Our life insurance attorneys just recovered a $500,000 denied ERISA life insurance claim for our client.
If your life insurance claim has been denied under the Employee Retirement Income Security Act (ERISA), you have the right to appeal the decision. Here are the general steps you should follow:
- Have a life insurance attorney review the denial letter so that the reasons for the denial are understood.
- Gather supporting documentation for your life insurance lawyer: Collect all relevant documentation that supports your claim, such as medical records, insurance policy documents, and any other evidence that may help your case.
- Have a life insurance lawyer submit your appeal: The appeal must be in writing sent to the insurance company within the time limit specified in the denial letter. ERISA requires that you must typically file your appeal within 180 days of the date of the initial denial.
- Have your life insurance law firm review the insurer's response: The insurer must respond within 45 days of receiving your appeal, or within 90 days if there are special circumstances. The response will explain the reasons for their decision, cite any specific policy provisions that were used to make the decision, and provide any additional information they relied on to make the decision.
- Have your life insurance attorney request external review: If your appeal is denied again, you may request an external review by an independent third party, such as an arbitrator or an independent medical examiner. ERISA requires insurers to provide an external review process, but you must typically request this within 4 months of the date of the second denial.
- Have your lawyer write a legal brief to send to the legal department: ERISA provides a mechanism for lawsuits to be filed in federal court to challenge the insurer's decision.
It is important to consult with an experienced life insurance attorney who knows ERISA claims if you are facing a denied life insurance claim under ERISA.