City, county, state and federal employees are government employees. Government employees are considered public employees. Public employees enjoy many benefits, including participation in a government sponsored retirement pension plan. Another benefit of being a public employee is that insurance claims such as long term disability insurance claims, health insurance claims, and life insurance claims are exempt from the Employee Retirement Income Security Act (ERISA) which governs employee benefit plans. ERISA is an arcane federal law which is complicated and affords less protection to employees than Congress intended when it passed the act in 1974. Under ERISA, the deck is stacked against the employee when filing for long term disability insurance benefits, health insurance benefits, life insurance benefits, and other employer sponsored benefits. Therefore, such claims brought by public employees are considered non-ERISA and goverened by state law.
Non-ERISA claims are treated similarly to that of an individual who went out into the open market and purchased a private insurance policy. This is important because claimants are afforded more favorable state consumer protection laws. If the employee's insurance claim is denied, the employee is entitled to bring suit for breach of contract in state court, have a jury trial, bring new and additional evidence to trial, and sue for bad faith and punitive damages, if the case supports it under the law of your state.
In essence, the difference between having a claim goverened by ERISA vs. state law can mean the difference between having the insurance benefits approved or denied.
The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents individuals that have had their valid insurance benefits denied, delayed or terminated.
You can reach Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email J.P. directly at [email protected].