ERISA Claims

ERISA claims are filed by private-sector employees wrongfully denied benefits like long-term disability insurance. ERISA is a federal law that requires insurance companies to act fairly and pay what they owe. See if a top disability denial lawyer can file an ERISA claim on your behalf and fight hard for everything you deserve.

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Why Take Legal Action?

By challenging a wrongful disability insurance denial, you can pursue the benefits and justice you deserve.

Results Secured

  • $1.36 million for a New York man whose Aetna long-term disability claim and appeal were denied
  • $1.21 million for a California worker denied disability benefits
  • $975,000 for a physician who lost his hearing and was denied long-term disability benefits by Unum
Rae Theodore

Fact-Checked and Legally Reviewed by: Rae Theodore

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What Is an ERISA Claim?

An ERISA claim is a legal challenge to a denial of benefits, most commonly long-term disability (LTD) benefits.

The Employee Retirement Income Security Act of 1974 (ERISA) sets standards for disability insurance plans offered by private employers. If an insurance company doesn’t meet its obligations, you can file an ERISA claim to get the benefits you’re owed.

Policyholders and beneficiaries can file an ERISA claim when:

  • Seeking benefits under a long-term disability insurance policy
  • Appealing a wrongful denial of LTD benefits
  • Suing an insurance company if they refuse to overturn a denial

Insurance companies have a fiduciary duty to act fairly and put their policyholders’ interests above their own. When they deny or delay paying legitimate ERISA claims, their actions could be considered bad faith, subjecting them to costly penalties.

LawFirm.com works with ERISA lawyers who have secured over $131 million for workers facing LTD claim denials.

Get a free case review now to see if a top disability attorney may be able to file an ERISA claim on your behalf and fight for the benefits you’re entitled to.

Eligibility to File an ERISA Appeal

When an insurance company denies your request for long-term disability benefits, they’re required to send you a letter outlining why your claim wasn’t approved. However, you have the right to appeal this denial.

You may be able to file an ERISA claim to appeal a denial of long-term disability benefits if you’re:

  • A worker or former worker enrolled in an ERISA benefit plan provided by your employer
  • The beneficiary of a plan participant

ERISA law only applies to private-sector employees, so government employees, military personnel, church workers, and others who fall outside of that category aren’t entitled to its protections.

ERISA benefit claims allow those facing unfair LTD denials to seek compensation to help pay for their medical bills, everyday living expenses, and more while they’re unable to work.

“I can’t express my gratitude enough to the law firm for being my ally in this fight. They stood by me, advocating for my rights and ensuring that I wasn’t left to struggle alone.”

– Illinois truck driver with a denied LTD claim who worked with our partner firm

ERISA Claims and Appeals Process

ERISA provides a detailed process for filing claims for benefits, appealing unjust claim denials, and suing a provider for denying a claim.

An ERISA lawyer can handle all of the paperwork involved in appealing a disability insurance denial, so you can focus on your health and well-being.

The basic ERISA claims procedures include:

  • Collecting evidence to support and strengthen your ERISA claim, like medical records showing you have a qualifying medical condition
  • Filing an appeal with the insurance company that denied your claim
  • Presenting your case in court if the insurer refuses to overturn its decision

Your long-term disability denial lawyer will fight to secure an ERISA lawsuit settlement, allowing you to access the compensation you deserve as quickly as possible during this challenging time.

ERISA claim for benefits and the statute of limitations: You only have 60 to 180 days to start the ERISA appeals process, depending on the specific rules of your LTD policy.

Don’t delay: Call (888) 726-9160 right now or chat with a case manager so you don’t lose out on the benefits you’re owed.

ERISA Claims and Appeals: Compensation Amounts

LawFirm.com works with top disability lawyers who have successfully filed ERISA claims and appeals on behalf of hardworking Americans across the country.

The ERISA lawyers in our network have recovered over $131 million for victims of unfair LTD claim denials.

Results secured by our ERISA lawyers include:

  • $1.36 million to a patient suffering from fibromyalgia and chronic fatigue syndrome
  • $800,000 for an LTD claim denied by Unum
  • Over $500,000 to a Michigan client denied disability benefits
  • $400,000 for a long-term disability insurance denial
  • $395,000 to a policyholder with a denied long-term disability claim
  • $325,000 for a Michigan policyholder facing a disability claim denial for depression
  • $172,000 on behalf of a Chicago woman denied long-term disability benefits
  • $155,000 for an Illinois woman in a disability denial case
  • $100,000 to a New Jersey patient whose disability claim for mental health issues was denied
  • $77,000 for a Cigna disability claim denial in Michigan
  • $316,000 to a patient with lupus and fibromyalgia whose claim was denied
  • $450,000 for a client denied disability benefits
  • $1.15 million on behalf of a woman denied disability insurance benefits

Compensation amounts for ERISA claims can vary based on the facts of each case. Factors like the strength of your medical evidence, how long your disability is expected to last, and your earning potential in your field all play a role in determining your potential payout.

Throughout the process, keep in mind that insurers don’t always offer a fair amount right away. An experienced ERISA lawyer can fight to secure a settlement that reflects the true value of your losses.

Get a free case review now to see if a top disability denial lawyer can file an ERISA claim on your behalf and seek the compensation you deserve.

Common Reasons for ERISA Claim Denials

By rejecting valid ERISA claims, insurance companies can avoid paying the money they owe and boost their bottom line. Many insurers have a reputation for unfairly denying long-term disability claims and depriving employees of the benefits they paid for.

