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Many Bay Area workers are covered by their employer’s ERISA group benefits plan. While ERISA provides key legal protections for plan beneficiaries, it also sets up a complex claims process. Unfortunately, the big insurance companies sometime take advantage of this process, denying valid claims. At Kantor & Kantor LLP, our skilled Belmont ERISA lawyers are committed to fighting for the rights and interests of people who have had their claim unfairly denied.
ERISA has a very strict, highly structured claims process. Plan beneficiaries need to know how to navigate their way through this process so that they can obtain the full compensation available. On the other side, insurance companies are staffed by trained professionals who know exactly how to work the process to their financial benefit.
One of the key things that you need to know about ERISA denials is that you will be required to file an administrative appeal. Under the law, you generally only have 180 days to submit this appeal. If you fail to take action in the proper time frame, you could lose out on your benefits. The bottom line: you need to act quickly. If your claim file does not include the correct documents and records, your case will be severely disadvantaged.
A claim file, also known as the “administrative record,” is the foundation of all ERISA claims. In the simplest terms, your claim file is a collection of all the documents and records you have sent to the insurance company, from your initial application to any other supporting information that you have submitted. The insurance company is required to consider all of the information included in your claim file when making a decision and considering any internal appeal that you bring. Should a lawsuit need to be filed in your case, the court will be largely limited to looking at the information contained in your claim file. That bears repeating: If you fail to submit any relevant supporting documents or records to the insurance company, you likely will lose out on access to that information in court. Do not let this happen to you, as it could devastate your case. Work with a Belmont ERISA attorney who can make sure that you file a strong claim and appeal.
At Kantor & Kantor LLP, our Belmont ERISA lawyers are standing by, ready to help you with your claim. To schedule your free, no obligation case evaluation, please call our main office today at (510) 992-6130 or reach out to us directly through our website.
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