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At Kantor & Kantor, our skilled Oakland ERISA lawyers help people protect their legal rights and financial interests. As most employer-sponsored insurance plans are covered by the Employee Retirement Income Security Act (ERISA), workers need to have a basic understanding of the ERISA claims process. Unfortunately, ERISA claims can be immensely challenging. The reality is that insurers are far too aggressive in denying claims. If your claim was denied in Alameda County, CA, please contact our Oakland ERISA attorneys today for free legal guidance.
Submit an Application: When you submit an application for ERISA benefits, you will want to be sure that you have put together a strong claim. One of the most important things to remember about insurers is that these companies will use any justification they can find to delay, deny, or underpay benefits. Be sure that you have included all relevant documents, records, and other supporting evidence.
Await the Decision: Under rules and regulations in ERISA, you are owed a decision within 45 days of the date your application is received. Before the 45-day point, the insurance company must update you on the status of your claim. In some cases, you will receive your decision at this time. In other cases, you will get a notice that informs you that the insurer needs an extra 30 days to review your claim. The insurance company can take up to two 30-day extensions. If you receive a denial letter from the insurance company, you need to contact an Oakland ERISA lawyer immediately.
File an Appeal: The first stage of the appeals process is a reconsideration of your claim. This is also referred to as an administrative appeal. You only have 180 days to appeal. With an administrative appeal, the insurer will take a fresh look at your claim. At this time, you need to submit supplemental evidence that directly addresses the reason your claim was denied. Do not submit an appeal on your own; seek guidance from an experienced Oakland ERISA lawyer.
Initiate Litigation: The last stage of the ERISA claims process is litigation. If the insurance company refuses to offer you the benefits you deserve, you may need to take your claim to court. Your ERISA claim may be resolved before this point. Unfortunately, that does not occur in every case. Insurance companies will not always play by the rules. Our Oakland ERISA lawyers are prepared to help you file a lawsuit.
We can help. At Kantor & Kantor, our Oakland ERISA lawyers are proud to be strong advocates for claimants in Alameda County, CA. If you or a family member is having trouble obtaining your full ERISA benefits, please contact our law office today to schedule a free, no strings attached review of your case.
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