If your long-term disability insurance policy was obtained through your private employer, it is likely 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 fall 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).

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

You can reach Miami 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 Attorney Gonzalez-Sirgo directly at [email protected].

J.P. Gonzalez-Sirgo
J.P. Gonzalez-Sirgo, P.A.
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