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Denied ERISA Claims Chicago

Denied ERISA Claims Chicago

Your employer-provided benefits, like a pension, 401(k), and long term disability insurance, are designed to provide financial support and protection from unexpected costs when you and your loved ones need assistance. Unfortunately, dealing with insurers and plan administrators can be a hassle, and denied or disputed claims are very common. Bartolic Law have successfully appealed hundreds of denied ERISA claims in Chicago, and we want you to be aware of the steps you need to follow to protect yourself and your rights in this situation. 

What Is ERISA?

If your health care coverage, pension, or long-term disability insurance are provided through an employer-sponsored plan, your rights are almost always protected under the Employee Retirement Income Security Act, also known as ERISA. This is a federal law that requires employers to provide detailed information about employee retirement plans, health plans, and other benefits. This includes specific information on what is and is not covered and guidelines for filing appeals in the event of a dispute.

Protecting Yourself Against Denied Claims

Insurance companies are for-profit businesses. It is not uncommon for them to deny or dispute your claim, even if the claim is truly a valid one. Some simple steps to take that can help to protect you against a denied claim include: 

  • Review your Summary Plan Description, which is a detailed guidebook regarding your benefits. ERISA requires all employers to make this available. 
  • Follow all requirements regarding in-service providers and procedures for scheduling appointments. 
  • Make sure your medical provider has current insurance information.
  • Respond promptly to communications from your insurer. 
  • If the insurer denies the entire claim, make sure they provide a reason. 

Among the most common reasons for ERISA claims denials are failure to provide accurate information, not obtaining authorization before an appointment or procedure, lack of medical necessity, policy exclusions, and simple errors on the part of the insurer or medical provider involved. 

Dealing With a Denied Claim

Despite your precautions and following all the appropriate policies, your benefits claim may still be denied or disputed. As these benefits are covered under ERISA, your first step in dealing with the situation should be to consult with an experienced Chicago ERISA attorney. We can help you navigate the complex laws that apply while guiding you through each step of the ERISA appeals process. This includes:

  • Having our attorney review your plan summary;
  • Requesting additional information from the insurer;
  • Negotiating with representatives on your behalf;
  • Gathering the appropriate evidence in your case;
  • Filing an ERISA appeal. 

Get Our Chicago ERISA Attorneys on Your Side

At Bartolic Law, we can help protect you against denied ERISA claims. We have the experience and knowledge to resolve ERISA claims through skillful negotiation, often saving our clients the hassle of a court trial. And when litigation is necessary, we have the dedication and tenacity it takes to protect your interests. If your employer-benefits claim was denied, contact our Chicago ERISA attorney today to request a free consultation to discuss the details in your case.

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