When insurance companies deny or terminate your ERISA-governed benefits, you need experienced legal advocates who know how to fight back. At The Garner Firm, we specialize in taking on major insurance companies that routinely deny legitimate claims for long-term disability (LTD), short-term disability (STD), life insurance, and accidental death and dismemberment (AD&D) benefits.
The Employee Retirement Income Security Act (ERISA) governs most employer-sponsored benefit plans, creating a complex legal framework that heavily favors insurance companies. These insurers employ sophisticated tactics to minimize payouts, often denying valid claims through biased medical reviews, surveillance, and procedural technicalities. Our experienced ERISA litigation attorneys understand these strategies and know how to counter them effectively.
Understanding ERISA Welfare Benefit Claims
ERISA covers four primary types of welfare benefit claims that our firm regularly litigates:
Long-Term Disability (LTD): Provides income replacement when illness or injury prevents you from working for an extended period, typically after a waiting period of 90-180 days.
Short-Term Disability (STD): Offers temporary income replacement for shorter periods of disability, usually lasting weeks to months.
Life Insurance: Employer-sponsored life insurance benefits that should pay out to beneficiaries upon an employee’s death.
Accidental Death & Dismemberment (AD&D): Additional coverage that pays benefits for deaths or serious injuries resulting from accidents.
Major Insurance Companies We Sue
Our firm has extensive experience litigating against the following major insurance companies in ERISA benefit denial cases:
New York Life Insurance Company/Life Insurance Company of North America (LINA)
New York Life is one of the largest mutual life insurance companies in the United States, providing group life and disability benefits to millions of employees. Despite their marketing emphasis on financial strength and reliability, New York Life frequently denies legitimate ERISA claims.
LINA, formerly part of the Cigna Group and now part of New York Life, is known in the ERISA litigation community for aggressive claim denial practices. They handle millions of employer-sponsored benefit claims and have faced numerous lawsuits for due to their claim handling. Visit New York Life’s official website: https://www.newyorklife.com
Unum Group
Unum Group is a Fortune 500 company and one of the world’s largest providers of long-term and short-term disability insurance, often through employer-sponsored plans governed by ERISA. The company operates through a number of major subsidiaries, including Unum Life Insurance Company of America, Provident Life and Accident Insurance Company, The Paul Revere Life Insurance Company, and Colonial Life & Accident Insurance Company. Despite its prominence in the insurance market, Unum has a well-documented and checkered history of allegations involving the systematic and wrongful denial of valid disability claims. This history has led to significant multi-state regulatory settlements, widespread litigation from policyholders, and media scrutiny for what critics describe as bad faith tactics designed to prioritize profits over paying legitimate claims, a pattern that continues to affect countless individuals who find their benefits unjustly denied or terminated. Visit Unum’s official website: https://www.unum.com
Unum Life Insurance Company
As the primary United States-based underwriting subsidiary of its parent corporation, Unum Life Insurance Company of America is the specific legal entity that issues and administers a vast number of the group, long-term disability (LTD), and short-term disability (STD) insurance policies sold nationwide. For policyholders, this is the name most often seen on official plan documents, correspondence, and, crucially, claim denial and termination letters. Unum Life was at the very center of the regulatory actions and widespread litigation that exposed a corporate culture allegedly rooted in bad faith claim denial strategies, particularly for claims governed by ERISA. Consequently, when an individual’s disability claim is denied by Unum Life Insurance Company of America, it may not be an isolated event but rather a potential continuation of a long-standing business practice that frequently necessitates legal intervention to secure rightful benefits.
Paul Revere Life Insurance Company
Paul Revere, now owned by Unum, was historically known for providing high-quality disability insurance to professionals. However, under Unum’s ownership, Paul Revere policies are often subject to the same aggressive claim handling practices.
Provident Life and Accident Insurance Company
Provident, also owned by Unum, handles both group and individual disability claims. Like other Unum subsidiaries, Provident has repeatedly been accused of employing systematic denial practices that prioritize cost savings over legitimate claim payments.
