Your Rights Under the Employee Retirement Income Security Act (ERISA)

If your long-term disability insurance is through your employer, there is a good chance that your policy is regulated or governed by the Employee Retirement Income Security Act of 1974, also referred to as ERISA.  In fact, most group policies are under ERISA.

The Employee Retirement Income Security Act is a federal law that establishes standards for the majority of voluntary pension and health plans.  Among the many mandates under this law is the requirement that all plan participants receive information about the policy features and funding.  This certificate booklet is supposed to explain the terms of the policy.

Some of the other features of ERISA include the following:

  • Establishes fiduciary responsibilities for plan management.
  • Mandates that plans set up a grievance and appeals process for claims made by plan participants. 
  • Provides participants with the right to file a lawsuit to obtain benefits and to sue for breaches of fiduciary duty.

Over the years, there have been numerous amendments to ERISA, which have increased the protection offered to plan participants, including the Consolidated Omnibus Budget Reconciliation Act (COBRA) and the Health Insurance Portability and Accountability Act (HIPAA).

People with valid long-term disability claims are often denied benefits.  If you have applied for long-term disability benefits and have been turned down, you can and should file an appeal.  There are some stipulations to filing an appeal under the Employee Retirement Income Security Act, which should be discussed with a Miami insurance claims lawyer.

Contact the law firm of J.P. Gonzalez-Sirgo, P.A. for assistance with your long-term disability claim. We represent disability insurance policyholders who have been denied benefits in Miami and throughout Florida.  Our law firm offers a free consultation and case evaluation.  Call us today at (305) 461-1095 or toll free at (866)-71-CLAIM for answers to your long-term disability insurance questions.