ERISA litigation is one of the most complex areas of insurance and employment law. Under ERISA, lawsuits cannot be filed against insurance companies for the denial of employee-provided disability benefits until the claimant has exhausted all possible avenues of administrative appeal. If the claimant fails in any measure to follow the appeals process exactly as it is described in the summary plan document (SPD), the judge can dismiss the lawsuit with prejudice, effectively terminating any chance that the insurance company’s adverse ruling will be reversed.
When you entrust your ERISA litigation to attorney J. Price McNamara, you can rest easy knowing that he will use all of the resources at his disposal to gather the most compelling evidence of your disability available and present it in a manner that the court will find acceptable. Because the court will consider only the evidence contained in the administrative record created during the ERISA claims and appeals processes, and will not allow you to introduce new evidence after your lawsuit has been filed, it is essential that you schedule your free, no-obligation case review with Mr. McNamara as soon as possible.
You can obtain the benefits that are rightfully yours, and J. Price McNamara will fight toward making that happen.
In order to file an ERISA lawsuit, you must be certain that you have followed the appeal process described in your summary plan description (SPD) with absolute precision. The judge will scrutinize your SPD to confirm that you have met all of the conditions for pursuing litigation. You must also be aware of what ERISA litigation entails, as well as how the law limits the types of damages you are able to obtain through your lawsuit.
In the vast majority of ERISA cases are unusual, the federal judge who has sole discretion over the outcome of the case is compelled by the law to give deference to the insurance company being sued. Claimants have no opportunity to speak to the judge, call or cross examine witnesses, or introduce evidence that is not contained in the administrative record. Insurance companies often file motions for dismissal that must be countered, as well.
There is far more to the successful handling of an ERISA case than drafting an appeal letter on behalf of an injured employee. J. Price McNamara will collect and organize medical records and statements, represent you in communications and settlement conferences with your plan administrator, and make sure that there are absolutely no weak spots in your administrative record. He will act as an aggressive advocate for your rights until your case has been resolved.
If you are covered by a privately purchased disability policy and feel that your claim for benefits has been unfairly denied, you can immediately file a lawsuit against your insurer in a state court. Your case will be heard by a jury, and you will be permitted to present evidence, call and cross examine witnesses, and (depending on the laws of your state) pursue damages beyond the benefits you were wrongly denied. In ERISA cases, a single federal judge reviews your case, and you are restricted in terms of the evidence that will be considered and the damages you will be able to obtain.
Although ERISA cases are tried in federal court, the judge may apply the most relevant statute of limitations in the state in which the employee filed his or her disability claim to his or her lawsuit. However, the judge may also uphold the statute of limitations contained in the summary plan description if it differs from, but does not conflict with, a controlling statute and is considered “reasonable.” It is therefore important that, if you are considering ERISA litigation, you act swiftly and definitively.