Philadelphia’s ERISA Employee Benefits Law Firm
Helping Those Who Have Had Their Employee Benefits Claim Denied
We represent executives, employees, former employees, plan participants, and their beneficiaries in all aspects of ERISA employee benefits law. This includes claims for:
- short-term disability (STD) benefits;
- long-term disability (LTD) benefits;
- health insurance benefits;
- life insurance and accidental death and dismemberment (AD&D) benefits;
- pension benefits;
- 401(k) benefits; and
- other types of employee benefits.
What is ERISA?
ERISA is an acronym that stands for the Employee Retirement Income Security Act of 1974. It is a federal law that governs nearly all employee benefit plans in the United States. The biggest exceptions are for so-called “church plans,” which are employee benefit plans sponsored by certain religious organizations, and “governmental plans,” which are plans sponsored by the federal, state, and local governments. ERISA is complicated, sometimes counter-intuitive, and can be a potential minefield to those individuals who do not interact with ERISA-regulated plans regularly.
Many insurers responsible for deciding your claim for benefits are often the very same entities responsible for paying the claims. As a result, they have a conflict of interest and a financial incentive to deny your claim.
All plan participants and their beneficiaries are entitled to a full and fair review of their claims for benefits. Unfortunately, that often does not occur. Many insurers and other entities who are responsible for deciding your claim for benefits are often the very same entities responsible for paying the claims. As a result, they have a conflict of interest and a financial incentive to deny your claim. When a benefit claim is denied, there are specific steps a plan participant must take to appeal the denial and protect his or her rights. Failing to do so can result in your appeal being denied, and your ability to challenge the determination in court seriously compromised, if not barred altogether. It is important that your claim be thoroughly, persuasively, and accurately documented to protect your rights and put you in the best position to have your claim approved.
We will work with you every step of the way through the benefits claim process by developing a strategy designed to help you prevail on your claim. No two claims are alike, and we treat each client as an individual who has specific needs, goals, and problems. We will help you complete claim forms, obtain the necessary records, and counsel you regarding your claim. If necessary, we will work with you through the claims appeal process and seek payment of your benefits in a court of law.
Breaches of Fiduciary Duty
In addition to benefits claims, we handle claims alleging breaches of fiduciary duty by the people, organizations, and vendors that administer and service employee benefit plans on an individual and class basis. Benefit plan fiduciaries, including insurance companies, are supposed to act prudently and in the interest of plan participants and their beneficiaries. Unfortunately, sometimes employee benefits plan fiduciaries put their interests ahead of those of the plans and/or plan participants by, for example, charging the plans they serve excessive fees or engaging in self-dealing. When that happens, they breach their fiduciary duty and must be held accountable. The Garner Firm holds fiduciaries accountable for their bad acts.
Employee Benefits (ERISA) Claims are Complicated. We Can Help!
The laws governing employee benefit plans are complicated. Adam H. Garner is an experienced ERISA employee benefits lawyer who has years of ERISA employee benefits litigation experience. If you have questions regarding your employee benefits, the claims process, or the denial of your claim for benefits, contact The Garner Firm today.
“ERISA is, we have observed, a ‘comprehensive and reticulated statute,’ the product of a decade of congressional study of the Nation’s private employee benefit system.”— MERTENS V. HEWITT ASSOCS., 508 U.S. 248, 249 (1993) (SCALIA, J.)