New Jersey residents who have submitted insurance claims may have experienced denials. Although being denied is not uncommon, the insured may have questions, especially as far as private long-term disability is concerned.

The Employee Retirement Act of 1974, or ERISA, was put in place by the federal government to protect employees from mismanagement of funds pertaining to health care, disability, life insurance and other benefits provided by their employers. ERISA provides a minimum standard that employers must follow.

ERISA requires participants to be transparent when they provide information to employees, including any changes, as well as provide grievance and appeals processes, such as the right to litigate for benefits and potential violations involving fiduciary duty.

Because ERISA is a federal law, it takes priority over any state law, even if the state legislature passed the bill after 1974. Many state laws offer increased protection over federal laws, so those with plans governed by ERISA may not be receiving the protection provided by New Jersey state law, and legal remedies are restrictive. For example, those who wish to contest denied private long-term disability claims face an inability to obtain jury trials, awards for attorneys’ fees and costs as well as complete judicial reviews.

ERISA does not cover government or church employees, workers’ compensation benefits or non-resident aliens who have plans that originated outside of the United States. Also, some New Jersey residents may not know if their plans fall under the ERISA umbrella.

Because the laws concerning ERISA are incredibly complicated, those who face private long-term disability claim denials might want to seek legal counsel before the statute of limitations runs out. An attorney may provide valuable information concerning whether plans fall under ERISA as well as how federal and state laws may impact contested benefits. An experienced ERISA attorney may help those who are struggling to get their insurance claims settled by litigating on their behalf to achieve favorable outcomes.