How to file an ERISA appeal in New Jersey

On Behalf of | Dec 11, 2020 | ERISA

The Employee Retirement Income Security Act (ERISA) establishes certain standards for health insurance plans purchased through your employer. These standards include the claim and appeal process, as well as the information that your insurance company is required to give you. Here’s how to file an appeal if your insurance claim is denied.

How do you file an appeal with ERISA?

If your insurance plan is subject to ERISA, you can appeal a denied claim. The exact appeal process can vary according to your plan, but you’ll typically have to submit your appeal in writing. You might also have to submit medical documents and other evidence that proves that you’re filing a legitimate claim. If you want to add comments, you can submit these and other relevant information in writing.

Typically, the insurance company will send you a written notice explaining why your ERISA claim was denied. It should also give you instructions on how to submit an appeal and tell you what kind of documents it will need. Once you’ve received this information, you might find it easier to file an appeal with the help of an attorney.

How can an attorney help you file an appeal?

While your health insurance is supposed to cover a wide variety of issues and conditions, many health insurance companies are reluctant to approve claims. Even if you have a legitimate case, they might find reasons to deny your claim so they don’t have to pay out benefits.

Hiring an attorney could help you speed up the process and get your benefits as quickly as possible. When you have the law on your side, some insurance companies will accept your claim because they don’t want to deal with a lawsuit. Your attorney could also represent you if the case ends up going to court.