The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law enacted to protect an individual from pension and insurance fraud. Its rules apply to almost all employee group short term and long term disability policies. Among other things, ERISA gives a policyholder the right to appeal an insurance company’s decision to deny their claim for disability benefits.
When the appeals process has been exhausted, ERISA allows a participant in a group disability benefits insurance program to sue “to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan.”
Despite this, ERISA disputes rarely make it to the trial stage. For the most part, ERISA disputes are settled in mediation or settlement conferences, rather than the courtroom. However, if the two sides are unable to reach an agreement, then the case proceeds to trial.
What Can You Expect to Win in a ERISA Disability Lawsuit?
An ERISA lawsuit is a bench trial before a judge with no jury. The judge will issue a court decision, not a settlement.
What remedies can you seek in an ERISA disability trial? Since ERISA preempts state laws (such as breach of contract, bad faith, negligence, fraud, etc.), the plaintiff is limited in the remedies that are available.
For instance, ERISA does not allow a plaintiff to seek compensatory or punitive damages in an ERISA lawsuit. The plaintiff is only entitled to their monthly benefits and any back benefits they are owed. The judge may award attorney’s fees as well.
In most cases, a plaintiff cannot recover for retroactive offsets, interest paid on past due benefits, or a lump sum settlement for future benefits.
If you are not satisfied with the judge’s decision, you may file an appeal with the United States Court of Appeals.
You Need a Qualified Disability Lawyer to Handle Your ERISA Settlement or Lawsuit
In order to prevail in an ERISA disability lawsuit, you’ll need the representation of an experienced ERISA claims attorney who will be able to effectively demonstrate the seriousness of your medical condition and how it makes you unable to work. They should be able to anticipate the insurance company’s delay and denial tactics and plan an effective strategy that overwhelmingly shows that you deserve the disability benefits you’ve paid for.
Leading Houston disability attorney M. Stanley Whitehead has successfully represented policyholders in hundreds of disability insurance cases. He won’t hesitate to take on the big insurance companies like Cigna, Aetna, Liberty Mutual, the Hartford, Liberty, UNUM and others. He’s willing to do whatever it takes to ensure his clients receive the disability benefits they deserve, even if it means filing an ERISA lawsuit in federal court.
Contact the law offices of Houston Disability Benefits Attorney M. Stanley Whitehead
Contact the law offices of M. Stanley Whitehead at (866) 365-7898 to schedule a free, no obligation consultation meeting to discuss your case. Don’t delay in getting help — there are strict deadlines for filing an appeal after an insurance company has denied your claim. The sooner we get to work on your case, the better your chances of obtaining a favorable decision for your appeal.
