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What is ERISA?

Employee Retirement Income Security Act (ERISA)

Federal legislation (U.S. Code Title 29, Chapter 18, associated Internal Revenue Code and miscellaneous provisions) that preempts state regulation of workers' medical and pension benefits. Under ERISA, an insurance program has been established to guarantee that employees receive their pension benefits in the event that a pension plan is terminated. Sounds good doesn't it. Unfortunately, this legislation is very complex and claims are limited to the amount of the benefit being claimed.

Despite its name and the purpose behind it, to protect employees from unscrupulous employers, the effect has been just the opposite. It has had the devastating effect on the ability of people who receive their insurance through their employment to have their claims fairly evaluated and properly paid. The effect is most pronounced in the area of health, life and disability claims since this insurance is most often provided through work.

Perfecting and Litigating ERISA Claims

The reason for the lack of fairness and proper payment of claims in ERISA cases is that when an insurance company denies an ERISA claim, it knows that even if it is wrong in denying the claim, the most the court can force the insurance company to pay is the claim it should have paid in the first place. If that is all the insurance company can be liable for, what is the incentive for the insurer to pay the claim?

All ERISA claims have several things in common. They are most frequently litigated in Federal Court, a court in which most lawyers are uncomfortable. Before getting to court there is an administrative appeal that you must follow. It is imperative that this appeal procedure is followed. If it is not, you will in all likelihood lose your right to sue the insurance company. If you wish a brief summary of the appeal process and what you must do to make sure the appeal is properly prosecuted, e-mail us and we will send you one.

If you think that your insurance provider is giving you the runaround, you can work with an insurance claim lawyer at Kantor & Kantor, LLP. Our firm has many years of experience representing clients in insurance disputes. Among the insurance providers against whom we have prevailed are:

  • Paul Revere
  • LINA
  • Cigna
  • Standard

Get Representation From ERISA Attorneys in California

Our attorneys work with clients on a broad range of cases, ranging from providing representation in insurance bad faith cases to ERISA litigation in federal courts. While many lawyers are unfamiliar with handling an ERISA denial, our legal team regularly practices ERISA litigation and will ensure that you understand all avenues available to you. Following an ERISA denial, it's important that you file an appeal in the appropriate fashion with the aid of ERISA attorneys. California residents who fail to do so may not be able to undertake ERISA litigation and ultimately be denied the benefits that they deserve.

If you believe that your claim for insurance benefits has been wrongfully denied, you can receive a free initial consultation from our ERISA attorneys. California residents looking for representation in long term care, health, or disability insurance denials can also contact us at 1-800-4INSLAW (1-800-446-7529) for advice and representation.

Call for a free consultation 800-4INSLAW (800-446-7529)

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The information on this website is for general information purposes only. Nothing on this site should be taken as legal advice for any individual case or situation. This information is not intended to create, and receipt or viewing does not constitute, an attorney-client relationship.
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