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Posted on December 20, 2024 - 3:13 pm by

If your job includes employee benefits packages, you have certain rights. The Employee Retirement Income Security Act (ERISA) sets standards for most voluntarily established employee benefit plans in private industry, ensuring your rights as a participant. However, understanding these rights and when legal assistance may be necessary is crucial.

Here is a guide to help you recognize when you might need an ERISA Employee Benefits Attorney.

Understanding ERISA

The Employee Retirement Income Security Act (ERISA) is a federal law established in 1974 to protect employee benefits. Initially, the legislation focused on ensuring workers receive their pension benefits. However, in 1986, a significant U.S. Supreme Court ruling broadened the scope of ERISA to include a broader range of benefits under its protections. Now, ERISA also covers several types of insurance benefits:

ERISA covers private-sector employers and labor unions that sponsor benefit plans, and it applies to plans funded by employer contributions or employee salary reductions.

ERISA was enacted to protect the interests of employee benefit plan participants and their beneficiaries. It sets forth provisions for reporting, disclosure, and fiduciary responsibilities while giving participants the right to sue for benefits and breaches of fiduciary duty. Despite these protections, navigating the complexities of ERISA can be difficult, especially when claims are denied or benefits are mishandled.

Signs You Need an ERISA Employee Benefits Attorney

How do you know when you need an ERISA employee benefits attorney in California?

  1. Claim Denial: If your claim for benefits has been denied, it is one of the most common reasons to seek legal assistance. Our ERISA attorneys can help you understand the reasons for the denial and assist you in the appeal process. We know the legal standards that insurance companies must meet and can advocate for you effectively.
  2. Complex Plan Provisions: Employee benefit plans can have intricate terms, conditions, and exclusions. If you are having trouble understanding the language of your plan documents or if you are unsure of your rights, consulting an ERISA attorney can clarify your options.
  3. Fiduciary Breaches: If you believe that your employer or plan administrator has violated their fiduciary duty—such as failing to act in the best interest of participants, mismanaging plan assets, or misleading you about your benefits—you will want an ERISA attorney.
  4. Retirement Plan Issues: Issues concerning retirement plans, including pension and 401(k) plans, can also arise under ERISA. Whether it is a dispute over benefits owed upon retirement or mismanagement of the plan’s assets, an attorney can assist in ensuring your rights are protected.
  5. Disability Benefits Disputes: Claims for long-term disability insurance benefits can be particularly challenging. If your claim is denied or you are facing complications regarding the continuation of benefits, an ERISA attorney can help gather medical evidence, assess policy language, and appeal the insurer’s decision.
  6. Administrative Errors: Administrative mistakes happen, and sometimes benefits may be delayed or denied due to an error. If you suspect an administrative error has impacted your benefits, an attorney can help you navigate the appeals process and rectify the situation.

We are the California ERISA Law Firm that Insurance Companies Fear

If your employer provides insurance coverage and your claim is denied or other disputes arise, you should speak with our ERISA lawyers about your case. We specialize in ERISA cases, and even judges and other attorneys turn to us for help.

Understanding when to seek help from an ERISA employee benefits attorney can make a significant difference in resolving disputes and securing the benefits you deserve. If you encounter any of the situations described above, call us for a free 30-minute telephone conversation to review your claims and recommend next steps.