In the complex world of employee benefits, one federal law stands as a beacon of protection for workers: The Employee Retirement Income Security Act (ERISA). Enacted in 1974, ERISA is designed to safeguard the interests of employees and ensure they receive the benefits they deserve.
What is ERISA?
ERISA is a powerful piece of federal legislation that is intended to protect employee benefits from misuse. For disability insurance claims, ERISA sets stringent minimum standards for these plans which the plan and insurance company must follow.
As a result of the heavy regulation among ERISA plans, there is a profound legal obligation to your employer and the disability insurance companies. Under ERISA, employers and insurance companies are not just expected but legally bound to act in your best interest — the plan participant.
However, navigating the complexities of ERISA can be challenging, especially when facing a disability. This is where legal expertise becomes invaluable.
How ERISA Protects Your Benefits
ERISA provides several protections for plan participants:
- Disclosure of Information: Transparency is the cornerstone of trust, and ERISA recognizes this fundamental principle. The legislation mandates that plan providers must inform participants about the nitty-gritty of plan features and funding. This obligation to disclose information is not just a guideline — it's a legal requirement under ERISA.
The key tool in this disclosure process is the Summary Plan Description (SPD). This document is your roadmap to understanding your plan. It outlines the plan's terms and conditions, benefits, rights, and obligations. It's like a user manual for your benefits plan, giving you a comprehensive overview of what you're entitled to and how to claim it.
ERISA also mandates the provision of a certificate of insurance. This document serves as proof of your coverage under the plan. It's your ticket to availing the benefits you're entitled to, and ERISA ensures you have it in your hands.
- Accountability of Plan Fiduciaries: As the insurer of group disability insurance policies, insurance companies have an obligation to act in the best interest of the plan beneficiaries, i.e., employees covered under the insurance contract. In this context, they are considered an ERISA fiduciary.
As such, they have an obligation to make timely claim determinations, to act reasonably when making claim determinations, to apply the terms of the disability insurance policy, and to conduct full and fair reviews.
Courts have routinely found various scenarios in which disability insurance companies have not acted as fiduciaries, thus violating ERISA regulations.
- Right to Sue: When it comes to safeguarding your rights and benefits under ERISA, the law provides a powerful tool: the right to sue. This is not just a last-resort option; it's a fundamental right granted to you as a plan participant.
ERISA empowers you to take action should your disability insurance claim and administrative appeal be denied. You have the right to file a lawsuit to recover due benefits. With Dabdoub Law Firm by your side, we will fight relentlessly to ensure you receive what you are rightfully owed.
Attorneys That Specialize in Handling Your Disability Insurance Claims
This law firm was created with a single purpose in mind: to help people get disability benefits from insurance companies.
With that kind of focus, we have:
- Experience with every disability insurance company;
- A proven track record of success by winning major long term disability lawsuits;
- Recovered millions of dollars in disability benefits for clients like you;
Every day, our disability lawyers work to get insurance companies to approve long-term disability claims or appeal disability benefits denials.
With so much at stake, shouldn’t you have expert disability lawyers on your side?
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help.
Call to speak with a disability insurance lawyer. (800) 969-0488