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Are you a Woodside, CA resident who is covered by an ERISA group welfare plan? If so, there may come a time in which you need to make a claim under this plan to obtain much needed income, medical coverage or retirement benefits. Unfortunately, insurance companies reject many wholly valid ERISA claims. At Kantor & Kantor LLP, we help plan beneficiaries fight back. Our dedicated Woodside ERISA lawyers are standing by, ready to hear your case.
The primary purpose of ERISA is to ensure that plan beneficiaries are subject to a fair, standardized claims process. ERISA contains many minimum requirements that ensure that employer sponsored benefits plans are safe and secure. For example, some key requirements include:
All key information regarding your specific ERISA plan should be included in a Summary Plan Description (SPD) document that the plan administrator (usually the employer) is required to send to you. Before filing your claim, you should always obtain and review your SPD.
One of the key aspects of the ERISA claims process is that you will only have 180 days to file an appeal, in the event that your original application is rejected. If an insurance company denies your claim, that company is legally obligated to send you an official denial letter that clearly articulates the exact reasons why your claim was denied. In filing an administrative appeal, you need to include additional evidence (documents, records, statement, testimony, etc.) that directly addresses the insurance company’s purported reasoning.
Notably, if you fail to include any relevant evidence during this stage of the claims process, you will lose out on the right to use that evidence for the remainder of your case. In fact, if you are required to file a lawsuit to seek your benefits, the court will be limited to only reviewing the evidence that is already in your claim file. This is why you need to get a Woodside ERISA lawyer by your side as soon as you get a denial letter, your lawyer will ensure that all necessary evidence makes it into your case file.
At Kantor & Kantor LLP, our Woodside, CA ERISA lawyers have helped many claimants obtain the full and fair benefits they rightfully deserve. If you or a family member is having any trouble with your claim, please call us today at (510) 992-6130 to set up a free review of your legal case.
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