ERISA BENEFITS LAW GROUP

Helping people with ERISA claims for disability and life insurance benefits.

If you have purchased disability insurance you probably did so thinking that if you become disabled, you will receive insurance benefits to protect you from the financial burdens that stem from being unable to work.

When you purchase life insurance you probably feel assured that when you die, your family will receive insurance benefits to protect them from the financial burdens that stem from losing a wage earner in the family.

Much of life and disability insurance is provided through employment. Many people have learned through bitter experience just how important a factor that is. If you are insured through your employment, your rights are governed by ERISA (the Employee Retirement Income Security Act). What does that mean?

If you are denied benefits, you cannot just sue the insurer like in ordinary insurance disputes. You must proceed under ERISA. That means that you have to appeal to the insurance company first - the same insurance company that denied your benefits in the first place.

Then, when you make it through the insurance company’s appeal process, you may file a suit in federal court - only in federal court, not in state court. But, even then, you won’t get your day in court where you can testify, call witnesses, introduce evidence and have a jury decide whether your claim was wrongly denied. No, all you can do is to present the insurance claim file (they call it an “Administrative Record”) to the judge, not a jury. Then, the judge doesn’t decide who was right or wrong. The judge only decides whether the insurance company was “downright unreasonable”. The judge looks at whether there was sufficient evidence to support the decision. The judge doesn’t determine what evidence is better, yours or the insurance company. He doesn’t weigh the evidence and give the victory to the side with the strongest evidence. He only looks first at the insurance company’s evidence to decide if there was enough there to support the decision, regardless of whether other evidence in the file was more reliable and contradicted the evidence relied on by the insurer.

So how does the insurance company win? First, they have a stable of doctors who are paid to say that you are not disabled. They then get written reports from these doctors who have never examined you or even seen you. They “rely” on these reports and ignore the records from your doctors. Then, they deny your claim. If you sue, the deck is stacked against you and, without help, you are not likely to win. Because ERISA is so complicated and technical, many lawyers will not take these cases. But, there are a few attorneys around the country who are experienced in this field and they can help level the playing field and improve your chances of a favorable outcome. Want to know more?




New Orleans
110 Veterans Memorial Highway
Suite 350
Metairie, LA 70005   map
p: 504.834.8333
f: 504.613.0929

Shreveport
3421 Youree Drive
Shreveport, LA 71105   map
p: 318.734.0235
f: 888.817.7232

Toll Free: 877.626.3501

 


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