Reasons for ERISA claims denials may include:

  • Not enough evidence: Your insurance company may claim that you haven’t submitted enough medical evidence to support your disability claim.
  • Missed deadlines: There are time limits for filing a claim for benefits and appealing a denial. If you take too long, your ERISA claim could be rejected.
  • Incomplete information: Insurers look for any reason to deny a valid claim, including mistakes or missing information in your application for benefits.
  • Policy rules: Each long-term disability policy has unique rules for who qualifies for benefits and under what circumstances.

An ERISA lawyer can ensure that your claim is filed correctly and before any deadlines, increasing your chances of a successful outcome.

These legal professionals are well-versed in ERISA claims and appeals procedures, as well as the tactics that insurance companies often use to deny legitimate LTD claims.

Get Help With the ERISA Appeal Process

ERISA appeals for long-term disability denials can be difficult to navigate without the help of an experienced attorney.

LawFirm.com works with ERISA lawyers who can even the playing field for victims of injustice and take on powerful insurance companies.

The ERISA law firms in our network:

  • Can help victims in all 50 states
  • Don’t charge any upfront costs or hourly fees
  • Have decades of experience handling LTD claims

Our legal partners have secured over $131 million for victims facing unfair long-term disability denials.

ERISA claims procedure regulations can be complicated, but you don’t have to go it alone. Get the legal help you need and deserve during this challenging time.

Call (888) 726-9160 right now or get a free case review to see if a top ERISA lawyer can fight hard for you.

ERISA Claims FAQs

What does ERISA stand for?

ERISA stands for the Employee Retirement Income Security Act of 1974, a federal law that establishes minimum standards for benefit plans like long-term disability in private industry.

ERISA claims and appeals regulations protect plan participants and ensure that they get the benefits they’re entitled to.

What are ERISA lawsuits?

ERISA lawsuits are legal claims filed against insurance companies and plan administrators to resolve disputes related to employee benefit plans like disability insurance.

Insurers have a legal duty to act in the best interest of policyholders. When they fall short, ERISA claims can hold them accountable and force the company to pay the benefits owed.

Claimants may need to exhaust their administrative remedies by filing an ERISA appeal before taking legal action. An ERISA lawyer can explain the administrative process and pursue benefits on your behalf, so you can focus on your health.

Call (888) 726-9160 now to see if a top disability lawyer can fight for you.

What does ERISA insurance cover?

ERISA covers most employer-sponsored benefit plans, including long-term disability insurance and more. ERISA requires the insurance company overseeing the administration of benefits to provide plan documents outlining the terms and your rights as a participant.

ERISA also sets the rules for the claims process, like benefit determination and the standard of review for claims and appeals.

A claims administrator who violates ERISA plan rules or fails to provide a fair review can be penalized.

What is an ERISA complaint?

An ERISA complaint is a legal action taken under the Employee Retirement Income Security Act (ERISA) to enforce your right to benefits.

When employees or their beneficiaries are wrongfully denied long-term disability insurance or other benefits, ERISA litigation allows them to seek the benefits they’re owed.

How do I file an ERISA claim for a long-term disability denial?

ERISA claims involving LTD denials are complex and best handled by lawyers who specialize in this area of the law.

An ERISA attorney can:

  • Collect evidence to build a strong case
  • File your appeal with the insurance company
  • Represent you in court if your appeal is denied

By working with a lawyer who understands ERISA claims and appeals regulations, you can increase your chances of getting the benefits you deserve.

Get a free case review now to get started.

Rae Theodore

Fact-Checked and Legally Reviewed by: Rae Theodore

Rae Theodore is a writer and editor with more than 30 years of experience in legal publishing. She earned a bachelor’s degree in English from Pennsylvania State University.

  1. Florida Bar Journal. (2016). “Discovery in ERISA cases? How Florida federal courts are changing the ERISA landscape one case at a time.” Retrieved November 19, 2024, from https://www.floridabar.org/the-florida-bar-journal/discovery-in-erisa-cases-how-florida-federal-courts-are-changing-the-erisa-landscape-one-case-at-a-time/
  2. Healthcare.gov. (n.d.). “Appealing a health plan decision.” Retrieved November 19, 2024, from https://www.healthcare.gov/appeal-insurance-company-decision/
  3. Maine Bureau of Insurance. (n.d.). “Individuals versus group.” Retrieved November 19, 2024, from https://www.maine.gov/pfr/insurance/consumers/disability-insurance/individuals-versus-group
  4. Sokolove Law. (2024, October 1). “ERISA Claims.” Retrieved November 19, 2024, from https://www.sokolovelaw.com/disability-insurance-denial/long-term-disability-denial/erisa-law/
  5. U.S. Department of Labor. (n.d.). “Employee Retirement Income Security Act (ERISA).” Retrieved November 19, 2024, from https://www.dol.gov/general/topic/retirement/erisa
  6. U.S. Department of Labor. (n.d.). “FAQs about Retirement Plans and ERISA.” Retrieved November 19, 2024, from https://www.dol.gov/sites/dolgov/files/EBSA/about-ebsa/our-activities/resource-center/faqs/faqs-retirement-plans-erisa.pdf
  7. U.S. Department of Labor. (n.d.). “Fiduciary Responsibilities.” Retrieved November 19, 2024, from https://www.dol.gov/general/topic/retirement/fiduciaryresp
  8. U.S. Department of Labor. (n.d.). “Plan Information.” Retrieved November 19, 2024, from https://www.dol.gov/general/topic/health-plans/planinformation
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