The Prudential Insurance Company of America
Prudential is a major player in the group benefits market, providing disability and life insurance through employer-sponsored plans. Prudential has previously described disability as a “choice” and the company as the “return to work” company. Our experience has shown that Prudential also employs carefully crafted tactics designed to minimize claim payouts. Visit Prudential’s official website: https://www.prudential.com
Lincoln Financial Group/Lincoln National Life Insurance Company
Lincoln Financial, which is based in Radnor, Pennsylvania, provides group benefits through employer-sponsored plans and has grown significantly through acquisitions. They are presently one of the largest, if not the largest, group disability insurer. Their claims handling practices have become increasingly aggressive as they seek to improve profitability. We frequently handle appeals of wrongly denied disability claims against Lincoln Financial and the company has become a frequent target of litigation. Visit Lincoln Financial’s official website: https://www.lincolnfinancial.com
Reliance Standard Life Insurance Company
Reliance Standard, part of the Tokio Marine group, is based in Philadelphia and focuses primarily on group benefits and has developed a reputation for thorough but sometimes overly aggressive claim investigations. It has been subject to withering criticism in judicial opinions for its claim handling practices. In our experience, its claims handling practices often fail to comply with ERISA’s regulatory requirements, resulting in claim denials that cannot withstand judicial scrutiny. Visit Reliance Standard’s official website: https://www.reliancestandard.com
Sun Life Assurance Company of Canada
Sun Life operates extensively in the U.S. group benefits market. Like the other insurers listed above, Sun Life has developed a reputation for wrongly denying ERISA benefits claims. Recently, The Garner Firm’s Adam Garner served as lead counsel in a nationwide class action against Sun Life related to its administration of dependent child life insurance benefits. You can read the Court’s opinion granting final approval of the class action settlement reached in that case here. Information regarding the settlement itself may be found at www.erisasettlementsunlife.com. Visit Sun Life’s official website: https://www.sunlife.com
Why Choose The Garner Firm for Your ERISA Litigation
Our firm brings unique advantages to ERISA benefit litigation:
Specialized Expertise: Led by Adam Garner and Melanie Garner, our team focuses exclusively on ERISA and employment law, providing deep knowledge of insurance company tactics and federal court procedures.
Proven Track Record: We have successfully recovered millions of dollars in benefits for clients, including landmark cases that have influenced ERISA jurisprudence.
Comprehensive Approach: From initial claim reviews to federal court litigation, we handle every aspect of ERISA benefit disputes.
No Upfront Fees: We often work on a contingency basis, meaning you pay no attorney fees unless we recover benefits for you.
Personal Attention: Unlike larger firms that treat ERISA cases as commodities, we provide personalized service and direct attorney access.
Take Action: Contact The Garner Firm Today
Don’t let insurance companies deny you the benefits you’ve earned and deserve. Time limits apply to ERISA appeals and litigation, making prompt action essential.
Call us today at (215) 645-5955 for a free consultation, or contact us online to discuss your case.
Our experienced ERISA attorneys are ready to fight for your rights and recover the benefits you need.
Frequently Asked Questions About Suing Insurance Companies Under ERISA
Can I sue my insurance company for denying my ERISA benefits?
Yes, you can sue insurance companies under ERISA, but typically only after exhausting the plan’s administrative appeal process. ERISA provides a federal cause of action for wrongfully denied benefits, but strict procedural requirements and deadlines must be followed.
How long do I have to appeal a denied ERISA claim?
Most ERISA plans require disability appeals to be filed within 180 days of receiving a denial notice, though some benefits like life insurance have shorter 60-day appeal deadlines. Missing these deadlines can permanently bar your right to benefits, making prompt action essential.
What standard of review applies to ERISA benefit disputes?
Many ERISA plans grant discretionary authority to plan administrators, resulting in “arbitrary and capricious” review that heavily favors insurance companies. However, courts can apply de novo review if the plan doesn’t grant discretion or if certain state laws ban the use of discretionary clauses.
Can insurance companies offset my disability benefits with other income?
Yes, most ERISA disability plans contain offset provisions that reduce benefits by Social Security disability, workers’ compensation, and other income sources. However, improper offset calculations are common and can be challenged.
What are independent medical examinations (IMEs) and can I refuse them?
IMEs are medical evaluations arranged by insurance companies, often by doctors who rarely find claimants disabled. Despite their name, Independent Medical Exams are often not independent. While you often cannot refuse an IME without risking benefit termination, you have rights regarding the examination process that should be protected.
How long does ERISA litigation typically take?
ERISA lawsuits usually take 6-24 months from filing to resolution, though complex cases can take longer. The timeline depends on factors such as court schedules, discovery requirements, whether the case settles or goes to judgment, and whether appeals are necessary.
Can insurance companies conduct surveillance on disability claimants?
Yes, insurance companies routinely conduct surveillance of disability claimants, including social media monitoring, video surveillance, and hiring private investigators. While generally legal, surveillance evidence can be challenged if improperly obtained or misrepresented.
Do You Have More Questions?
Contact The Garner Firm today. We offer free consultations and may be able to help you with your ERISA claim.