ERISA Employee Benefits Claims Attorney
Montgomery County, Pennsylvania
Kimberly H. Ashbach, Esq.
Many individuals receive their medical, life insurance, disability, retirement and other benefits in connection with, and as a benefit of, their employment. The employer has a lot of discretion in whether or not to offer certain benefit plans, but once they do, The Employee Retirement Income Security Act of 1974, or “ERISA” determines what obligations the Plan, the Sponsors, Administrators and fiduciaries owe to those participating in or benefitting from the Plans. ERISA governs and regulates the administration of “welfare” benefits (health insurance, long-term disability insurance, life insurance, health insurance, accidental death and dismemberment and like benefits) and “pension” benefits (retirement and other death benefits). Although the statute had as its original intent the protection of employee benefits, the statute, and the Courts and cases that have interpreted ERISA, often work to the detriment of an employee trying to recover his or her benefits from the Plans.
ERISA is a complex and foreboding statute to many, and the pursuit of these claims requires significant expertise. The time deadlines, administrative appeal requirements, and the documentation of the claims must be followed precisely and thoroughly, or claims can be lost quickly at the outset. These cases are by and large won or lost in the initial stages, as the Plan Administrator has wide latitude, the Plan language is often incomprehensible, and most times the denial of employee benefits is reviewed under a very strict standard of “arbitrary and capricious” behavior by the Plan. Unlike other insurance claims, there is no provision to add more documentation once you get to federal court, as the Court reviews the administrative record that formed the basis of the denial. Your best chance at recovery lies in being aggressive and detailed out of the gate, which often requires assistance from your physician in providing full documentation, in the example of a medical claim review, as well as a lawyer who knows how to proceed on these claims.
Need help with ERISA?
To learn more about ERISA and how I can help you in your situation, contact me directly at my Ambler, Pennsylvania, law offices today.
I have been handling ERISA claims in my practice since the early 90’s when many other associates in my firm shied away from the law as overly burdensome, complex and difficult to achieve recovery of benefits, due to its traps for the unwary. If you have such a claim and need assistance, I am here to help you achieve the best likelihood of success. These claims are very difficult but highly rewarding when you achieve recovery. When you help a sick individual get coverage for a bone marrow transplant, get a death benefit for a widow in need, or return someone’s stolen pension money, that counts for a good day at the office. Call me for your ERISA needs.