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- UNUM's 2008 Profits Come at the Expense of Long-Term Disability Policy Holder's Piece of Mind
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- Help! The Long Term Disability Adjsuter Wants to Take My Statement or Come To My House
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- Has Hartford Targeted Your Long Term Disability Claim For Termination
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- Must a Long Term Disability Carrier Give You Medical Reports They Rely on To Deny Your Claim?
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Florida First Responders and Their Rights to Workers' Compensation Benefits
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Robbed of Your Peace of Mind? Important Information on Long Term Disability Insurance Policies, The Claims Process, and How to Win Your Long Term Disabality Benefits.
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Cavey Barrett Blog
Cavey Barrett BlogLong Term Disability ERISA and Private Disability Insurance Claims
What is ERISA and Why Should You Care?
Your employer may have offered you a long term disability policy as part of your benefit package. Did you accept and begin paying premiums? If so, and if you are not employed by a church or a municipality, your claim is probably covered under the Empoyee Retirement Income Security Act (ERISA).The ERISA Act was passed by Congress in 1974 to address teamster union corruption. Remember Jimmy Hoffa who used teamster dues to fund his criminal enterprise?
Congress wanted to pass a simple (not), comprehensive (not) and uniform (never) application of law for health, life, disability and pension benefits plans. The ideas was to reduce litigation by having a uniform system that protected beneficiaires such as yourself while reducing premiums.
The reality is that ERISA, which impacts your health, life, disability insurance policies, and even your private penion or 401 K plan, has failed miserably at meeting those goals.
ERISA has become a complicated regulatory maze that has only benefited administrators of ERISA plans and the insurance companies that offer these policies. ERISA has been used to deny people, like you, the benefits you paid for and the benefits you deserve.
ERISA specifically prohibits you from making any state law claims. Many state insurance laws provide consumer protection provisions such as prohibiting "discrectionary clauses" in policies.
ERISA usually presumes the claims administrator was right in making the decision to deny or limit your benefits. You, must show the claims administrator was "arbitrary and capricious" in denying your claim if you are going to win.
This is true even if the claims administrator who is making the decision to pay also pays the benefits. Talk about a conflict of interest!
Even if you proved you have been robbed, all you get are the benefits you asked for to begin with. You can't sue for compensatory damages or punative damages. You can't even ask that the claims administrator who wronfully denied your benefits be punished.
Even the court in Florence Nightingale Nursing Service v. Blue Cross Blue Shield, 832 F. Supp. 1456, 1457 (N.D.Al. 1993) called ERISA, "Everything Ridiculous Imagined Since Adam."
The United States Supreme Court heard oral argument on April 23, 2008 on the question of what deference a claims administrator should be given in an ERISA plan. This decision will have monumental impact on ERISA cases in the future.
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FAQs
Long Term Disability ERISA and Private Disability Insurance Claims
Social Security Disability (SSD)
- How is disability defined and how do I apply for the benefits?
- Should I wait to apply for disability before applying for benefits?
Florida City and State Pension Disability Claims
Your Rights to Florida Workers’ Compensation Benefits - Medical Care and Lost Wage Benefits
- Is it possible to obtain both the State workers’ compensation benefits and Social Security benefits?
- How is it determined under law whether I am an employee or an independent contractor for the purpose of workers’ compensation claims?