Oakland ERISA Attorney
Committed ERISA Lawyers Serving Clients in Oakland, CA
If you have an employer-sponsored disability plan or pension, the chances are that ERISA governs it. This stands for the Employee Retirement Income Security Act and was implemented to protect workers’ rights under employer benefits.
Unfortunately, even given these federal rights, the insurance industry still has a significant advantage when you are filing a claim for benefits. If you have suffered a serious or disabling injury or illness and have been denied disability benefits under your employer-sponsored insurance policy, you should get the advice of an experienced Oakland ERISA attorney.
For over two decades, the team at Pillsbury & Coleman, LLP has represented victims of unfair practices by the insurance industry. We have a clear understanding of complex ERISA law and have enabled our clients to go forward and get the benefits they deserve under their employer-based disability policies.
What is ERISA?
ERISA is a federal law enacted in 1974 that set out to protect the rights of workers under their employer’s benefits. It enacted standards for
- Full disclosure to employees regarding all policy information
- A code of ethics for the administration of plans
- Legal representation in the case of settlement disputes
Although this law sought to protect workers who were seeking their rightful benefits, it has unfortunately weighed in favor of large insurance companies that have little consequence when they avoid or unfairly limit their payouts.
If you have been unfairly treated by the insurance company or have been unfairly denied benefits, ERISA law has
- Limited your rights and remedies
- Prevented your ability to file a lawsuit until all appeals processes have been exhausted
- Restricted presenting supporting evidence and at what point it can be introduced
- Disallowed a trial by jury
- Disallowed punitive damages to be sought
Unfortunately, with diminished legal consequences, insurance companies may find that it is to their financial benefit to continue unfair practices to contain their costs. If you have been denied legitimate benefits, you need the assistance of an experienced Oakland ERISA attorney.
Filing an ERISA Claim
If you have suffered a disabling illness or injury that prevents you from performing your job, an ERISA claim may be an option. In the case of a work-related accident or injury, your claim may not be covered by ERISA but must be pursued through workers’ compensation insurance.
For employer-sponsored disability claims, an ERISA claim is evaluated by the plan administrator. This is generally the employer or the insurance company. Under ERISA law, administrators are required to adhere to strict standards and timelines. In the case of a disability claim, your policy will define what disability means under your coverage. This definition of disability will be a factor in whether you are due benefits.
What Happens When an ERISA Claim is Denied?
When an ERISA claim is denied, you have the ability to appeal the denial. Although this is helpful, getting immediate financial assistance when you are unable to work is crucial.
Unfortunately, claims processes and appeals are time-consuming. ERISA law requires a claimant to exhaust all appeals avenues before they can bring a lawsuit against the insurance company. In the meantime, a claimant is feeling the burden of financial responsibilities as expenses mount. This is when having the assistance of an experienced Oakland ERISA attorney is critical.
How ERISA Claims Differ From Insurance Bad Faith Claims
Although California insurance laws apply to most insurance policies, the exception is insurance offered by an employer as part of their benefits offerings.
Whereas a bad faith suit can be filed against insurance companies under California insurance laws, federal ERISA law governing employer-based insurance supersedes state laws. ERISA law does not offer bad faith remedies against an insurance provider. The claimant is left with a lengthy appeal process and, only then, possible litigation.
Getting Legal Assistance From An Oakland ERISA Attorney
At Pillsbury & Coleman, LLP, our experienced Oakland ERISA lawyers can help you navigate the complicated ERISA claim process. We can assist you in your application for benefits, in a denial or termination appeal, or pursue litigation against the insurer in court. If you have suffered a disability and must rely on your employer-sponsored disability plan for your short or long-term wellbeing, we can help. Contact us to understand your rights under the law.