ERISA Life Insurance Policy Denials, Claim Delay, Disputes
If you are the beneficiary of an ERISA life insurance policy and your claim is being delayed or denied, call a Florida ERISA life insurance lawyer at the Law Offices of Jason Turchin today for a free consultation.
Losing a loved one can be an emotionally shattering experience that can also lead to significant financial hardships. In the aftermath of such a loss, families frequently struggle to regain their financial footing due to the sudden absence of the deceased’s income. Life insurance serves as a crucial support system for these families, offering a specified sum of money to the beneficiaries designated by the departed. The regulation of life insurance policies is twofold: state laws apply to policies purchased on an individual basis, while federal regulations govern employer-provided or employer-offered plans under the ERISA framework.
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What is ERISA and how does it impact life insurance?
The Employee Retirement Income Security Act (ERISA) of 1974 establishes the guidelines for the majority of employee-related benefits across the United States. This includes a wide range of benefits such as health insurance, disability coverage, retirement savings plans, and life insurance policies. It’s a common practice for employers or businesses to provide their employees with group life insurance plans among other benefits. The enactment of ERISA at the federal level was a direct response to the previously inconsistent approach by individual states in the administration and distribution of employee benefits.
How can you make a claim for life insurance on an ERISA policy?
It’s important to meticulously review not only the Life Insurance Policy but also the Plan Documents provided by the Plan Administrator of the company or organization offering the policy benefits. Frequently, the Plan Documents detail the procedure for filing a claim and specify who is eligible to make such a claim. These documents should be considered in tandem, though there may be instances where discrepancies arise between them, potentially leading to a dispute over life insurance claims.
What happens if your life insurance policy is denied and it is an ERISA policy?
As a beneficiary, it’s important to understand that you have certain legal entitlements. Should your claim be rejected, there are several steps you can take. Initially, it’s typically required to submit a written appeal directly to the insurance provider. This appeal acts as a formal request or challenge for the insurance company to disburse the benefits you are legitimately entitled to. In cases where the insurance provider refuses to grant the appeal, you may have the legal right to initiate litigation in federal court. Additionally, you might consider suing the insurance company for breach of fiduciary duty or explore other legal actions based on the specifics of your case. ERISA often brings up additional challenges, and it’s generally important to present a thorough appeal with all documents for them to consider during the review process.
What are some reasons an ERISA life insurance policy would be denied?
Insurance providers employ various tactics to avoid compensating life insurance beneficiaries, with denials linked to employment status being particularly frequent. For instance, an insurer might argue that the deceased was not employed full-time, failed to accumulate sufficient work hours, or was absent from work due to illness.
Other prevalent grounds for claim denial encompass issues or misinterpretations related to the application process, late premium payments, and questions of eligibility. A notable area of contention arises when a policy names a former spouse. Certain policies under ERISA might dictate specific considerations for former spouses, which can clash with state revocation upon divorce laws, such as those in Florida regarding divorce. This discrepancy can lead to legal challenges over which regulations take precedence and which documents—the policy or the Plan Documents—should be adhered to.
How can we help if your ERISA life insurance claim was denied?
Navigating the complexities of the ERISA federal statute can be overwhelmingly perplexing and exasperating for individuals not versed in legal protocols. Should you face a denial of your ERISA claim, it’s crucial to consult with an experienced life insurance attorney. At the Law Offices of Jason Turchin, we have experience in examining your case to determine if you’re still eligible for benefits. Our team is ready to assist you; contact us at 800-337-7755 or use our online contact form to submit your inquiry.