If you have ever gone through a job advertisement, you might have noticed that most employers offer employee benefits packages.
Some companies offer pensions and even disability insurance, not only to make the position more attractive for applicants but also to offer help to their employees.
However, a federal law oversees those benefits, the Employee Retirement Income Security Act, otherwise known as ERISA. We visited the website of J Price McNamara to learn more about ERISA claims and their eligibility.
What is ERISA?
ERISA is a federal law that sets the minimum requirements for most of the retirement and health plans established in the private industries. This plan was established for the betterment as well as the protection of the workforce in the private sector.
In 1974, Congress enacted the Employee Retirement Income Security Act (ERISA). It was enacted to oversee benefit plans for employees and ensure the companies were upfront about the financial stability of the plans. Furthermore, it aimed to make filing claims easier and faster for people.
When you claim these benefits, you do not deal with the human resource department of your employer. Instead, you deal with an insurance company more concerned with the financial bottom line than your service years.
You may need to consult an attorney who has experience with ERISA and can assist you through the process. One such attorney is J Price McNamara.
This is not your employer’s fault. They do not have the financial resources or the workforce to cover these benefits. They have insurance policies and administrators who oversee the benefits for them.
How Does ERISA Work?
Fortunately, you do not have to sign up for ERISA coverage. It is a federal law and is automatically in place to oversee your benefits if you work for someone else. Some benefits it covers are:
- Group health insurance
- Life insurance
- Long-term disability
- Accidental death
- Dental and vision insurance.
Claim Denial From Insurance Companies
One of the most expensive claims for an insurance company is the long-term disability claim. This isn’t for a work-related injury or illness. That would fall under a different type of protection. Long-term disability coverage is for something that happens outside of work that can keep you from working for a year or more.
Some types of long-term disability are cancer, dementia, multiple sclerosis, or even injuries from an accident, again unrelated to work. Depending on the circumstances, these claims can cost an insurance company a million dollars or more. The insurance company doesn’t want to pay out this kind of money.
The insurance companies want these claims to be paid out as little as possible. Remember, they are dealing with financial bottom lines, not what is in your best interest.
Eligibility of ERISA Claim
If you file a claim for your benefits and are denied for an unfair or wrong reason, you might be eligible for an ERISA claim.
Some of the reasons they may use to deny a claim may include arguing the necessity of the service, arguing that the service is not covered under your policy, and hiring their doctors who may come up with a different decision. They may even use a technical or administrative cause to deny your claim.
ERISA covers all private-sector companies that offer employee benefits and pension plans to their workforce. No matter how your employer has structured their business, if it’s a private entity, your claims are backed by ERISA.
Moreover, ERISA was put into law to ensure the coverage you were promised is there when you need it and your rightful claims are respected and provided. It may take a little effort to get those benefits you deserve. No one wants to have to go to court and fight a battle against an insurance company.
Your employer gave you certain benefits, and certain insurances, to reassure you that when the time came, you would be covered under certain circumstances. Undoubtedly, you have the right to file those claims, and fortunately, ERISA is there to ensure that your eligible claims are protected.