Benefit Overpayments & Recoupment

Benefit Overpayments & Recoupment

Roberts Bartolic LLP represents individuals facing claims by employee benefit plans for recoupment of overpayment of benefits. The Firm successfully resolved cases involving pension overpayments, long term disability overpayments, and health insurance overpayments. In approaching these matters, the fact of whether or not the overpayment occurred is often a subsidiary inquiry to how it occurred. ERISA does not provide plans and administrators with absolute rights to recover of overpaid benefits. ERISA views this right as an ‘equitable’ one, meaning a court would have to balance all facts and circumstances, including how the overpayment happened, who was responsible for it occurring, and what the effect of recoupment would have on you and the plan.

The Right Pension lawyers Can Help You Recover Overpayments

When you receive a notice stating your benefits will be recalculated and offset, there should be a sense of urgency to seek help. The plan administrator has the upper hand, as it will simply stop paying you to recover the overpayment. Roberts Bartolic LLP has helped countless clients settle overpayment disputes with pension plans where the pension plan miscalculated the pension benefit, sometimes decades ago. ERISA places obligations of accurate reporting and disclosure on the plans’ administrators, and the administrators’ failure to accurately communicate your benefit amount is a factor weighed in how the overpayment should be resolved, along with the time it took the administrator to discover its own error. Also, if the overpayment happened by accumulation of monthly overpayments, rather than in a single lump sum distribution, this weighs in your favor.

Use a Long Term Disability Attorney to Resolve Disputes

Roberts Bartolic LLP has also helped resolve disputes regarding overpayments in long term disability plans. The overpayment usually happens after you are awarded Social Security disability benefits. Initially, much or all of the retroactive award may have to be sent to the disability insurer because Social Security benefits are an offset from your gross long term disability benefit. Occasionally, the insurer fails to subsequently reduce your monthly benefit to reflect you are also receiving Social Security disability benefits. Just like with pension benefits, all the facts and circumstances must be considered to determine how to apportion responsibility for the overpayment and how to resolve repayment, if there should be any. Just because the insurer says you must repay the entire overpayment does not mean the insurer actually has a right to complete overpayment. But if you do not seek out help, it will fully recoup through withholding your benefits.

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