file an appeal, so read all communication you receive after you file and ensure you understand each notice.
ERISA also allows you to file a lawsuit if your appeal is denied. Given the complexity of ERISA cases, especially when dealing with a disability, it may be advantageous to enlist the help of someone who’s familiar with these matters.